The Epidemiology of Hospitalization for Pneumonia in Children under Five in the Rural Western Region of Nepal: A Descriptive Study

Abstract

Pneumonia is one of the major public health problems in children under five years of age. The aim of this study was to analyze the time, place, and characteristics of the distribution of pneumonia in hospitalized children under five years of age at the Dhaulagiri Zonal Hospital (DZH) in Nepal. A descriptive cross-sectional study was carried out at DZH from July 16, 2008 to August 17, 2011 for hospitalized children under five years of age and diagnosed with pneumonia. The main bacterial cause of pneumonia was Streptococcus pneumoniae and the main viral cause was Respiratory Syntical Virus (RSV). The majority of children admitted for treatment of pneumonia were males (60%), from upper class ethnic groups, and common among those aged 29 days to one year (49.1% of overall pneumonia cases). Data from this study show that pneumonia episodes in DZH occurred throughout the year with a sharp increase in the occurrence at the end of August to September. More cases were recorded during the rainy seasons and winter months in all three study years. The cases were from households most concentrated in Baglung municipality where the hospital is located. Pneumonia was found in higher proportions among hospitalized male children, those aged 29 days to one year, and in upper ethnic groups, during the rainy seasons and in winter months, and among local populations near the hospital in the rural western region of Nepal. Strengthening community-based case management, prevention strategies, and health care delivery system would help reduce pneumonia cases and the overall burden associated with it.

High incidence of rhinovirus infection in children with community‐acquired pneumonia from a city in the Brazilian pre‐Amazon region

“…For example, Nascimento‐Carvalho et al investigated multiple respiratory viruses in 181 children with CAP from Salvador in northeastern Brazil, detecting rhinovirus most frequently. However, despite its high prevalence, few others have tested for this pathogen . Liu et al mentioned the importance of investigating the presence of rhinovirus in samples from patients with a respiratory infection, reporting that they considered including it in their study.…”

“…The data showed a low frequency of RSV infection; in this study, however, was observed a relationship between RSV infection and severe CAP. Interestingly, the majority of studies of children with severe CAP have reported RSV as the most common pathogen . For example, Jonnalagadda et al investigated viral etiology in 406 children with severe pneumonia and reported that RSV was the most common virus identified in 39% of subjects.…”

Correlation between serum levels of C-reactive protein and infant pneumonia: A meta-analysis

“…Infant pneumonia, which is caused by infection with viruses or bacteria, has aroused public concern due to the substantial mortality and incidence in children worldwide (1,2). There are ~750,000 neonatal mortalities associated with pneumonia each year, which constitute >10% of child mortalities worldwide (3).…”

“…Mortality rates are >70% in south Asia and sub-Saharan Africa, where the incidence of pneumonia is estimated to be 0.36 (interquartile range, 0.32-0.40) episodes per child-year (2). Worldwide, the neonatal period is the most significant for pneumonia; at least one-third of the annual 10.8 million mortalities in children occur in the first month of life (6).…”

“…Moreover, infant pneumonia may be early or late onset, where early-onset neonatal pneumonia is generally considered to be a clinical manifestation in the first week of life, while the latter occurs in the following 3 weeks (7). Clinically, infant pneumonia is considered as a multifactorial disease affected by quality of life, poor immunization, air pollution, nutritional status, and other factors (2). Large quantities of bacteria and viruses may to be associated with infant pneumonia, with viral neonatal pneumonias including intrauterine, early-onset or late-onset pneumonias (6).…”