Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia
| Autor: | Fairuz Rani, Jessie Anne de Bruyne, Anna Marie Nathan, Rachel Jiun Yi Lee, Rafdzah Ahmad Zaki, I-Ching Sam, Lucy Chai See Lum, Caroline Judy Westerhout |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Pediatrics Critical Care and Emergency Medicine Pulmonology Urban Population lcsh:Medicine Disease Risk Factors Medicine and Health Sciences Child lcsh:Science Respiratory Tract Infections Multidisciplinary medicine.diagnostic_test Respiratory tract infections Mortality rate Child Health Age Factors Ventilatory Support Bacterial Infections Hospitalization Virus Diseases Child Preschool Female Pediatric Infections Research Article Pediatric Critical Care medicine.medical_specialty Adolescent Pediatric Pulmonology Respiratory Failure medicine Humans Retrospective Studies Asthma business.industry lcsh:R Infant Newborn Malaysia Infant Retrospective cohort study Pneumonia medicine.disease respiratory tract diseases Health Care Etiology lcsh:Q Chest radiograph business |
| Zdroj: | PLoS ONE, Vol 9, Iss 10, p e111162 (2014) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | AIM: Lower respiratory tract infections (LRTIs) are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia. METHODS: This retrospective study included children aged less than 18 years admitted for LRTIs over 13 months in a tertiary referral centre in Kuala Lumpur, Malaysia. Neonates, children with asthma and those with either no or a normal chest radiograph were excluded. Life-threatening infection was defined as that needing non-invasive ventilation or admission to the paediatric intensive care unit. Routine blood investigations and nasopharyngeal secretion results (bacterial and viral) were obtained. Chest radiographs were reviewed by a designated radiologist. Environmental data (rainfall, particulate matter ≤ 10 µm [PM10] and air pollution index [API]) was obtained from the respective government departments. RESULTS: Three hundred and ninety-one episodes of LRTIs were included. Viruses were implicated in 48.5% of LRTIs, with respiratory syncytial virus (RSV) being detected in 44% of viral LRTIs. Forty-six (11.8%) children had life-threatening disease and the overall mortality rate was 1.3% (5 children). RSV was detected in 26% of children with life-threatening LRTIs. In multivariate logistic regression, chronic lung disease, presenting history of apnoea and signs of hypoxia, was associated with life threatening LRTIs. Increased LRTI admissions were associated with low rainfall but not PM10 nor API. Of those on follow-up, 39% had persistent respiratory symptoms. CONCLUSION: One in nine children admitted with LRTI had a life-threatening LRTI. The aetiology was viral in almost half of admitted children. RSV was detected in a quarter of children with life-threatening LRTIs. Children who present with LRTIs and either have chronic lung disease, presenting history of apnoea or signs of hypoxia, should be observed carefully as the risk of deterioration to life-threatening illness is high. |
| Databáze: | OpenAIRE |
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