Epidemiology of acute respiratory infections in young children from Thailand
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P Sunakorn1, L Chunchit, S Niltawat
1Pediatric Infectious Diseases, Arkansas Children's Hospital, Little Rock 72202.
Insights
This study evaluated acute respiratory infections in young children, finding pneumonia to be most common. Viral causes predominated, though clinical features didn't clearly distinguish between viral and bacterial pneumonia.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Acute respiratory infections (ARIs) are a major cause of childhood morbidity and mortality globally.
- Understanding the epidemiology and clinical presentations of ARIs in specific populations is crucial for effective management.
Purpose of the Study:
- To prospectively evaluate the epidemiology and clinical presentations of ARIs in children under five years of age.
- To identify common pathogens and differentiate between viral and bacterial pneumonia presentations.
Main Methods:
- Prospective evaluation of 226 children aged 1-5 years admitted with ARIs.
- Inclusion criteria: illness duration < 2 weeks, no prior antibiotics, low socioeconomic status.
- Disease categorization (croup, bronchiolitis, pneumonia) and pathogen isolation (viral and bacterial).
Main Results:
- Pneumonia was the most frequent diagnosis (147 cases), followed by bronchiolitis (60) and croup (19).
- Respiratory syncytial virus was the most common pathogen (40 isolates); bacterial infections were confirmed in 23 cases.
- No significant clinical differences between bacterial and viral pneumonia; interstitial patterns favored viral, alveolar patterns favored bacterial, and mixed patterns were predominantly viral.
Conclusions:
- Pneumonia is the leading ARI in this pediatric cohort, with viral pathogens being most prevalent.
- Radiographic patterns can suggest etiology, but clinical differentiation between viral and bacterial pneumonia remains challenging.
- Further research into specific diagnostic markers and treatment strategies for pediatric ARIs is warranted.
Abstract:
A prospective evaluation of the epidemiology and presentations of acute respiratory infections in children younger than 5 years of age admitted to Children's Hospital Bangkok (1988 to 1989) was supported by the World Health Organization. There were 226 patients with the inclusion criteria: 1 to 5 years of age; duration of illness less than 2 weeks; no prior antibiotic therapy; and low socioeconomic status. The disease categories included: croup, 19 cases; bronchiolitis, 60 cases; and pneumonia, 147 cases. Pathogens isolated were: respiratory syncytial virus (40); parainfluenza III (1); influenza B (1); and adenovirus (1); bacterial infections were proved in 23 cases. No significant differences in clinical features between bacterial and viral pneumonia were found. Interstitial radiographic patterns were more common in viral pneumonia whereas alveolar patterns were more common in bacterial pneumonia. However, 91% of mixed radiographic patterns (interstitial and alveolar) in chest films were from viral pneumonia.