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Changing the Underlying Causes of Recurrent Pneumonia In Children: A Systematic Review.
Paz Quiñones Cabrera1, M Gratzia Ordóñez Suquilanda1, Jose A Castro-Rodriguez2
1Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
The causes of recurrent pneumonia in children have shifted, with a decrease in asthma and aspiration, and an increase in congenital conditions and immunodeficiencies. This highlights the need for updated diagnostic strategies for pediatric recurrent pneumonia.
Area of Science:
- Pediatric Pulmonology
- Clinical Pediatrics
- Epidemiology
Background:
- Recurrent pneumonia (RP) is a significant pediatric health concern.
- Traditionally linked to asthma, RP's etiology is evolving.
- Understanding these shifts is crucial for effective management.
Purpose of the Study:
- To systematically analyze and compare the changing underlying causes of recurrent pneumonia in children.
- To identify trends in RP etiology over two distinct time periods.
Main Methods:
- Systematic review of four databases (inception to November 2024).
- Included studies on children (<18 years) with RP and described causes.
- Divided analysis into Period I (1999-2013) and Period II (2014-2024).
Main Results:
- Analyzed 22 studies (3440 children); 94% had identified causes.
- Top causes included asthma, aspiration, congenital heart diseases (CHD), and lung malformations.
- Period II showed decreased asthma/aspiration but increased congenital malformations, immunodeficiency, CHD, and neurological causes.
Conclusions:
- The underlying causes of pediatric recurrent pneumonia have significantly changed in the last decade.
- Asthma is no longer the predominant cause.
- A comprehensive, tailored diagnostic approach is now essential for RP.
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