Clinical Characteristics and Underlying Factors Related to Recovery from Severe Pneumonia in Under-Five Children with or without Malnutrition Treated at Health Care Facilities in Bangladesh.

K A T M Ehsanul Huq,Michiko Moriyama,Mohammod Jobayer Chisti,Md Moshiur Rahman,Ryota Matsuyama,Nur Haque Alam

doi:10.3390/children8090778

K A T M Ehsanul Huq, Michiko Moriyama + Show 4 more

Open Access

https://doi.org/10.3390/children8090778

Copy DOI

Abstract

Severe pneumonia with co-morbidity of malnutrition is one of the leading causes of death among children younger than five years of age. We aimed to compare the clinical features related to recovery from severe pneumonia in malnourished and well-nourished under-five children. A significantly lesser proportion of malnourished children compared to well-nourished recovered from rapid breathing (86.5% vs. 90.2%; p = 0.035), chest wall in-drawing (90.5% vs. 93.9%; p = 0.019), and fever (92.2% vs. 95.2%; p = 0.021) on day six after admission to health-care facilities. Malnourished children with severe pneumonia had significantly more rapid breathing (Adjusted Odds Ratio (AOR)) 1.636, 95% Confidence interval (CI) 1.150–2.328 p = 0.006), chest wall in-drawing (AOR 1.698, 95% CI 1.113–2.590, p = 0.014), and fever (AOR 1.700, 95% CI 1.066–2.710, p = 0.026) compared to those in well-nourished children. The study results suggested the lesser disappearance of clinical features among the malnourished children in Bangladesh underscores their vulnerability to severe pneumonia.

Highlights

Within the above-mentioned scenario, this study aimed to compare the resolution of clinical features of severe pneumonia among the malnourished and well-nourished underfive-year-old children at day-care and hospital settings on day six after admission, using indicators such as no increased breathing, no lower chest wall in-drawing, no hypoxemia, no nasal discharge, and no fever, and sociodemographic factors
Maternal and paternal illiteracy was significantly higher among the malnourished children compared to those without malnutrition (18.3% vs. 8.7%; p < 0.001 and 20.7% vs. 12.9%; p < 0.001, respectively)
Malnourished children having severe pneumonia suffered more from rapid breathing (AOR 1.636, 95% CI 1.150–2.328 p = 0.006), chest wall in-drawing (AOR 1.698, 95% CI 1.113–2.590, p = 0.014), and fever (AOR 1.700, 95% CI 1.066–2.710, p = 0.026) compared to well-nourished children

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Pneumonia is the foremost infectious cause of death in children younger than five years of age, and malnourished children are more vulnerable to pneumonia [1]. Pneumonia and malnutrition are independently related to excess child deaths, and the combination of pneumonia and malnutrition has an additive adverse effect on child morbidity and deaths [2]. Children with the co-morbidity of pneumonia and severe malnutrition were found to be at a 15 times higher risk of deaths compared to those without severe malnutrition [3,4]

Objectives

Methods

Results

Conclusion