Recurrent Pneumonia in Children Admitted to Assiut University Children Hospital. Magnitude of the Problem and Possible Risk Factors

Abstract

Background: Incidence data indicate that recurrent pneumonia occurs in 7.7–9% of all children with community acquired pneumonia. We aim by this study to assess the prevalence of recurrent pneumonia among the admissions with diagnosis of pneumonia in Assiut university children hospital for one year and to try to define the possible related risk factors. Patients and methods: This is a prospective hospital based study in Assiut University Children’s Hospital. Children younger than 16 years admitted with a hospital diagnosis of pneumonia to Assiut University Children’s Hospital for one year from 1 February 2017 to 31 January 2018 were included. Results: Approximately 1 in 12 children with pneumonia in our locality have recurrent pneumonia with percentage of 12.61%. Cardiac diseases especially congenital heart diseases was the cause among 25.45% of the cases, immunodeficiency diseases represented 20.9% of the cases ,while bronchial asthma was the cause of recurrent pneumonia among 16.36% of the cases. As regard to risk factors in studied group, prematurity was detected among 7.27 % of the cases while more than 50% were formula fed and more than 60% exposed to pollution. Father smoking was detected among 36.36% of cases. Patients aged > 6 years showed significantly higher frequency in risk factors as obesity, indoor and outdoor pollution and use of steroids in comparison to other age groups. However, patients aged 0-3 years exhibited significantly higher % frequency of having heart disease, oro-motor in coordination /swallowing dysfunction, gastro esophageal reflux and under nutrition as risk factors for recurrent pneumonia in comparison to other age groups. Conclusions: The most frequent underlying cause for recurrent pneumonia in Assiut University Children’s Hospital which presents the largest referral pediatric hospital in Upper Egypt for one year according to our study was cardiac diseases; the second most frequent cause was immunodeficiency diseases, followed by bronchial asthma. Risk factors for recurrent pneumonia include socio-economic status of studied cases, prematurity, exposure to passive smoking and in or outdoor pollution, obesity, under nutrition, lack of breast feeding, gastro esophageal reflux and steroids usage.