Wheezy Chest in Children : Findings and Outcome

Abstract

Background: wheezy chest is a serious public health problem throughout the world, affecting people of all ages and were recognized as leading cause of morbidity and mortality in the under-five children in developing countries. The disease places a burden on the health services in term of admission to hospitals and health centers. Objectives: to identify some epidemiological aspects and fate of hospitalized cases of wheezy chest. Material and Methods: A descriptive study was used to the study 385 children with wheezy chest among those admitted to el-Husen university hospital, Cairo, from January to December 2012 using a pre-designed questionnaire to collect data from mothers of the admitted children. The children recruited were those < 12 years coming with respiratory distress for one year. The variables included are age, sex, education, income, crowding index, symptoms presented. Laboratory findings and x ray were done to some cases when needed in the clinical pathology and x ray departments at hospital in the routine investigation of such cases. Administrative and ethical issues as patient consent and confidentiality were followed in all steps of the study. The data were analyzed by SPSS program version 18. Descriptive and analytic statistics were done. The lowest accepted level of significance was 0.05 or less. Results: The highest affected age was infants (54%), males (53.7%), and of low income families (69.6%). Cough, dyspnea and tachypnea are the most frequent clinical findings (82.3%). Most investigations were normal, and more than half of cases have positive CRP. High percent had bronchovascular marking plus pneumonic patches and hyper-inflated chest in about 34.1% and 36.5% respectively. Most of admitted cases stayed at hospital for 10 days on average. High percent of the studied cases have respiratory distress (41.2%), wheezes (30.6%) and also recurrent wheezy chest (20.0%). The studied cases diagnosed as acute bronchiolitis (27.1%), bronchial asthma (18.8%) and bronchopneumonia (34.1%). The fates of cases were: improved with no complications (72.9%), improved with nebulizer (23.5%) and no case fatality recorded. Bronchopneumonia recorded highest CRP readings than the other acute respiratory infections. Conclusions and recommendations: wheezy chest is a major cause of hospitalization of male infant of poor families. Cough, dyspnoea and tachypnea were major findings. Wheezy chest were recognized as pneumonia, acute bronchiolitis, and bronchial asthma with better outcome. We recommend admission of severe cases of wheezy chest, and the wheezy chest with other health problems (liable for complications) to minimize over use of beds.