Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Medical Research Journal
MENU
Shortcuts Submit an article Author Guidelines Reviewers 2023 Focus and Scope

open access

Vol 4, No 1 (2019)
Original article
Published online: 2019-01-02
View PDF Download PDF file
Get Citation

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

Moustafa M. El–Saied1, Zienab M. Mohie El Deen1, Gamal A. Askar1
DOI: 10.5603/MRJ.a2019.0001
·
Medical Research Journal 2019;4(1):13-24.
Affiliations
  1. Pediatric department , Assiut University , Faculty of Medicine, Egypt

open access

Vol 4, No 1 (2019)
ORIGINAL ARTICLES
Published online: 2019-01-02

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.

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.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

Recurrent pneumonia, community acquired pneumonia congenital heart disease, gastro esophageal reflux disease, immunodeficiency diseases, bronchial asthma, socio-economic status, chronic lung diseases, pulmonary tuberculosis , aspiration syndrome

About this article
Title

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

Journal

Medical Research Journal

Issue

Vol 4, No 1 (2019)

Article type

Original article

Pages

13-24

Published online

2019-01-02

Page views

1956

Article views/downloads

2982

DOI

10.5603/MRJ.a2019.0001

Bibliographic record

Medical Research Journal 2019;4(1):13-24.

Keywords

Recurrent pneumonia
community acquired pneumonia congenital heart disease
gastro esophageal reflux disease
immunodeficiency diseases
bronchial asthma
socio-economic status
chronic lung diseases
pulmonary tuberculosis
aspiration syndrome

Authors

Moustafa M. El–Saied
Zienab M. Mohie El Deen
Gamal A. Askar

References (58)
  1. Weigl JAI, Bader HM, Everding A, et al. Population-based burden of pneumonia before school entry in Schleswig-Holstein, Germany. Eur J Pediatr. 2003; 162(5): 309–316.
    CrossRefPubMed
  2. Hoving MF, Brand PLP. Causes of recurrent pneumonia in children in a general hospital. J Paediatr Child Health. 2013; 49(3): E208–E212.
    CrossRefPubMed
  3. WHO/UNICEF (2009). Global action plan for prevention and control of pneumonia (GAPP). Geneva: World Health Organization.
  4. WHO(2014). Revised WHO classification and treatment of childhood pneumonia at health facilitiese Evidence summaries. Geneva:World Health Organization.
  5. WHO/UNICEF (2013).Ending preventable child death from pneumonia and diarrhea by2025: The integrated action plan for pneumonia and diarrhea (GAPPD). Geneva:World Health Organization.
  6. UNICEF, WHO(2006). Pneumonia. The forgotten killer of children. New York: UN Children’s Fund;Geneva: World Health Organization.
  7. Schnabel E, Sausenthaler S, Brockow I, et al. LISA Study Group. Burden of otitis media and pneumonia in children up to 6 years of age: results of the LISA birth cohort. Eur J Pediatr. 2009; 168(10): 1251–1257.
    CrossRefPubMed
  8. -Wald E. Recurrent and non-resolving pneumonia in children . SeminRespir Infect. 1993; 8: 46–58.
  9. Montella S, Corcione A, Santamaria F. Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience. Int J Mol Sci. 2017; 18(2).
    CrossRefPubMed
  10. Owayed AF, Campbell DM, Wang EE. Underlying causes of recurrent pneumonia in children. Arch Pediatr Adolesc Med. 2000; 154(2): 190–194.
    PubMed
  11. Saad K, Mohamed SA, Metwalley KA. Recurrent/Persistent Pneumonia among Children in Upper Egypt. Mediterr J Hematol Infect Dis. 2013; 5(1): e2013028.
    CrossRefPubMed
  12. -Morcos MW, Azmy A, Abu sh, et al. El Galaa Teaching Hospital, Egypt, Der pharma Chemica. 2016; 8(23): 16–21.
  13. Kumar M, Biswal N, Bhuvaneswari V, et al. Persistent pneumonia: Underlying cause and outcome. Indian J Pediatr. 2009; 76(12): 1223–1226.
    CrossRefPubMed
  14. -Ozdemir O, Sari S, Bakirtas A. Zorlu P, Ertan U. Underlying diseases of recurrent pneumonia in Turkish children. Turk J Med Sci. 2010; 40(1): 25–30.
  15. Bolursaz MR, Lotfian F, Ghaffaripour HA, et al. Underlying Causes of Persistent and Recurrent Pneumonia in Children at a Pulmonary Referral Hospital in Tehran, Iran. Arch Iran Med. 2017; 20(5): 266–269.
    CrossRefPubMed
  16. -Li Y, An Z, Yin D, et al. HUMAN VACCINES & IMMUNO-THERAPEUTICS ; VOL. 13. 2017; 7: 1681–1687.
  17. ÇAPANOĞLU M, ZORLU P, SARI E, et al. The Etiology of Recurrent Pneumonia with Onset During Infancy, and the Effect of Risk Factors on Age at First Episode and Episode Frequency. Turkish Journal of Pediatric Disease. 2017.
    CrossRef
  18. Patria MF, Esposito S. Recurrent lower respiratory tract infections in children: a practical approach to diagnosis. Paediatr Respir Rev. 2013; 14(1): 53–60.
    CrossRefPubMed
  19. Yousif TI, Elnazir B. Approach to a child with recurrent pneumonia. Sudan J Paediatr. 2015; 15(2): 71–77.
    PubMed
  20. Brand PLP, Hoving MF, de Groot EP. Evaluating the child with recurrent lower respiratory tract infections. Paediatr Respir Rev. 2012; 13(3): 135–138.
    CrossRefPubMed
  21. -Douglas T, Couriel J. Differential diagnosis of asthma in children. Asthma J. 2001; 6: 72–76.
  22. Lodha R, Puranik M, Chandra U, et al. Persistent pneumonia in children. Indian Pediatr. 2003; 40(10): 967–970.
    PubMed
  23. Ciftçi E, Güneş M, Köksal Y, et al. Underlying causes of recurrent pneumonia in Turkish children in a university hospital. J Trop Pediatr. 2003; 49(4): 212–215.
    CrossRefPubMed
  24. Hughes D. Recurrent pneumonia … Not! Paediatrics & Child Health. 2013; 18(9): 459–460.
    CrossRef
  25. Hellings PW, Fokkens WJ. Allergic rhinitis and its impact on otorhinolaryngology. Allergy. 2006; 61(6): 656–664.
    CrossRefPubMed
  26. O'Reilly MA, Marr SH, Yee M, et al. Neonatal hyperoxia enhances the inflammatory response in adult mice infected with influenza A virus. Am J Respir Crit Care Med. 2008; 177(10): 1103–1110.
    CrossRefPubMed
  27. Tversky JR, Le TV, Bieneman AP, et al. Human blood dendritic cells from allergic subjects have impaired capacity to produce interferon-alpha via Toll-like receptor 9. Clin Exp Allergy. 2008; 38(5): 781–788.
    CrossRefPubMed
  28. Singh V. TB in developing countries: diagnosis and treatment. Paediatr Respir Rev. 2006; 7 Suppl 1: S132–S135.
    CrossRefPubMed
  29. Lodha R, Puranik M, Natchu UCM, et al. Recurrent pneumonia in children: clinical profile and underlying causes. Acta Paediatr. 2002; 91(11): 1170–1173.
    PubMed
  30. Celebi S, Hacimustafaoglu M, Albayrak Y, et al. Recurrent Pneumonia in Children. Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection. 2010; 4(2): 56–59.
    CrossRef
  31. Chang AB, Byrnes CA, Everard ML. Diagnosing and preventing chronic suppurative lung disease (CSLD) and bronchiectasis. Paediatr Respir Rev. 2011; 12(2): 97–103.
    CrossRefPubMed
  32. Patria MF, Longhi B, Lelii M, et al. Children with recurrent pneumonia and non-cystic fibrosis bronchiectasis. Ital J Pediatr. 2016; 42: 13.
    CrossRefPubMed
  33. King P. Pathogenesis of bronchiectasis. Paediatr Respir Rev. 2011; 12(2): 104–110.
    CrossRefPubMed
  34. Gokdemir Y, Hamzah A, Erdem E, et al. Quality of life in children with non-cystic-fibrosis bronchiectasis. Respiration. 2014; 88(1): 46–51.
    CrossRefPubMed
  35. -Cabezuelo H, Vidal M, Abeledo G, et al. Underlying causes of recurrent pneumonia. An Pediatr (Barc. 2005; 63: 409–412.
  36. Panitch HB. Evaluation of recurrent pneumonia. Pediatr Infect Dis J. 2005; 24(3): 265–266.
    PubMed
  37. - AbS, Samuel S, Awad M, et al. Abdel- Meguid IE, Azmy J. Cystic fibrosis in Egyptian children: neonatal screening and high risk groups. JAC. 1993; 4: 313–317.
  38. Naguib ML, Schrijver I, Gardner P, et al. Cystic fibrosis detection in high-risk Egyptian children and CFTR mutation analysis. J Cyst Fibros. 2007; 6(2): 111–116.
    CrossRefPubMed
  39. Couriel J. Assessment of the child with recurrent chest infections. Br Med Bull. 2002; 61: 115–132.
    PubMed
  40. Wonodi CB, Deloria-Knoll M, Feikin DR, et al. Pneumonia Methods Working Group and PERCH Site Investigators. Evaluation of risk factors for severe pneumonia in children: the Pneumonia Etiology Research for Child Health study. Clin Infect Dis. 2012; 54 Suppl 2: S124–S131.
    CrossRefPubMed
  41. Cardoso MR, Cousens SN, de Góes Siqueira LF, et al. Crowding: risk factor or protective factor for lower respiratory disease in young children? BMC Public Health. 2004; 4: 19.
    CrossRefPubMed
  42. Jackson S, Mathews KH, Pulanic D, et al. Risk factors for severe acute lower respiratory infections in children: a systematic review and meta-analysis. Croat Med J. 2013; 54(2): 110–121.
    PubMed
  43. Fonseca Lima EJ, Mello MJ, Albuquerque Md, et al. Risk factors for community-acquired pneumonia in children under five years of age in the post-pneumococcal conjugate vaccine era in Brazil: a case control study. BMC Pediatr. 2016; 16(1): 157.
    CrossRefPubMed
  44. Rudan I, Boschi-Pinto C, Biloglav Z, et al. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008; 86(5): 408–416.
    PubMed
  45. Terra de Souza AC, Peterson KE, Andrade FM, et al. Circumstances of post-neonatal deaths in Ceara, Northeast Brazil: mothers' health care-seeking behaviors during their infants' fatal illness. Soc Sci Med. 2000; 51(11): 1675–1693.
    PubMed
  46. Nirmolia N, Mahanta T, Boruah M, et al. Prevalence and risk factors of pneumonia in under five children living in slums of Dibrugarh town. Clinical Epidemiology and Global Health. 2018; 6(1): 1–4.
    CrossRef
  47. Huong PL, Hien PT, Lan NT, et al. First report on prevalence and risk factors of severe atypical pneumonia in Vietnamese children aged 1-15 years. BMC Public Health. 2014; 14: 1304.
    CrossRefPubMed
  48. Lehmann D, Howard P, Heywood P, et al. Nutrition and morbidity: acute lower respiratory tract infections, diarrhoea and malaria. P N G Med J. 1988; 31(2): 109–116.
    PubMed
  49. Yoon PW, Black RE, Moulton LH, et al. The effect of malnutrition on the risk of diarrheal and respiratory mortality in children < 2 y of age in Cebu, Philippines. Am J Clin Nutr. 1997; 65(4): 1070–1077.
    CrossRefPubMed
  50. Peat JK, Keena V, Harakeh Z, et al. Parental smoking and respiratory tract infections in children. Paediatr Respir Rev. 2001; 2(3): 207–213.
    CrossRefPubMed
  51. -Ramezani M, Aemmi SZ, Moghadam ZE. Factors Affecting the Rate of Pediatric Pneumonia in Developing Countries: a Review and Literature Study. Int J Pediatr; Vol.3, N. 6-2, Serial No. 2015; 24.
  52. Ulshen M. Pediatric gastrointestinal disease. Gastroenterology. 2005; 128(5): 1526–1527.
    CrossRef
  53. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet. 2000; 355(9202): 451–455.
    PubMed
  54. Victora C. Infection and Disease: The Impact of Early Weaning. Food and Nutrition Bulletin. 2018; 17(4): 1–8.
    CrossRef
  55. Dherani M, Pope D, Mascarenhas M, et al. Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: a systematic review and meta-analysis. Bull World Health Organ. 2008; 86(5): 390–398C.
    PubMed
  56. -Taksande A, Yeole M. Risk factors of acute respiratory infection (ARI) in under- fives in a rural hospital of Central India. J Pediatric Neonatal Individual Med. 2016; 5(1): e050105.
  57. Po JYT, FitzGerald JM, Carlsten C. Respiratory disease associated with solid biomass fuel exposure in rural women and children: systematic review and meta-analysis. Thorax. 2011; 66(3): 232–239.
    CrossRefPubMed
  58. Searing D, Rabinovitch N. Environmental pollution and lung effects in children. Current Opinion in Pediatrics. 2011; 23(3): 314–318.
    CrossRef

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl