European Journal of Molecular & Clinical Medicine

Abstract

Background: Pneumonia continues to be one of the leading causes of mortality among children under five years of age despite effective vaccines and nutritional and environmental interventions. This study designed to study the risk factors and outcome of IMNCI classified severe and very severe pneumonia in under five children.
Methods: Children between 2-60 months, fulfilling inclusion criteria were enrolled as cases. Baseline clinical assessment and physical examinations findings recorded. Lab and radiological investigations done. Reassessment done at 48 hrs for the cases of treatment failure.
Results: There were 75 out of 119 with incomplete immunization, 73 out of 83 with lack of exclusive breast feeding, 104 out of 185 with poor and 125 out of 136 malnourished develops very severe pneumonia. There was significant association between incomplete immunization, lack of exclusive breast feeding, lower socioeconomic status and malnutrition for risk of severe pneumonia (p=0.00). Consolidation (241) over X ray chest PA view was most common finding followed by interstitial infiltration (49) and pleural fluid/air (10).The most common complication observed was empyema followed by meningitis and septicemia and 12 out 136 having very severe pneumonia died, while 124 were successfully discharged and there was significant association between very severe pneumonia with outcome as death (p=0.0056) and 41 out 136 having very severe pneumonia were having treatment failure, while 95 were successfully treated for illness.
Conclusion: Early identification of these risk factors and anticipation of treatment failure may have therapeutic implication for starting more intensive therapy, thereby preventing complications and reducing childhood mortality and morbidity due to pneumonia.