Lower Respiratory Infections among Children: Are Viruses a Serious Threat?
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 5
Abstract
Abstract: Acute lower respiratory tract infections (ALRIs) are the main cause of morbidity and mortality in younger children. It accounts for one fifth of all deaths in children below 5 years of age. In India not many studies are available about viral etiology of LRTI, so this study was done to determine viral etiologies of lower respiratory tract infections among children from one month to five years of age and to determine clinical profile of patients presenting with lower respiratory tract infections. Hospital based descriptive type of observational study conducted at SMS Medical College, Jaipur. 130 cases of lower respiratory tract infections who were hospitalized with the symptoms of cough, fever, and rapid breathing were studied. Cases were categorized into two groups: less than one year and more than one year. Their history, clinical examination and lab investigations were recorded on a proforma. Nasopharyngeal aspirates and nasopharyngeal swabs were tested for a panel of 8 viruses ie. RSV, Adeno, PIV-1, PIV-2, PIV-3, hMPV, Influenza A (FLUAV) and Influenza B (FLUBV) by RT PCR. Out of 130 cases, viruses were isolated from 90(69.23%), 83(63.8%) samples showed a single virus and 7(5.38%) samples showed multiple viruses. Most common viral organism in both age groups was RSV (83.3 % in < 1 year and 53 % in > 1 year) but the prevalence of other viruses like influenza B and Adenovirus was more in >1 year (23%,15.3% respectively) than in < 1 year of age (5.9% in both). Clinically cough, fever and rapid breathing was observed in all the cases while 114 (87.69%) cases had chest retractions and 86 (66.15%) cases had coryza. In the present study, viruses were the most common etiology of LRTIs in hospitalized children less than five year old . RSV was the most common organism in both age groups but the prevalence of other viruses like Adenovirus and influenza B increased in older age group. RSV predominantly presented as bronchiolitis while Influenza predominantly presented as pneumonia. As viruses were isolated from 90(69.23%) samples so antibiotics should be used judiciously in these children where co infection or secondary bacterial infections are a serious consideration.. Viral etiology of LRTI was consistant with clinical finding of cough & coryza where as presence of toxaemia& dehydration are consistant with nonviral etiology.
Authors and Affiliations
Dr. Amit Periwal, Dr. B S Sharma, Dr. Alok Kumar Goyal, Dr. Bharti Malhotra
Keywords
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