Malnutrition and anaemia associated with hypoxia among hospitalized children with community-acquired pneumonia in North India

Nemani, Tarishi; Awasthi, Sanjay

doi:10.1016/j.cegh.2016.08.011

Cited by 6 publications

(8 citation statements)

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“…In our study, additional clinical features of pallor and wheezing were significantly associated with presence of hypoxic pneumonia. Pallor was also found to be significantly associated with hypoxic pneumonia in a study conducted in India (12) and also in a Nigerian study (41). Therefore, pallor must be included as an additional general danger sign of pneumonia.…”

Section: Discussionmentioning

confidence: 94%

“…The Pneumonia Etiology Research for Child Health (PERCH) study, conducted in 7 countries to assess the etiology of and risk factors for severe and very severe pneumonia in children (1-59 months), reported the overall prevalence of hypoxia to be 35.8% (1,423/3,981) and 42.3% (748/1,769) among children with abnormal CXRs (28). Another observational study from India (12) conducted in a similar setting found hypoxia in 40% (54/135) of the patients, and of them, 37% (20/54) had pneumonia with lower chest indrawing and 63% (34/54) had severe pneumonia (12). Studies conducted in Nepal (24), Nigeria (25), and Sudan ( 26) have reported prevalence of hypoxemia to be 38.7, 41.5, and 42.7%, respectively, which is similar to that found by us.…”

Section: Discussionmentioning

confidence: 99%

“…Hypoxia in CAP is largely due to diffusion–perfusion mismatch at the alveolar level ( 10 ). Lower respiratory tract infections, with bacteria such as Streptococcus pneumoniae (SP), Haemophilus influenzae type B (Hib), and Staphylococcus aureus as well as viruses, increase the chances of hypoxia ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Hypoxic Community-Acquired Pneumonia in Children Under 5 Years of Age: An Observational Study in Northern India

et al. 2022

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BackgroundCommunity-acquired pneumonia (CAP) is the leading cause of under-five mortality in India. An increased risk of mortality has been reported in cases of hypoxic pneumonia.MethodsThe primary objective of this study was to assess the proportion of children aged 2–59 months, hospitalized with hypoxic CAP, as well as socio-demographic, clinical, and radiological features associated with it. The secondary objective was to determine the risk of mortality among hospitalized cases of hypoxic CAP. This prospective, observational study was conducted in four districts of Northern India, between January 2015 and April 2021. A hospital-based surveillance network was established. Inclusion criteria were as follows: (a) child between 2 and 59 months, (b) hospitalization with symptoms of WHO-defined CAP, (c) resident of project district, (d) illness of <14 days, and (e) child had neither been hospitalized for this illness nor recruited previously. Children whose chest x-rays (CXRs) were either unavailable/un-interpretable and those that received any dose of pneumococcal conjugate vaccine-13 were excluded. Hypoxic pneumonia was defined as oxygen saturation <90% on pulse oximetry or requiring oxygen supplementation during hospital stay.ResultsDuring the study period, 71.9% (7,196/10,006) children of severe pneumonia were eligible for inclusion, of whom 35.9% (2,580/7,196) were having hypoxic pneumonia. Female gender and use of biomass fuel for cooking increased the odds of hypoxic CAP. Clinical factors like wheezing, pallor, tachypnea, low pulse volume, presence of comorbidity, general danger signs, severe malnutrition, and radiological finding of primary end-point pneumonia ± other infiltrates (PEP±OI) also increased the odds of hypoxic CAP in a conditional logistic regression model. Adjusted odds ratio for mortality with hypoxia was 2.36 (95% CI: 1.42–3.92).ConclusionAlmost one-third of cases hospitalized with severe CAP had hypoxia, which increased chances of mortality. Besides known danger signs, certain newer clinical signs such as pallor and wheezing as well as PEP+OI were associated with hypoxic CAP. Therefore, objective assessment of oxygen saturation must be done by pulse oximetry in all cases of CAP at the time of diagnosis.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Hypoxic Community-Acquired Pneumonia in Children Under 5 Years of Age: An Observational Study in Northern India

et al. 2022

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“…Hal ini mirip dengan penelitian yang dilakukan oleh Nemani dan Awasthi, bahwa anemia ringan (Hb 10-10,9 g/dl) tidak berhubungan dengan derajat keparahan pneumonia (OR 0,74; IK 0,205-2,704), namun anemia sedang (Hb 7-9,9 g/dl) dan anemia berat (Hb <7 g/ dl) dibuktikan mempengaruhi kegagalan respons terapi antibiotik empirik, berturut-turut (OR 3,89; IK 1,27-11,89) dan (OR 8,5; IK 1,8-39,23). 10 Penelitian kami tidak membagi derajat anemia. Penelitian ini mendapatkan gambaran efusi pleura sebagai faktor risiko kegagalan terapi antibiotika empirik.…”

Section: Diskusiunclassified

Faktor Risiko Kegagalan Antibiotika Empirik pada Pneumonia Anak (Studi Retrospektif)

Setyoningrum¹,

Rahmawati²

2020

J Indon Med Assoc

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Pendahuluan: Pneumonia disebabkan oleh berbagai macam mikroorganisme. Terapi awal pneumonia anak adalah pemberian antiobiotika empirik. Pengamatan respon terapi antibiotika sangat diperlukan karena tidak semua anak menunjukkan respon yang baik terhadap terapi awal. Tujuannya yaitu menganalisis faktor risiko yang berhubungan dengan kegagalan respon terapi antibiotika empirik pada pneumonia anak.Metode: Penelitian dilakukan secara analitik observasional dengan pendekatan penelitian retrospektif dari 1 Januari 2014 – 31 Desember 2016 di Ruang Rawat Inap Anak RSUD Dr. Soetomo. Subjek adalah anak usia 2-59 bulan dengan terapi antibiotika empirik ampisilin dan gentamisin. Respon terapi dinilai 2-3 hari masa perawatan.Hasil: Didapatkan 297 anak dengan pneumonia berusia 2-59 bulan, 42 (14%) subjek gagal terapi antibiotika empirik. Dari sembilan variabel yang diteliti, analisis multivariat regresi logistik didapatkan gambaran efusi pleura (PR 7.25; p <0,001), atelektasis (PR 4,56; p 0,008), dan trombositosis (PR 3.32; p 0,008) secara statistik bermakna mempengaruhi respons terapi antibiotika empirik pada pneumonia anak. Kesimpulan: Gambaran efusi pleura, atelektasis dan trombositosis merupakan faktor risiko kegagalan respon terapi antibiotika empirik pada pneumonia anak di RSUD Dr. Soetomo.

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“…Mechanisms underlying and influencing progression from pneumonia to severe pneumonia or complications are not clearly understood. It is reported that co‐morbid conditions like malnutrition, anaemia, and hypoxemia increase the risk of CAP‐associated mortality . In addition, there are several studies suggesting that genetic factors result in exaggerated and persistent inflammatory response in certain cases leading to adverse AO of CAP .…”

Section: Introductionmentioning

confidence: 99%

Interleukin 1 receptor antagonist (IL1RA) gene polymorphism and levels associated with adverse outcome in severe community‐acquired pneumonia in children: A hospital‐based study in India

Awasthi

Yadav

Pandey

et al. 2018

Pediatric Pulmonology

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Malnutrition and anaemia associated with hypoxia among hospitalized children with community-acquired pneumonia in North India

Abstract: c l i n i c a l e p i d e m i o l o g y a n d g l o b a l h e a l t h 4

Cited by 6 publications

References 11 publications

Epidemiology of Hypoxic Community-Acquired Pneumonia in Children Under 5 Years of Age: An Observational Study in Northern India

Epidemiology of Hypoxic Community-Acquired Pneumonia in Children Under 5 Years of Age: An Observational Study in Northern India

Faktor Risiko Kegagalan Antibiotika Empirik pada Pneumonia Anak (Studi Retrospektif)

Interleukin 1 receptor antagonist (IL1RA) gene polymorphism and levels associated with adverse outcome in severe community‐acquired pneumonia in children: A hospital‐based study in India

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