Risk factors of acute lower respiratory tract infection: a study in hospitallized central Indian children under 5 year age

Abstract

Background and aim: Preventive measures of regional relevance can be conceived based on understanding of predominant risk factors. Present observational study endeavored collection of evidence on hierarchy of risk factors for acute lower respiratory infection (ALRI), in under 5 year age children hospitalized in a city in central India. Method: A transactional case control observational study was carried out in 100 hospitalized under 5 year age children of ALRI and 100 healthy babies of similar age and sex composition selected as controls concurrently from immunization and well baby clinic. Hierarchical order of risk factors was elucidated. Result: Low birth weight, incomplete immunization, faulty breast feeding and weaning practices, poor living condition and malnutrition, prematurity and caesarian birth were prominent risk factors for ALRI. First year of life reveals as most vulnerable period in the regard. Conclusion: Risk factors defined by the study are consistent with other reports but, with a variant hierarchical pattern. Good antenatal and immunization care, good breast feeding and nutrition care, restriction of overcrowding and infection from family contacts emerged as key prevention percepts. Effective health education and access to basic mother child health services, specially to premature and those under 1 year age appeared as pertinent preventive interventions against ALRI in preschool babies in specific regional context.

History of Low Birth Weight and Exclusive Breastfeeding on the Incidence of Acute Respiratory Infection in Children Under Five Years

“…Low birth weight in term infants is a surrogate marker of intrauterine growth restriction. 9 This presents a high risk of ARI due to structural deformation that endangers lung health and impaired immune competence. The same study was also conducted by other research who said the effect of LBW on ARI showed significant results, namely with a p-value of 0.04 with an RR value of 1.15 times (95% CI 1.00 -1.31) which means that children under five years with LBW are at risk 1.15 times to experience ARI when compared to children under five years with normal birth weight.…”

Faktor Risiko Fisiologis Penyebab Kejadian Infeksi Saluran Pernafasan Akut (ISPA) pada Balita: Literatur Riview

“…Ke delapan belas artikel yang telah di-review, terdapat berturut-turut 7, 4, 4, 6, dan 6 artikel yang membahas keterkaitan faktor fisiologis usia, BBLR, status gizi, ASI eksklusif, dan jenis kelamin dengan kejadian ISPA pada balita. Secara detail terdapat tiga artikel yang mengulas adanya pengaruh dari keempat kombinasi faktor risiko fisiologis (Anteneh & Hassen, 2020;Deepti & Abha, 2018;Nguyen et al, 2019;Taksande & Yeole, 2016). Penelitian Sultana et al (2019) dan Ullah et al (2019) mengatakan usia balita kurang dari 12 bulan dan jenis kelamin pria lebih berisiko tinggi terkena ISPA.…”

“…Balita dengan BBLR umumnya mengalami hambatan pertumbuhan selama di dalam kandungan. Menurut penelitian Deepti & Abha (2018) hal ini menjadi salah satu penyebab terjadinya deformasi dari sturuktural paru pada calon bayi. Pendapat ini memperkuat laporan Ronkainen et al (2016) yang menduga terjadi pembatasan pertumbuhan intra-uterus pada balita BBLR sehingga timbul kelainan struktur dan fungsi paru.…”

“…Ig A sekretori berfungsi melindungi bayi dari infeksi bakteri dan virus (Cacho & Lawrence, 2017;Fields & Demerath, 2013;Gregory & Walker, 2013). Argumentasi tersebut diperkuat oleh Deepti & Abha (2018) yang mengatakan bahwa kolostrum yang terdapat dalam ASI memiliki peran dalam mentransfer imunitas pasif yang dimiliki ibu untuk melindungi bayinya dari infeksi. Oleh sebab itu bayi yang memiliki riwayat inisiasi ASI yang terlambat, lebih berisiko menderita ISPA bagian bawah di kemudian hari.…”