Epidemiologic pattern of respiratory diseases among hospitalized pediatric patients in Khulna, Bangladesh
Keywords:Respiratory diseases, Acute respiratory infection, Lower tract respiratory infection, Pneumonia, Bronchitis, Khulna
Background: High burden of acute respiratory infections (ARIs) with a significant rate of mortality is notable in developing countries including Bangladesh. Despite the frequent reports of ARIs, the exact prevalence and spectrum of ARIs in this country is unknown even at subnational level. The aim of the study was to determine of current spectrum of respiratory diseases of children in Bangladesh.
Methods: The current study analyzed 2993 pediatric patients admitted form June 2019 to January 2020 into Khulna Shishu Hospital, Khulna, Bangladesh using a quantitative interpretative approach.
Results: A total of 1382 patients (46.17%) were admitted because of ARIs and were predominately male children (65.77%). Among different ARIs, hospitalization was mainly due to lower tract respiratory infections (LRTI) and the prevalent cases of ARIs could be classified into undifferentiated ARI (20.92%), pneumonia (14.84%) and LRTI other than pneumonia and bronchitis (9.02%), bronchitis (1.40%). Mortality rate was observed 2.51%, although the highest rate of mortality (65%) was recorded among the infant age groups.
Conclusions: This study showed the risk group and risk factors of developing severity in ARIs leading to a high hospitalization rate due to ARIs among children in Bangladesh. More such studies at national level are required to develop proper combating strategy to decrease the mortality and the morbidity associated with ARIs in the country.
Ahmad OB, Lopez AD, Inoue M. The decline in child mortality: a reappraisal. Bull World Health Organ. 2000;78(10):1175-91.
Akhter N, Anne RA, Shapla NR, Jesmin E, Begum N. Pattern of morbidities in under five children and health seeking behaviour of their parents. JAFMC Bangladesh. 2015;11(1):59-63.
UNICEF. Key statistics on child survival in Bangladesh. The state of Worlds Children. 2003;1:12-6.
Yaya S, Bishwajit G. Burden of Acute Respiratory Infections Among Under-Five Children in Relation to Household Wealth and Socioeconomic Status in Bangladesh. Trop Med Infect Dis. 2019;4(1):36.
Williams BG, Gouws E, Boschi PC, Bryce J, Dye C. Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis. 2002;2(1):25-32.
Simoes EAF, Cherian T, Chow J. Acute Respiratory Infections in Children. In: Jamison DT, Breman JG, Measham AR, eds. Disease Control Priorities in Developing Countries. 2nd ed. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; 2006.
Bobelyte O, Gailiute I, Zubka V, Zilinskaite V. Sepsis epidemiology and outcome in the paediatric intensive care unit of Vilnius University Children's Hospital. Acta Med Litu. 2017;24(2):113-20.
Zaman K, Zeitlyn S, Chakraborty J, Francisco A, Yunus M. Acute lower respiratory infections in rural Bangladeshi children: patterns of treatment and identification of barriers. Southeast Asian J Trop Med Public Health. 1997;28(1):99-106.
Bhuia MR, Das S. Acute respiratory infection and its determination for Bangladesh under 5 children. J Nat Bio Sci Med. 2013;11(1):125-32.
Kamal MM, Hasan MM, Davey R. Determinants of childhood morbidity in Bangladesh: evidence from the Demographic and Health Survey 2011. BMJ Open. 2015;5(10):7538.
Rahman MM, Shahidullah M. Risk factors for acute respiratory infections among the slum infants of Dhaka city. Bangladesh Med Res Counc Bull. 2001;27(2):55-62.
Holloway KA, Karkee SB, Tamang A, Gurung YB, Kafle KK, Pradhan R, et al. Community intervention to promote rational treatment of acute respiratory infection in rural Nepal. Trop Med Int Health. 2009;14(1):101-10.
Khan TA, Madni SA, Zaidi AK. Acute respiratory infections in Pakistan: have we made any progress? J Coll Physicians Surg Pak. 2004;14(7):440-8.
GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(9):909-48.
Sultana M, Sarker AR, Sheikh N, Akram R, Ali N, Mahumud RA, et al. Prevalence, determinants and health care-seeking behavior of childhood acute respiratory tract infections in Bangladesh. PLoS One. 2019;14(1):210433.
Smyth RL, Openshaw PJ. Bronchiolitis. Lancet. 2006;368(9532):312-22.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair RH, Amann M, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224-60.
Rudan I, Boschi PC, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86(5):408-16.
Gross J. The severe impact of climate change on developing countries. Med Global Survival. 2002;7(2): 96-100.
Azziz BE, Alamgir AS, Rahman M, Homaira N, Sohel BM, Sharker MA, et al. Incidence of influenza-like illness and severe acute respiratory infection during three influenza seasons in Bangladesh, 2008-2010. Bull World Health Organ. 2012;90(1):12-9.
Khor CS, Sam IC, Hooi PS, Quek KF, Chan YF. Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years. BMC Pediatr. 2012;12:32.
Althouse BM, Flasche S, Minh LN, Thiem VD, Hashizume M, Ariyoshi K, et al. Seasonality of respiratory viruses causing hospitalizations for acute respiratory infections in children in Nha Trang, Vietnam. Int J Infect Dis. 2018;75:18-25.
Selvaraj K, Chinnakali P, Majumdar A, Krishnan IS. Acute respiratory infections among under-5 children in India: A situational analysis. J Nat Sci Biol Med. 2014;5(1):15-20.
Pinzon RAM, Aguilera OP, Zarate AC, Hoyos MA. Acute respiratory infection in children from developing nations: a multi-level study. Paediatr Int Child Health. 2016;36(2):84-90.
Maimunah AH, Patmanathan I. The under-fives: Acute respiratory illness. National Health and Morbidity Survey Report. Ministry of Health Malaysia. 1987.
Kabir ARML, Amin MR, Mollah ABH. Respiratory Disorders in Under-Five Children Attending Different Hospitals of Bangladesh: A Cross Sectional Survey. J Respiratory Med Res Treat. 2016;183615.
Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, Shet A, et al. Causes of neonatal and child mortality in India: a nationally representative mortality survey. Lancet. 2010;376(9755):1853-60.
Kanungo R. Knowledge of serotype prevalence & burden of invasive pneumococcal disease: A prerequisite to vaccine introduction in the country. Indian J Med Res. 2015;142(3):241-4.
National Institute of Population Research and Training, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Measure Evaluation. Bangladesh Urban Health Survey 2013 Final Report. NIPORT, icddr,b and Measure Evaluation. 2015.
Mitra and associates. Bangladesh Demographic and Health Survey. USA: NIPORT, Mitra and Associates, and ICF International. 2016.