Clinical Classification of Acute Respiratory Symptoms in a Sample of Under Five Years Children in Erbil City

Abstract

Background: Pneumonia is an important cause of morbidity and mortality in developing countries. They are responsible for the death of more than two million children under five year of age every year10, 11.

Objective: To find out the proportions of clinical types of respiratory tract infections, also to find out the factors that might be associated with severity of pneumonia and to compare the proportions of pneumonia between the hospital and primary health care centers attendees.

Patients and Methods: Case series study conducted among 300 children aged two months to five years in the outpatient clinic of Raperin Teaching Hospital / Erbil and six primary health care centers(PHCCs)from the first of march 2017 to thirty of march 2018. The questioner was completed through direct interview. A chi square test of association was used to compare proportions. A p value equal or less than 0.05 was considered as statistically significant.

Results: The majority of cases 42% of the patients were infant and 59% were male. Sever pneumonia was diagnosed in 7%, pneumonia 5% and no pneumonia 88%. all of the patients presented with the cough, wheeze 100% in sever pneumonia 86% in pneumonia, and 35% in other group, fever are high in all groups, lethargy was higher among sever pneumonia patients (81%), chest indrawing also high among those with sever pneumonia 76.2% and those with pneumonia was 73.3% while only 1.5% among other groups. also unable to drink in sever pneumonia was 81%. No association between the diagnosis of pneumonia and sever pneumonia with age, gender and residence. The prevalence of sever pneumonia was 12.5% among low socioeconomic status (SES), 2.2% among those of moderate socioeconomic status and 0% among high socioeconomic status.The prevalence of pneumonia and sever pneumonia were higher among those with family history of asthma and higher among those whose father was smoker. Also 13.3% of the hospital cases had severe pneumonia compared with 0.7% of the cases of the PHCCs. Regarding pneumonia, 4% of the hospital cases had pneumonia compared with 6% of the cases of PHCCs.

Conclusion: This study showed significant association with wheezes, immunization, history of chronic illness, SES, family history of asthma and smoking in father. The majority of cases with sever pneumonia was higher among hospital cases compared with PHCC. and pneumonia cases were lesser in hospital compared with PHCC.