Abstract
Background: Acute lower respiratory tract infections associated with anemia occur more commonly in children than in adults. But anemia due to whatever aetiology per se, as a risk factor for developing ALRTI, has not been fully evaluated. Hence this observational case control study shall be conducted for assessing anemia, as a risk factor for developing ALRTI in children.
Material & Methods: An observational case control study done on 270 with acute lower respiratory tract infection admitted in Pacific Institute of Medical Sciences, Udaipur were included in the study group and 270 age and sex-matched children selected on outpatient basis were included under the control group. The primary outcome was comparing the presence or absence of anemia in cases of acute lower respiratory tract infection and healthy control group. Secondary outcome were correlated the severity of anemia with severity of respiratory tract infection, if any.
Results: Our study showed that the age distribution of 270 cases and 270 controls, maximum children that is 41.85% were in the age group of 9 to 23 months. Male preponderance was found in our study (1.4:1). 184 (68.14%) out of 270 cases in the study group were found anemic while only 97 (35.92%) out of 270 control group were found anemic. For lower respiratory tract infection anemia looks like a significant risk factor with p value < 0.001 and odds ratio of 3.49.
Conclusion: Iron deficiency anemia is a significant risk factor for Lower Respiratory Tract Infection. Prevention and early diagnosis of anemia is important to reduce the prevalence of LRTI.
Keywords: ALRTI, Iron deficiency anemia, Hemoglobin, Risk factors.
References
- Christi MJ, Tebruegge M, La Vincente S, Graham SM. Pneumonia in severely malnourished children in developing countries-mortality risk, etiology and validity of WHO clinical signs: a systematic review. Trop med int health.2009; 14(10):1173-89.
- Graham SM, English M, Hazir T, Enarson P.Challenges to improving case management of childhood pneumonia at health facilities in resource-limited settings. Bull WHO 2008; 86: 349-55.
- Rudan I, Boschi-Pinto C. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86:408-16.
- Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-61.
- Kotecka PV. Nutritional anemia in young children with Focus on Asia and India. Indian J Community Med. 2011;36:8-16.
- De Benoist B, McLean E, Egli I, Cogswell M. Worldwide prevalence of anemia 1993-2005. WHO Global Database on Anemia Geneva, World Health Organization.
Available: http://apps.who.int/iris/bitstream/10665/43894/1/9789241596657_eng.pdf.
- Jackson S, Mathews KH, Pulani D, Falconer R, Rudanl, Campbel H et al. Risk factors for severe acute lower respiratory infections in children – a systematic review and meta-analysis, Croat Med J 2013; 54:110-21.
- Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2008 (WHO/NMH/ NHD/MNM/11) (http:// www.who.int/vmnis/prevalence/anaemia.pdf).
- Kotecka PV. Nutritional Anemia in Young Children with Focus on Asia and India. Indian J Community Med. 2011; 36:8–16.
- Ashraf M, Wani J G, Ahmed J. Low Hemoglobin level a risk factor for acute lower respiratory tract infections in children. JCDR. 2014;April:8;4;PC01-PC03.
- Malla T, Pathak OK, Malla KK. Is Low Hemoglobin level a risk factor for acute lower respiratory tract infections? J Nepal Pediatric Soci. 2010;30:1–7.
- Ramakrishnan K, Harish PS. Hemoglobin level as a risk factor for lower respiratory tract infections. Indian J Pediatr. 2006;73:881–883.
- Savitha MR, Nandeeshwara SB, Pradeep Kumar MJ, ulHaque F, Raju CK. Modifiable risk factors for acute lower respiratory tract infections. Indian J Pediatr. 2007;74:477– 82.
- Mourad S, Rajab M. Hemoglobin level as a risk factor for lower respiratory tract infections in Lebanese children. North American Journal of Medical Sciences. 2010;2:461.
Corresponding Author
Dr Lakhan Poswal
Senior Professor, Dept. of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India