Clinico-Epidemiological Profile and Outcome of Acute Lower Respiratory Infections among Hospitalized Children Age 2 Months to 5 Years: A Prospective Observational Study from a Tertiary Care Centre in North-Western India

Abstract

Background: Acute lower respiratory infections (ALRIs) remain one of the leading causes of childhood morbidity and mortality, particularly in low- and middle-income countries. Identification of factors associated with severe disease is essential for improving clinical outcomes.

Objective: To evaluate the clinico-epidemiological profile, associated risk factors, and clinical outcome of children admitted with acute lower respiratory infections.

Methods: This prospective observational study included 210 children aged 2 months to 5 years admitted with ALRIs at the Department of Paediatric Medicine, SMS Medical College and Attached Group of Hospitals, Jaipur. Demographic characteristics, nutritional status, immunization status, environmental exposures, laboratory investigations, disease severity, treatment requirements, and outcomes were recorded. Statistical analysis was performed using SPSS, and multivariable logistic regression identified independent predictors of severe disease.

Results: Severe pneumonia was the most common presentation (59.5%), followed by very severe pneumonia (21.4%). Low birth weight, poor maternal literacy, incomplete immunization, malnutrition, anaemia, use of non-gas cooking fuel, and attached kitchen were significantly associated with greater disease severity (p<0.05). Multivariable logistic regression identified malnutrition, anaemia, incomplete immunization, low birth weight, maternal literacy, cooking fuel, attached kitchen, and increasing age as independent predictors of severe pneumonia. Oxygen therapy and mechanical ventilation requirements increased significantly with disease severity. Overall mortality was 1.4%, with all deaths occurring among children with very severe pneumonia.

Conclusion: Nutritional deficiencies, inadequate immunization, adverse household environmental conditions, and low birth weight independently increase the risk of severe ALRIs in children. Early identification of these modifiable factors, together with timely treatment and preventive interventions, may substantially reduce disease severity and improve clinical outcome.