Journal Article

Burden, predictors, and outcome of unconsciousness among under-five children hospitalized for community-acquired pneumonia: A retrospective study from a developing country

Mamun, Gazi Md. Salahuddin, Shahrin, Lubaba, Saha, Haimanti, Shaima, Shamsun Nahar, Ahmed, Tahmeed, Chisti, Mohammod Jobayer, Shahid, Abu Sadat Mohammad Sayeem Bin, Nuzhat, Sharika, Sultana, Mst. Shahin, Afroze, Farzana, Sarmin, Monira

2023

Overview

Despite the reduction of death from pneumonia over recent years, pneumonia has still been the leading infectious cause of death in under-five children for the last several decades. Unconsciousness is a critical condition in any child resulting from any illness. Once it occurs during a pneumonia episode, the outcome is perceived to be fatal. However, data on children under five with pneumonia having unconsciousness are scarce. We’ve retrospectively analyzed the data of under-five children admitted at the in-patient ward of Dhaka Hospital of icddr,b during 1 January 2014 and 31 December 2017 with World Health Organization classified pneumonia or severe pneumonia. Children presented with or without unconsciousness were considered as cases and controls respectively. Among a total of 3,876 children fulfilling the inclusion criteria, 325 and 3,551 were the cases and the controls respectively. A multivariable logistic regression analysis revealed older children (8 months vs. 7.9 months) (adjusted odds ratio, aOR 1.02, 95% CI: 1.004–1.04, p = 0.015), hypoxemia (aOR 3.22, 95% CI: 2.39–4.34, p<0.001), severe sepsis (aOR 4.46, 95% CI: 3.28–6.06, p<0.001), convulsion (aOR 8.90, 95% CI: 6.72–11.79, p<0.001), and dehydration (aOR 2.08, 95% CI: 1.56–2.76, p<0.001) were found to be independently associated with the cases. The cases more often had a fatal outcome than the controls (23% vs. 3%, OR 9.56, 95% CI: 6.95–13.19, p<0.001). If the simple predicting factors of unconsciousness in children under five hospitalized for pneumonia with different severity can be initially identified and adequately treated with prompt response, pneumonia-related deaths can be reduced more effectively, especially in resource-limited settings.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Bangladesh - epidemiology / Biology and Life Sciences / Cardiovascular disease / Care and treatment / Child / Children / Community-acquired infections / Complications and side effects / Congenital diseases / Consciousness / Cyanosis / Dehydration / Demographic aspects / Developing Countries / Diarrhea / Edema / Hospital patients / Hospitals / Humans / Hypoxemia / Infant / Intensive care / Laboratories / LDCs / Loss of consciousness / Malnutrition / Medicine and Health Sciences / Mortality / Multivariable control / Nutritional status / Oxygen therapy / Patient outcomes / Patients / Pediatric research / Pneumonia / Pneumonia - complications / Pneumonia - epidemiology / Pneumonia - therapy / Pneumonia in children / Preschool children / Regression analysis / Respiration / Retrospective Studies / Risk factors / Sepsis / Signs / Sociodemographics / Statistics / Unconsciousness / Unconsciousness - complications / Ventilators