Patterns of respiratory tract infections in children under 5 years of age in a low–middle-income country

Abstract

Abstract Background Respiratory tract infections (RTIs) are among the most commonly encountered major public health problems, with a higher prevalence of lower RTIs among children and more generally the poor. The present study aimed to describe the pattern of respiratory tract infections in Egyptian children aged under 5 years and explore possible associations between socio-demographics and nutritional status and types of RTIs. Methods Over 6 months beginning in September 2018 (including one winter season), a cross-sectional, observational, epidemiological study was conducted on a sample of patients with upper and lower RTIs diagnosed clinically and/or radiologically in the outpatient clinics at Cairo University Children’s Hospital in Egypt. An interview questionnaire was employed to collect socio-demographic and nutritional data. Heights/lengths and weights were measured and analyzed using the World Health Organization’s (WHO) Anthro Plus [Computer Program]. Patients with pneumonia (n = 28) were compared to 97 healthy children of the same age and sex. Results The total number of children diagnosed with upper and lower respiratory infections was 611. Malnutrition was present in 12.4% of all children with upper and lower RTIs. Lower RTI and malnutrition were substantially more prevalent among children aged under 2 years (p = 0.048 and p < 0.001, respectively). The strongest predictor of lower RTI was a younger age (OR 0.797, CI 0.713–0.89, p < 0.001). Conclusion At our center, approximately one-third of infections in under-fives were lower RTI. Malnutrition was one of the significant risk factors for lower RTI in children below 2 years. The nutritional status of infants and young children should be improved by encouraging exclusive breastfeeding during the first 6 months of life and strengthening the healthcare and nutritional counseling available for vulnerable children, particularly in rural regions.