FREQUENCY AND DETERMINANTS OF ACUTE RESPIRATORY TRACT INFECTIONS IN CHILDREN UNDER FIVE: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL IN ABBOTTABAD
DOI:
https://doi.org/10.71000/4b1j7m16Keywords:
pneumonia, children, , : Bronchiolitis, , Immunization, Respiratory Infections, Rural Population, VaccinationAbstract
Background: Acute respiratory tract infections (ARTIs) remain among the leading causes of morbidity and mortality in children worldwide, particularly in low- and middle-income countries. These infections, including pneumonia, bronchitis, influenza, and bronchiolitis, are more prevalent in children due to their developing immune systems. They are commonly classified as upper or lower respiratory tract infections and occur more frequently in colder seasons and rural settings.
Objective: The study aimed to determine the frequency and types of acute respiratory tract infections in children under five years of age and to identify the demographic and preventive factors associated with their occurrence.
Methods: A cross-sectional study was conducted over ten months at Ayub Medical Complex, Abbottabad, involving 173 children aged ≤5 years. Participants were selected through stratified random sampling. Data were collected using a pretested structured questionnaire administered to parents, covering demographics, vaccination status, and infection history. Descriptive and inferential analyses were performed using IBM SPSS version 16. Quantitative variables were expressed as mean ± standard deviation, while categorical variables were reported as frequencies and percentages.
Results: Out of 173 participants, 63 (36.4%) had acute respiratory tract infections, while 110 (63.6%) were infection-free. Males constituted 110 (63.6%) and females 63 (36.4%). Most participants resided in rural areas (133, 76.9%), with only 40 (23.1%) from urban regions. Pneumonia was the most prevalent infection (31, 17.9%), followed by bronchiolitis (8, 4.6%) and pharyngitis (4, 2.3%). Regarding immunization, 103 (59.5%) were fully vaccinated, 36 (20.8%) partially vaccinated, and 34 (19.7%) unvaccinated.
Conclusion: The study concludes that ARTIs are more common among male children and those living in rural areas. Pneumonia is the predominant form, and complete immunization significantly reduces the risk of infection. Targeted interventions focusing on vaccination, nutrition, and environmental hygiene can effectively lower the disease burden.
References
Gan G, Liu H, Liang Z, Zhang G, Liu X, Ma L. Vaccine-associated thrombocytopenia. Thromb Res. 2022;220:12-20.
Perez A, Lively JY, Curns A, Weinberg GA, Halasa NB, Staat MA, et al. Respiratory Virus Surveillance Among Children with Acute Respiratory Illnesses - New Vaccine Surveillance Network, United States, 2016-2021. MMWR Morb Mortal Wkly Rep. 2022;71(40):1253-9.
Soni A, Kabra SK, Lodha R. Respiratory Syncytial Virus Infection: An Update. Indian J Pediatr. 2023;90(12):1245-53.
Rice E, Oakes DB, Holland C, Moore HC, Blyth CC. Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19. Curr Opin Infect Dis. 2023;36(6):522-8.
Procianoy GS, Procianoy RS, Silveira RC. Regional disparities in BCG vaccination coverage and tuberculosis incidence in infants among Brazilian states. J Trop Pediatr. 2024;70(4).
Minta AA, Ferrari M, Antoni S, Lambert B, Sayi TS, Hsu CH, et al. Progress Toward Measles Elimination - Worldwide, 2000-2023. MMWR Morb Mortal Wkly Rep. 2024;73(45):1036-42.
Konstorum A, Mohanty S, Zhao Y, Melillo A, Vander Wyk B, Nelson A, et al. Platelet response to influenza vaccination reflects effects of aging. Aging Cell. 2023;22(2):e13749.
Jog P, Memon IA, Thisyakorn U, Hozbor D, Heininger U, von König CHW, et al. Pertussis in Asia: Recent country-specific data and recommendations. Vaccine. 2022;40(8):1170-9.
Rai E, Alaraimi R, Al Aamri I. Pediatric lower respiratory tract infection: Considerations for the anesthesiologist. Paediatr Anaesth. 2022;32(2):181-90.
Yang Q, Liu F, Chang L, Lai S, Teng J, Duan J, et al. Molecular epidemiology and clinical characteristics of enteroviruses associated HFMD in Chengdu, China, 2013-2022. Virol J. 2023;20(1):202.
Zerbo O, Ray GT, Fireman B, Layefsky E, Goddard K, Lewis E, et al. Maternal SARS-CoV-2 vaccination and infant protection against SARS-CoV-2 during the first six months of life. Nat Commun. 2023;14(1):894.
Shope TR, Chedid K, Hashikawa AN, Martin ET, Sieber MA, Des Ruisseau G, et al. Incidence and Transmission of SARS-CoV-2 in US Child Care Centers After COVID-19 Vaccines. JAMA Netw Open. 2023;6(10):e2339355.
Luna CM. Impact of vaccination on the epidemiology and prognosis of pneumonia. Rev Esp Quimioter. 2022;35 Suppl 1(Suppl 1):104-10.
Talbird SE, Carrico J, La EM, Carias C, Marshall GS, Roberts CS, et al. Impact of Routine Childhood Immunization in Reducing Vaccine-Preventable Diseases in the United States. Pediatrics. 2022;150(3).
Saiman L, Walsh EE, Branche AR, Barrett A, Alba L, Gollerkeri S, et al. Impact of Age and Comorbid Conditions on Incidence Rates of COVID-19-Associated Hospitalizations, 2020-2021. Influenza Other Respir Viruses. 2024;18(11):e70016.
Devin J, Marano R, Mikhael M, Feaster W, Sanger T, Ehwerhemuepha L. Epidemiology of Neonatal COVID-19 in the United States. Pediatrics. 2022;150(4).
Davis MM, Halasyamani LK. COVID-19 Vaccination and Parent-Reported Symptomatic Child Asthma Prevalence. JAMA Netw Open. 2024;7(7):e2419979.
Huang QS, Wood T, Aminisani N, Kvalsvig A, Baker MG, Nghiem N, et al. Comparison of the Incidence and Risk Factors of Acute Respiratory Illness Associated With COVID-19 and Influenza: Results of the SHIVERS II, III, and IV Prospective Community Cohort Study. J Infect Dis. 2025;232(2):450-64.
Wang Y, Su S, Ma M, Weng R, Zhang Z, Liu D, et al. Clinical characteristics and outcomes of COVID-19 in pediatric patients with rheumatic diseases. Pediatr Res. 2025;97(6):2045-55.
Li M, Song Z, Wan W, Zhou H. Burden of non-COVID-19 lower respiratory infections in China (1990-2021): a global burden of disease study analysis. Respir Res. 2025;26(1):125.
Watanabe A, Kani R, Iwagami M, Takagi H, Yasuhara J, Kuno T. Assessment of Efficacy and Safety of mRNA COVID-19 Vaccines in Children Aged 5 to 11 Years: A Systematic Review and Meta-analysis. JAMA Pediatr. 2023;177(4):384-94.
Top KA, Bettinger JA, Embree JE, Jadavji T, Purewal R, Sauvé L, et al. Active Surveillance for Myocarditis and Pericarditis in Canadian Children from 2021 to 2022: A Canadian Immunization Monitoring Program ACTive Study. J Pediatr. 2025;284:114642.
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Copyright (c) 2025 Muhammad Hashim, Muhammad Adnan Bashir, Sajid Raza, Sufyan Siraj, Aima zahra, Hafsa Abdul Malik , Muhammad Umair, Abid Hussain, Tayyaba Inayat, Laiba inayat (Author)
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