Assessment and Prevalence of Acute Lower Respiratory Tract Infections in Pediatrics in Tertiary Care Hospital

Assessment and Prevalence of Acute Lower Respiratory Tract Infections in Pediatrics in Tertiary Care Hospital | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment and Prevalence of Acute Lower Respiratory Tract Infections in Pediatrics in Tertiary Care Hospital Anand Kishore Morampudi, Sarada Akula, Deepthika Vemula, Dr.Sai wapna Tirumalasetty This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6164269/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Acute Lower Respiratory Tract Infection (LRTI) remains a major health concern among pediatric patients, significantly contributing to morbidity and mortality. This study assesses the prevalence, distribution patterns, and key socio-demographic factors influencing LRTI incidence in children in and around Rajahmundry, Rampachodavaram, and West Godavari. Results: 515 pediatric patients were included in this prospective cohort study from August 2024 to January 2025. Pneumonia was the most common condition (45.4%, n=234), followed by bronchiolitis (23.3%, n=120), bronchitis (18.3%, n=94), and acute bronchitis (13%, n=67). Males (53.2%) were affected slightly more than females (46.8%). The highest incidence was observed in children aged 4-6 years (44.3%). Key socio-demographic risk factors included low maternal education, inadequate breastfeeding duration, and low birth weight. Conclusions: Pneumonia is the most prevalent LRTI in this region. Socioeconomic factors, including maternal education, birth weight, and breastfeeding practices, play a crucial role in disease incidence. Addressing these factors through targeted interventions can help reduce the burden of LRTI in pediatric populations. The study findings provide valuable insights for healthcare providers and policymakers to enhance preventive strategies and pediatric healthcare services. Pediatrics Acute Lower Respiratory Tract Infection Pneumonia Bronchiolitis Pediatric Health Risk Factors Prevention Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 BACKGROUND ACUTE LOWER RESPIRATORY TRACT INFECTION Acute Lower Respiratory Tract Infection (LRTI) is an acute infection affecting the airways and pulmonary tissue below the level of the larynx. The condition typically involves inflammation of the bronchi, bronchioles, and/or lung tissues (WHO). Acute lower respiratory tract infection remains one of the major health concerns throughout the world, particularly in children. These infections, which involve both airways and lung parenchyma, the trachea, bronchi, and bronchioles remain one of the most frequent causes of morbidity and mortality among under-five-year-old children throughout the world. Despite this, LRTIs remain one of the leading causes of morbidity and mortality among children and a significant burden on healthcare systems and family resources worldwide. They range from mild to severe; the former has the potential for long-term consequences. Understanding the causes, symptoms, diagnosis, and management of ALRTI is important to healthcare providers and parents. RESPIRATORY SYSTEM: The respiratory system is an essential physiological system, allowing for the exchange of gases between the inner environment and the outer world. It helps in aerobic respiration, keeping the oxygen supply present in the blood while removing carbon dioxide as waste products. The respiratory system maintains a balance in the blood, thus making it possible for the body to maintain pH and achieve homeostasis. This system also allows for the removal of noxious waste products, which is essential for maintaining the efficiency of the respiratory system. The respiratory system can be classified into two primary parts: the upper respiratory tract, which is concerned with the nasal cavity, pharynx, larynx, and vocalization. This portion of the respiratory system's major functions for respiration and voice involves the nasal cavity, which contains mucous membranes and cilia. The air passageway as well as a food pathway, the larynx, known as the voice box, also generates sound and protects the air passage. There are a few major structures in the lower respiratory tract that are very important for breathing and gas exchange in the body. The trachea or the windpipe allows air to enter the lungs through bronchi and bronchioles. The lobes and segments of the lungs allow for the oxygenation of blood and the removal of waste gases. The nose and nasal cavity are very important parts of the respiratory system, with the external nose made up of cartilage and bones and the nasal cavity lined with the thin mucous membrane and ciliated epithelium. The pharynx is a muscular tube that connects the nasal cavity and mouth to the esophagus and larynx, and it regulates air temperature and moisture content while protecting the delicate tissues inside the lungs. The larynx, or voice box, is where the vocal cords are located for speech production and regulate the intake and exhalation of air. The respiratory system is a complex, highly regulated system that ensures equilibrium between oxygen and carbon dioxide in the body. The three major organs in the system are the lungs, alveoli, and the pleura. The lungs are located inside the chest and are covered by a two-layered membrane known as the pleura that allows it to move about while respiration takes place. The lungs guarantee that vital functions and homeostasis are maintained. Inhalation incorporates air intake in the diaphragm, intercostal muscles, and chest cavity volume, hence creating a negative pressure environment in the lungs. This allows oxygen, which cells use to carry on their activities, to be introduced into the cells while carbon dioxide, a metabolic waste product, is removed from the body's system. This is a passive process at rest, where the diaphragm and the external intercostal muscles relax and let the volume of the chest cavity decrease, thus letting air out of the lungs. This is a critical process in respiration since it is during expiration that the body eliminates the carbon dioxide-rich air built up during internal respiration. The connection between the relaxation of muscles with the alteration of pressure during expiration shows how the respiratory system is considered a functional unit. Lung volumes and capacities are the fundamental elements of assessment in the determination of respiratory function, diagnosis of pulmonary pathology, and management of lung health. The total maximum volume of air that the lungs can hold is the sum of the vital capacity and residual volume. The gas exchange takes place in the alveoli, where oxygen diffuses into the capillary blood and carbon dioxide diffuses from the blood into the lungs to be exhaled. This is made possible by the alveolar-capillary membrane that separates the alveoli from the capillary blood. Generally, the respiratory system contributes a lot in ensuring that the oxygen and carbon dioxide balance in the body is maintained. The transport of gases in our bodies is the role played by the respiratory system. Oxygen is transported by binding to hemoglobin on red blood cells, and carbon dioxide through a variety of mechanisms. Respiratory regulation is achieved by the coordination of several centers; including the modular rhythm city center and set basic rhythm pontine respiratory group (PRG), and other parts of the respiratory centers in the brainstem as well as the higher brain centers; mechanoreceptors within the airways and lungs. These centers harmonize to provide the delicate balance required for sustaining the breathing process that sustains life. The most common diseases afflicting children are acute lower respiratory tract infections (LRTI) infections, responsible for 15% of all deaths of children under the age of five. The burden is particularly extreme in low and middle-income countries as overcrowding, nutritional deficiencies, and lack of health care considerably contribute to the vulnerability of the young populations. Even in developed nations, LRTIs have posed significant economic burdens while demanding constant awareness, effective preventive measures, and adequate access to medical services. EPIDEMIOLOGY The epidemiology of LRTIs is affected by seasonal variation, where most series depict marked peaks during winters in temperate regions and rainy seasons in tropical areas. Infants and young children have an especially high susceptibility to infections due to a less developed immune system, with narrower airways compared to adults and older children. Early detection of these conditions, followed by swift intervention with proper therapy, is the key to managing respiratory conditions. The situation is more alarming in developing countries, where poverty, malnutrition, and poor health facilities prevail. Younger children, particularly infants and toddlers, are at a higher risk of developing ALRTIs because of their undeveloped immune systems and narrow airways. Health infrastructure, vaccination programs, and awareness of respiratory health are the key factors in minimizing the effects of ALRTIs in children. These strategies can be focused on the root determinants of respiratory infections, with better access to quality healthcare services, burden reduction, and better health results for children across the globe. ETIOLOGY Acute respiratory tract infections or LRTIs among children are caused by several agents. Viruses account for approximately 90% of these infections. The main viral cause is the respiratory syncytial virus, which is present mainly in infants and young children. There is a fine balance between the infectious agent and the developing immune system of children, making it important to be very alert and take adequate preventive measures. Severe viral causes include influenza viruses, parainfluenza viruses, human meta-pneumo-virus, and adenoviruses. New corona viruses like SARS-CoV-2 brought a paradigm shift in the etiological scenario that underlines preparedness and rapid response strategies to control viral load and its consequences on public health. Bacterial pathogens, such as Streptococcus pneumonia and Homophiles influenza type b, play an important role in the etiology of serious lower respiratory tract infections due to higher rates of illness and death. Conjugate vaccines have significantly decreased the incidence and severity of bacterial LRTIs, thus reducing morbidity and mortality. Co-infections in respiratory diseases increase in importance and are under investigation due to complications they cause in the diagnostic and treatment modalities and because of the increased severity of diseases. To combat co-infections in respiratory health conditions, one must understand the mechanism underlying the disease progression; it requires approaches of diagnosis, distinguishing between the co-existing infections so that they can be treated according to specific target strategies. Personalized treatment approaches for specific cases should enhance the responsiveness of therapy as well as of active management of respiratory infections and subsequently optimize patient care and decrease burdens on healthcare. This study thus aims to innovate the current therapeutic as well as preventative measures with emerging profiles of changes in pathogenic varieties in constant respiratory infections. PATHOPHYSIOLOGY The pathogenesis of ARTIs in children involves inflammation and injury of the lower airways as a result of viral or bacterial infections. Clinical presentation of ALRTIs can vary from a mild self-limiting illness to a severe, life-threatening disease that necessitates intensive care. Symptoms include cough, fever, tachycardia, and increased work of breathing. DIAGNOSIS Diagnosis is key in the management of the conditions and prevention of complications. The diagnosis process encompasses clinical assessment, laboratory tests, and imaging studies. The WHO has developed clinical criteria for pneumonia in children based on respiratory rate and chest in drawing, but these criteria have limited specificity and lead to over diagnosis and overuse of antibiotics. Molecular methods, including PCR assays, have revolutionized the detection of viruses because of their sensitivity and ability to identify multiple pathogens in one test. Blood cultures from bacterial pathogens have low yields but remain important in severe cases. Newer techniques, like PCR-based detection of bacterial DNA in blood samples, promise a better future but are not widely available. MANAGEMENT: The treatment for acute LRTIs in children is a multi-component therapy system that focuses on the disease severity and possible etiologic agents. It is based mainly on supportive care, which includes appropriate hydration, controlling fever, and oxygen supplementation, among others. Nutritional support is also considered essential, even more so when the setting of care is very resource-limited, as with malnutrition compounding the progression of the illness. Antibiotic treatment is typically given if there is an existing or suspected bacterial infection, but the empirical use of antibiotics in viral LRTIs results in antibiotic resistance. Bronchodilators and high-dose corticosteroids are given and advanced respiratory care in severe cases. PREVENTION; Prevention is key to the reduction of acute respiratory infections in children. This can be facilitated by vaccinations for S. pneumonia and RSV. Good hygiene includes hand washing, avoiding touching the face, and minimization of contact with infective individuals. A healthy lifestyle includes a diet, physical activity regularly, exclusive breastfeeding, and abstinence from smoking. The allergy and asthma have to be properly managed so as not to increase the respiratory infection. Awareness about vaccination should exist, and children should regularly undergo health checks by healthcare providers. Sanitization of toys and surfaces children are frequently exposed to will also decrease the rate at which germs spread. It would therefore require strict infection control practices in the healthcare institution, regular check-ups with health professionals, and regular vaccination to avoid the spread of nosocomial respiratory pathogens. MATERIALS & METHODS The field practice areas of the Pediatric Department at the Government Teaching General Hospital, attached to a medical college at Rajahmundry, Andhra Pradesh, India conducted a community-based, Prospective observational Cohort study between August 2024 and January 2025. Study design: A Prospective observational cohort study + Study site; The study was conducted in the Pediatric Department of Government Teaching General District Hospital, Rajahmundry, Andhra Pradesh, India 533102. Study period: From August 2024 to January 2025 for six months. Ethical Clarence / IRB: We submitted research detailed protocol to the IRB/IEC committee Vikas Institute of Pharmaceutical Sciences approved our research with IRB/IEC number PD06/IRB/VIPS/2024-2025 under the same title(The assessment of prevalence of acute lower respiratory tract infection in pediatrics at Government teaching general hospital, Rajahmundry). Therefore, the institution guarantees that research within its college-attached hospital i.e Government Teaching General Hospital, Rajahmundry to research the pediatric population, Rajahmundry Government Teaching General Hospital is a tertiary care hospital multi-specialty wing separate block for pediatric patients in this two (2) pediatric units with fully latest equipped setup present in both units. Study population: 515 cases were collected from the pediatric department in the government teaching general hospital, Rajahmundry according to the study criteria. Our study starts data collection in 6 months (Aug 2024-Jan 2025) through close observation and recording of newly admitted cases. A cohort study is a group of patients (in this case, pediatric patients) with a specific focus on those who were diagnosed with acute lower respiratory tract infections (LRTI). The conditions included pneumonia, bronchitis, acute bronchitis, and bronchiolitis. Inclusion Criteria Children 1 month -14 yrs Patients of either sex Patients with Co-morbid conditions Patients with any psychiatric disorders Patients with cancer-related problems Presenting with the symptoms suggestive of an acute lower respiratory tract infection. Exclusion Criteria: Pregnant and Lactating women Patients with any psychiatric disorders Patients with cancer-related problems Children with chronic respiratory conditions (asthma, cystic fibrosis) Parents or guardians are those who are not willing to give consent. Data analysis: The study data was analyzed using SPSS ( version 30 2024 September ) descriptive statistics to understand information deeply. Software revealed patterns and key insights, producing valuable outcomes. Statistical techniques allowed a systematic analysis for clear conclusions. RESULTS Table 01; Percentage of gender having particular disease condition Acute LRTIs in children are mainly categorized into pneumonia, bronchiolitis, acute bronchitis, and bronchitis. Male predominance is found in most cases, with a male-to-female ratio of 53.2–46.8%, respectively. Pneumonia prevails among all LRTIs, followed by bronchiolitis; the latter is more common in males. Bronchitis is the most common, with both sexes having a significant percentage. Table 02: Symptoms of Acute LRTI among pediatric patients (N=515) SYMPTOMS Number of subjects (%) Associated with FEVER 298 (57.86%) COLD/ Running nose 395 (76.67%) COUGH(dry/wet, with sputum) 497 (96.5%) SORE THROAT 106 (20.5%) Low saturation levels 121 (23.4%) Associated with tachycardia 208 (40.6%) Associated with SOB 113 (22%) Acute LRTIs in children often present with cough, cold/running nose, fever, tachycardia, low oxygen saturation, shortness of breath, and sore throat, necessitating comprehensive symptom analysis for appropriate treatment. GENDER DISTRIBUTION A study found a significant peak in lower respiratory tract infections among children aged 4–6 years, with around 234 cases. Male children had a higher prevalence, with 115 cases compared to females. Age-specific trends showed that the incidence was moderate in the 1–3 years age group, moderate in the 7–9 years age group, and low among children aged 10 years and above. There is a need for increased surveillance measures in the 4–6 age group and age-specific preventive measures among young male children. Table 03: Factors associated with acute LRTI in pediatrics (N=515) VARIABLE CATEGORY NO.OF SUBJECTS PEARSON CHI-SQUARE VALUE df P-VALUE Incidence rate Age in years 1-3 4-6 7-9 10 & above 131(25.4%) 227(44.3%) 104(20.1%) 53(10.2%) 28.6 3 <0.001 Peak IR 4 years 2 nd high in 5 years old Lowest-13 yars Gender Male Female 274(53.2%) 241(46.8%) 2.16 1 <0.142 - - Place of residence Rural Urban Tribal(agency) 169 (32.8%) 194 (37.3%) 152 (29.9%) 1.84 2 <0.398 34.56% 34.95% 30.29% Birth weight Below 2kg 2-3kg 3kg & above 194 (37.7%) 213 (41.3%) 108 (21%) 36.5 2 <0.001 37.7% 41.3% 21% Mother education Uneducated 1-10 th Inter Degree/PG 181(35.1%) 236(46.8%) 58 (11.2%) 40 (6.9%) 14.7 3 2 246 (47.8%) 250 (48.5%) 19 (3.7%) 22.4 2 3 246 (47.8%) 250 (48.5%) 19 (3.7%) 22.9 2 <0.001 - - - Duration of breastfeed (months) <6 months 6-12 months 12-18months 18 & more 2(0.39%) 90(17.31%) 197(37.3%) 232(45.%) 23.1 3 <0.001 0.39% 17.31% 37.3% 45.% The age-specific distribution of acute lower respiratory tract infections (ARRIs) in children is such that they peak at 4–6 years of age and taper off with increasing age. The highest incidences in preschool and early school-age children, 4–6, are decreasing. Preventive measures should be age-oriented with intervention strategies set around the younger pediatric population, and education to parents on early childhood. The study reveals an equal burden of LRTI in the major residential areas, with minimum cases being reported from tribal areas. Most cases are reported among mothers with education, high among illiterate mothers. The research underlines the significance of maternal education in preventing LRTI, along with the need for equity in healthcare access to focus on less-educated populations for preventive strategies. This indicating breastfeeding duration patterns in pediatric ALRTI cases at Government Teaching General Hospital Rajahmundry, the following is a key discussion: The data reveals an inverse relationship between the duration of breastfeeding and prevalence of acute lower respiratory tract infections (ALRTI): The duration of breastfeed highest cases (230) were reported in infants who were breastfed for up to 6 months, suggesting that early breastfeeding protection was inadequate. Cases decreased (190) in the 6–12 month group, indicating potential protective effects of continued breastfeeding Further reduction (90) in 12–18 month group demonstrates extended breastfeeding's protective role Notably absent cases in 18 + months category supports WHO recommendations for extended breastfeeding These results demonstrates immunological benefits of breast milk. Implication for strengthening breastfeeding promotion in the first 6 months. Continued breastfeeding beyond 6 months for prevention of ALRTI. The importance of maternal education on optimal breastfeeding duration. Improve lactation support services particularly for mothers with infants aged < 6 months. Institute educational programs on benefits of extended breastfeeding. Direct preventive efforts towards infants whose breastfeeding duration is less. The analysis of 234 pediatric pneumonia patients using the CURB-65 scale the following distribution: Risk Category Summary: Score 0: 19 patients (8.11%) - Very low risk Score 1: 114 patients (48.5%) - Low risk Score 2: 67 patients (28.5%) - Moderate risk Score 3: 29 patients (12.84%) - Severe risk Score 4: 5 patients (2.1%) - Very severe risk Score 5: 0 patients (0%) - Highest risk Table 04; CURB Scale results distributions S.N SCORE CATEGORY NO.OF SUBJECTS PERCENTAGE RISK CATEGORY Score 0 19 patients 8.11 % Very low risk Score 1 114 patients 48.5% Low risk Score 2 67 patients 28.5% Moderate risk Score 3 27 patients 12.84 % Severe risk Score 4 03 patients 2.1 % Very severe risk Score 5 0 patients 0 % Highest risk The majority of patients (56.6%) fall into the very low & low-risk category, suggesting good prognosis for most cases Nearly one-third of patients (28.5%) require moderate intervention A significant minority (12.8%) present with severe pneumonia requiring intensive care No patients scored the maximum of 5 points, which is expected in a pediatric population DISCUSSION Age Profile: Peak incidence at 4–6 years (44.3% of cases), suggesting a vulnerable age due to an underdeveloped immune system and increased exposure in daycare/school environments. Incidence decreases with age, suggesting improved immune maturation and reduced contact exposure with pathogens in confined environments. Gender Profile: Male children were more prone, with a prevalence of 53.2%, which may be attributed to biological and environmental factors that impact vulnerability. Symptoms: High prevalence of cough (96.5%), cold/runny nose (76.67%), and fever (57.86%) underscores the common presentation of ALTAI. The presence of low saturation of oxygen (23.4%) and tachycardia (40.6%) underscores the severity of respiratory distress in some cases. Early treatment of common presentations such as cough and fever can prevent the condition from turning serious. Maternal education emerged as a very significant predictor: Higher prevalence in children of mothers with lesser educational background. Health education and related programs need to be targeted toward reducing the LIT risk. Residential Distribution: It was similar between rural and urban settings, signifying balanced exposure, though fewer cases were seen in tribal settings. Duration of Breastfeeding Prolonged breastfeeding for more than six months was inversely proportional to the occurrence of ALTAI. Strengthening the WHO recommendations on extended breastfeeding for better protection against respiratory infections. Severity Evaluation (CURB-65 Scale) The majority of patients, 57.3%, were at low risk and required less intervention. The severe cases were few, only 13.6%, and thus required high-level care. Early diagnosis is essential. Preventive Measures and Advice Immunization: Flu and pneumococcal vaccines to reduce bacterial and viral infections. Education: Healthcare providers should be trained and educated about symptom identification and management in the community. Nutrition and Hygiene Promotion of improved breastfeeding and nutrition along with hygiene measures for prevention Access to health care Equal access should be made available in all residential zones. 8. Future Work Studying symptom patterns and their relationship with seasonal fluctuations and severity Investigating gender-specific susceptibility and intervention to achieve better results Development of more precise diagnostic methods and treatment plans for complex cases with co-infections. CONCLUSION Pneumonia is the most prevalent disease, accounting for 45.4% of cases, largely due to delayed healthcare, low vaccination rates, poor hygiene, overcrowding, poor nutrition, and indoor air pollution, with age-related risk factors. Abbreviations ALRTI – Acute Lower Respiratory Tract Infection CRP – C-Reactive Protein CURB-65 – Clinical scoring system for pneumonia severity IEC – Institutional Ethics Committee IRB – Institutional Review Board LRTI – Lower Respiratory Tract Infection PCR – Polymerase Chain Reaction PRG – Pontine Respiratory Group RSV – Respiratory Syncytial Virus SPSS – Statistical Package for the Social Sciences WHO – World Health Organization References Ventre K, Randolph A. Ribavirin for respiratory syncytial virus infection of the lower respiratory tract in infants and young children. Cochrane Database of Systematic Reviews. 2010 May 12;2010(5). Trifonova I. viral pathogens causing acute lower respiratory tract infections in children under 5 years old in bulgaria [Internet]. Morressier; 2018 May [cited 2024 Sep 5].Available from: http://dx.doi.org/10.26226/morressier.5ad774dcd462b80296ca66bc. Dangor Z, Verwey C, Lala SG, Mabaso T, Mopeli K, Parris D, et al. 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Evaluation of Etiologic Agents of Lower Respiratory Tract Infections in Children Hospitalized Just Before Normalization of COVID-19. The Journal of Pediatric Academy. 2024 Mar 6;327(9). Acute Lower Respiratory Tract Infection. In: Medical Management of Pulmonary Diseases [Internet]. CRC Press; 1999 [cited 2024 Sep 5]. p. 323–4. Available from: http://dx.doi.org/10.1201/9781482276756-68. Yanagihara K. The role of molecular diagnosis in acute respiratory tract infection. Respiratory Investigation. 2019 Nov;57(6):511. Joseph P Mizgerd Acute Lower Respiratory Tract Infection. Pediatric Infectious Disease Journal. 2008 Jun;27(6):577. World health organization(WHO) , October 03 2024, https://www.who.int/home/search-results?indexCatalogue=genericsearchindex1&searchQuery=LOWER%20RESPIRATORY%20TRACT %20INFECTION&wordsMode=AnyWord. Additional Declarations The authors declare no competing interests. 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Pneumonia accounts for the highest percentage (45.4%), followed by bronchiolitis (23.3%), bronchitis (18.3%), and acute bronchitis (13%).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/51c49b89601c367194f7cb13.png"},{"id":78230732,"identity":"7f790190-6222-47c0-a77f-76c26bf0eb39","added_by":"auto","created_at":"2025-03-11 07:27:50","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":83902,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGender Distribution According to Age Group\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA graphical representation showing the peak incidence of lower respiratory tract infections among children aged 4-6 years, with a higher prevalence among male children. The incidence is moderate in the 1-3 and 7-9 years age groups and lowest in children aged 10 years and above.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/8f7120f71d26a58fde7ab994.png"},{"id":78229223,"identity":"aa3478bc-910c-42bc-876e-0f47bb1fa7f4","added_by":"auto","created_at":"2025-03-11 07:19:50","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":42891,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGender Distribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese figures highlight the gender-based distribution of LRTI cases. Males exhibit a slightly higher prevalence (53.2%) compared to females (46.8%), suggesting potential biological or environmental factors.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/60c10f5b0e0b2f3345827904.png"},{"id":78229233,"identity":"da01243a-b707-40c3-860f-2c58f5a67970","added_by":"auto","created_at":"2025-03-11 07:19:50","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":53569,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGender Distribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese figures highlight the gender-based distribution of LRTI cases. Males exhibit a slightly higher prevalence (53.2%) compared to females (46.8%), suggesting potential biological or environmental factors.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/24078ddd9690b45b88083e51.png"},{"id":78229230,"identity":"ac108f27-48fd-4b25-a80f-45d2cbe5e9bc","added_by":"auto","created_at":"2025-03-11 07:19:50","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":72401,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePlace of Residence\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA comparative analysis of LRTI incidence across different residential areas—rural, urban, and tribal. The study shows a nearly equal burden among urban and rural populations, with slightly fewer cases in tribal areas.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/c7ec29ea8672997bcfbc2a2e.png"},{"id":78229234,"identity":"f3e80066-3feb-4d0e-be18-270746a5f01d","added_by":"auto","created_at":"2025-03-11 07:19:50","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":64774,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMaternal Education (Bar Graph)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis figure demonstrates the correlation between maternal education and the incidence of pediatric LRTI cases. The highest prevalence is among children of mothers with lower educational backgrounds, emphasizing the role of maternal awareness in preventing respiratory infections.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/59ffd534c7101d0a1bfc1ab9.png"},{"id":78230739,"identity":"b30f3843-35f7-4337-af80-a6077ab98728","added_by":"auto","created_at":"2025-03-11 07:27:51","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":75355,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDuration of Breastfeeding (Bar Graph)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA graphical representation of the inverse relationship between breastfeeding duration and LRTI prevalence. Infants breastfed for less than six months exhibit the highest LRTI incidence, whereas extended breastfeeding beyond 18 months provides better protection against infections.\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/781a0f7aadd57dde99be5ef3.png"},{"id":78230734,"identity":"c17b1421-b30f-4ce0-ab75-f06a1aa43634","added_by":"auto","created_at":"2025-03-11 07:27:50","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":53969,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCURB-65 Scale Analysis for Pediatric Pneumonia Patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA distribution of pneumonia severity in pediatric patients based on the CURB-65 scale. The majority fall into the low-risk category (score 1: 48.5%), while a smaller proportion exhibits severe cases (score 3: 12.84%, score 4: 2.1%). No cases were observed at the highest risk category (score 5). This section provides essential insights into the graphical representation of the study data, enhancing understanding of key findings related to pediatric acute lower respiratory tract infections.\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/febc5d4851ef6f31ede682fd.png"},{"id":78232558,"identity":"49e28a20-8684-4091-b428-d5e3e5c6c9ce","added_by":"auto","created_at":"2025-03-11 07:43:51","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":262176,"visible":true,"origin":"","legend":"\u003cp\u003eUnnumbered image in the Background section.\u003c/p\u003e","description":"","filename":"11.png","url":"https://assets-eu.researchsquare.com/files/rs-6164269/v1/648d2bdf3bb255c3c4ffbe2e.png"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eAssessment and Prevalence of Acute Lower Respiratory Tract Infections in Pediatrics in Tertiary Care Hospital\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eACUTE LOWER RESPIRATORY TRACT INFECTION\u003c/h2\u003e \u003cp\u003eAcute Lower Respiratory Tract Infection (LRTI) is an acute infection affecting the airways and pulmonary tissue below the level of the larynx. The condition typically involves inflammation of the bronchi, bronchioles, and/or lung tissues (WHO). Acute lower respiratory tract infection remains one of the major health concerns throughout the world, particularly in children. These infections, which involve both airways and lung parenchyma, the trachea, bronchi, and bronchioles remain one of the most frequent causes of morbidity and mortality among under-five-year-old children throughout the world. Despite this, LRTIs remain one of the leading causes of morbidity and mortality among children and a significant burden on healthcare systems and family resources worldwide. They range from mild to severe; the former has the potential for long-term consequences. Understanding the causes, symptoms, diagnosis, and management of ALRTI is important to healthcare providers and parents.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eRESPIRATORY SYSTEM:\u003c/h2\u003e \u003cp\u003eThe respiratory system is an essential physiological system, allowing for the exchange of gases between the inner environment and the outer world. It helps in aerobic respiration, keeping the oxygen supply present in the blood while removing carbon dioxide as waste products. The respiratory system maintains a balance in the blood, thus making it possible for the body to maintain pH and achieve homeostasis. This system also allows for the removal of noxious waste products, which is essential for maintaining the efficiency of the respiratory system.\u003c/p\u003e \u003cp\u003eThe respiratory system can be classified into two primary parts: the upper respiratory tract, which is concerned with the nasal cavity, pharynx, larynx, and vocalization. This portion of the respiratory system's major functions for respiration and voice involves the nasal cavity, which contains mucous membranes and cilia. The air passageway as well as a food pathway, the larynx, known as the voice box, also generates sound and protects the air passage. There are a few major structures in the lower respiratory tract that are very important for breathing and gas exchange in the body. The trachea or the windpipe allows air to enter the lungs through bronchi and bronchioles. The lobes and segments of the lungs allow for the oxygenation of blood and the removal of waste gases. The nose and nasal cavity are very important parts of the respiratory system, with the external nose made up of cartilage and bones and the nasal cavity lined with the thin mucous membrane and ciliated epithelium. The pharynx is a muscular tube that connects the nasal cavity and mouth to the esophagus and larynx, and it regulates air temperature and moisture content while protecting the delicate tissues inside the lungs. The larynx, or voice box, is where the vocal cords are located for speech production and regulate the intake and exhalation of air. The respiratory system is a complex, highly regulated system that ensures equilibrium between oxygen and carbon dioxide in the body. The three major organs in the system are the lungs, alveoli, and the pleura. The lungs are located inside the chest and are covered by a two-layered membrane known as the pleura that allows it to move about while respiration takes place. The lungs guarantee that vital functions and homeostasis are maintained. Inhalation incorporates air intake in the diaphragm, intercostal muscles, and chest cavity volume, hence creating a negative pressure environment in the lungs. This allows oxygen, which cells use to carry on their activities, to be introduced into the cells while carbon dioxide, a metabolic waste product, is removed from the body's system.\u003c/p\u003e \u003cp\u003eThis is a passive process at rest, where the diaphragm and the external intercostal muscles relax and let the volume of the chest cavity decrease, thus letting air out of the lungs. This is a critical process in respiration since it is during expiration that the body eliminates the carbon dioxide-rich air built up during internal respiration. The connection between the relaxation of muscles with the alteration of pressure during expiration shows how the respiratory system is considered a functional unit. Lung volumes and capacities are the fundamental elements of assessment in the determination of respiratory function, diagnosis of pulmonary pathology, and management of lung health. The total maximum volume of air that the lungs can hold is the sum of the vital capacity and residual volume. The gas exchange takes place in the alveoli, where oxygen diffuses into the capillary blood and carbon dioxide diffuses from the blood into the lungs to be exhaled. This is made possible by the alveolar-capillary membrane that separates the alveoli from the capillary blood. Generally, the respiratory system contributes a lot in ensuring that the oxygen and carbon dioxide balance in the body is maintained. The transport of gases in our bodies is the role played by the respiratory system. Oxygen is transported by binding to hemoglobin on red blood cells, and carbon dioxide through a variety of mechanisms. Respiratory regulation is achieved by the coordination of several centers; including the modular rhythm city center and set basic rhythm pontine respiratory group (PRG), and other parts of the respiratory centers in the brainstem as well as the higher brain centers; mechanoreceptors within the airways and lungs. These centers harmonize to provide the delicate balance required for sustaining the breathing process that sustains life.\u003c/p\u003e \u003cp\u003eThe most common diseases afflicting children are acute lower respiratory tract infections (LRTI) infections, responsible for 15% of all deaths of children under the age of five. The burden is particularly extreme in low and middle-income countries as overcrowding, nutritional deficiencies, and lack of health care considerably contribute to the vulnerability of the young populations. Even in developed nations, LRTIs have posed significant economic burdens while demanding constant awareness, effective preventive measures, and adequate access to medical services.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEPIDEMIOLOGY\u003c/h3\u003e\n\u003cp\u003eThe epidemiology of LRTIs is affected by seasonal variation, where most series depict marked peaks during winters in temperate regions and rainy seasons in tropical areas. Infants and young children have an especially high susceptibility to infections due to a less developed immune system, with narrower airways compared to adults and older children. Early detection of these conditions, followed by swift intervention with proper therapy, is the key to managing respiratory conditions.\u003c/p\u003e \u003cp\u003eThe situation is more alarming in developing countries, where poverty, malnutrition, and poor health facilities prevail. Younger children, particularly infants and toddlers, are at a higher risk of developing ALRTIs because of their undeveloped immune systems and narrow airways. Health infrastructure, vaccination programs, and awareness of respiratory health are the key factors in minimizing the effects of ALRTIs in children. These strategies can be focused on the root determinants of respiratory infections, with better access to quality healthcare services, burden reduction, and better health results for children across the globe.\u003c/p\u003e\n\u003ch3\u003eETIOLOGY\u003c/h3\u003e\n\u003cp\u003eAcute respiratory tract infections or LRTIs among children are caused by several agents. Viruses account for approximately 90% of these infections. The main viral cause is the respiratory syncytial virus, which is present mainly in infants and young children. There is a fine balance between the infectious agent and the developing immune system of children, making it important to be very alert and take adequate preventive measures. Severe viral causes include influenza viruses, parainfluenza viruses, human meta-pneumo-virus, and adenoviruses. New corona viruses like SARS-CoV-2 brought a paradigm shift in the etiological scenario that underlines preparedness and rapid response strategies to control viral load and its consequences on public health. Bacterial pathogens, such as Streptococcus pneumonia and Homophiles influenza type b, play an important role in the etiology of serious lower respiratory tract infections due to higher rates of illness and death. Conjugate vaccines have significantly decreased the incidence and severity of bacterial LRTIs, thus reducing morbidity and mortality. Co-infections in respiratory diseases increase in importance and are under investigation due to complications they cause in the diagnostic and treatment modalities and because of the increased severity of diseases. To combat co-infections in respiratory health conditions, one must understand the mechanism underlying the disease progression; it requires approaches of diagnosis, distinguishing between the co-existing infections so that they can be treated according to specific target strategies.\u003c/p\u003e \u003cp\u003ePersonalized treatment approaches for specific cases should enhance the responsiveness of therapy as well as of active management of respiratory infections and subsequently optimize patient care and decrease burdens on healthcare. This study thus aims to innovate the current therapeutic as well as preventative measures with emerging profiles of changes in pathogenic varieties in constant respiratory infections.\u003c/p\u003e\n\u003ch3\u003ePATHOPHYSIOLOGY\u003c/h3\u003e\n\u003cp\u003eThe pathogenesis of ARTIs in children involves inflammation and injury of the lower airways as a result of viral or bacterial infections. Clinical presentation of ALRTIs can vary from a mild self-limiting illness to a severe, life-threatening disease that necessitates intensive care. Symptoms include cough, fever, tachycardia, and increased work of breathing.\u003c/p\u003e\n\u003ch3\u003eDIAGNOSIS\u003c/h3\u003e\n\u003cp\u003eDiagnosis is key in the management of the conditions and prevention of complications. The diagnosis process encompasses clinical assessment, laboratory tests, and imaging studies. The WHO has developed clinical criteria for pneumonia in children based on respiratory rate and chest in drawing, but these criteria have limited specificity and lead to over diagnosis and overuse of antibiotics.\u003c/p\u003e \u003cp\u003eMolecular methods, including PCR assays, have revolutionized the detection of viruses because of their sensitivity and ability to identify multiple pathogens in one test. Blood cultures from bacterial pathogens have low yields but remain important in severe cases. Newer techniques, like PCR-based detection of bacterial DNA in blood samples, promise a better future but are not widely available.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eMANAGEMENT:\u003c/h2\u003e \u003cp\u003eThe treatment for acute LRTIs in children is a multi-component therapy system that focuses on the disease severity and possible etiologic agents. It is based mainly on supportive care, which includes appropriate hydration, controlling fever, and oxygen supplementation, among others. Nutritional support is also considered essential, even more so when the setting of care is very resource-limited, as with malnutrition compounding the progression of the illness. Antibiotic treatment is typically given if there is an existing or suspected bacterial infection, but the empirical use of antibiotics in viral LRTIs results in antibiotic resistance. Bronchodilators and high-dose corticosteroids are given and advanced respiratory care in severe cases.\u003c/p\u003e \u003cp\u003ePREVENTION;\u003c/p\u003e \u003cp\u003ePrevention is key to the reduction of acute respiratory infections in children. This can be facilitated by vaccinations for S. pneumonia and RSV. Good hygiene includes hand washing, avoiding touching the face, and minimization of contact with infective individuals. A healthy lifestyle includes a diet, physical activity regularly, exclusive breastfeeding, and abstinence from smoking. The allergy and asthma have to be properly managed so as not to increase the respiratory infection. Awareness about vaccination should exist, and children should regularly undergo health checks by healthcare providers. Sanitization of toys and surfaces children are frequently exposed to will also decrease the rate at which germs spread. It would therefore require strict infection control practices in the healthcare institution, regular check-ups with health professionals, and regular vaccination to avoid the spread of nosocomial respiratory pathogens.\u003c/p\u003e \u003c/div\u003e"},{"header":"MATERIALS \u0026 METHODS","content":"\u003cp\u003eThe field practice areas of the Pediatric Department at the Government Teaching General Hospital, attached to a medical college at Rajahmundry, Andhra Pradesh, India conducted a community-based, Prospective observational Cohort study between August 2024 and January 2025.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eStudy design:\u0026nbsp;\u003c/strong\u003eA Prospective observational cohort study +\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eStudy site;\u0026nbsp;\u003c/strong\u003eThe study was conducted in the Pediatric Department of Government Teaching General District Hospital, Rajahmundry, Andhra Pradesh, India 533102.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eStudy period:\u0026nbsp;\u003c/strong\u003eFrom August 2024 to January 2025 for six months.\u0026nbsp;\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEthical Clarence / IRB:\u003c/strong\u003e We submitted research detailed protocol to the IRB/IEC committee Vikas Institute of Pharmaceutical Sciences approved our research with IRB/IEC number PD06/IRB/VIPS/2024-2025 under the same title(The assessment of prevalence of acute lower respiratory tract infection in pediatrics at Government teaching general hospital, Rajahmundry). Therefore, the institution guarantees that research within its college-attached hospital i.e Government Teaching General Hospital, Rajahmundry to research the pediatric population, Rajahmundry Government Teaching General Hospital is a tertiary care hospital multi-specialty wing separate block for pediatric patients in this two (2) pediatric units with fully latest equipped setup present in both units.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eStudy population:\u0026nbsp;\u003c/strong\u003e515 cases were collected from the pediatric department in the government teaching general hospital, Rajahmundry according to the study criteria. Our study starts data collection in 6 months (Aug 2024-Jan 2025) through close observation and recording of newly admitted cases. A cohort study is a group of patients (in this case, pediatric patients) with a specific focus on those who were diagnosed with acute lower respiratory tract infections (LRTI). The conditions included pneumonia, bronchitis, acute bronchitis, and bronchiolitis.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eInclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eChildren 1 month -14 yrs\u003c/li\u003e\n \u003cli\u003ePatients of either sex\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePatients with Co-morbid conditions\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePatients with any \u0026nbsp;psychiatric disorders\u003c/li\u003e\n \u003cli\u003ePatients with cancer-related problems\u003c/li\u003e\n \u003cli\u003ePresenting with the symptoms suggestive of an acute lower respiratory tract infection.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eExclusion Criteria:\u003c/strong\u003e\u003c/p\u003e\n\n\u003cul type=\"disc\"\u003e\n \u003cli\u003ePregnant and Lactating women\u003c/li\u003e\n \u003cli\u003ePatients with any \u0026nbsp;psychiatric disorders\u003c/li\u003e\n \u003cli\u003ePatients with cancer-related problems\u003c/li\u003e\n \u003cli\u003eChildren with chronic respiratory conditions (asthma, cystic fibrosis)\u003c/li\u003e\n \u003cli\u003eParents or guardians are those who are not willing to give consent.\u003c/li\u003e\n\u003c/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eData analysis:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study data was analyzed using SPSS ( version 30 2024 September ) descriptive statistics to understand information deeply. Software revealed patterns and key insights, producing valuable outcomes. Statistical techniques allowed a systematic analysis for clear conclusions.\u003c/p\u003e\n\n\n\n"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eTable 01;\u003c/strong\u003e Percentage of gender having particular disease condition\u003c/p\u003e\n\u003cdiv\u003e\n \u003cdiv align=\"left\"\u003e\u003cimg 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\"\u003e\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003eAcute LRTIs in children are mainly categorized into pneumonia, bronchiolitis, acute bronchitis, and bronchitis. Male predominance is found in most cases, with a male-to-female ratio of 53.2\u0026ndash;46.8%, respectively. Pneumonia prevails among all LRTIs, followed by bronchiolitis; the latter is more common in males. Bronchitis is the most common, with both sexes having a significant percentage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 02:\u0026nbsp;\u003c/strong\u003e Symptoms of Acute LRTI among pediatric patients (N=515)\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003eSYMPTOMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003eNumber of subjects (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssociated with FEVER\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e298 (57.86%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOLD/ Running nose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e395 (76.67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOUGH(dry/wet, with sputum)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e497 (96.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSORE THROAT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e106 (20.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLow saturation levels\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e121 (23.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssociated with tachycardia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e208 (40.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9029%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssociated with SOB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.27184%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 45.8252%;\"\u003e\n \u003cp\u003e113 (22%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv\u003eAcute LRTIs in children often present with cough, cold/running nose, fever, tachycardia, low oxygen saturation, shortness of breath, and sore throat, necessitating comprehensive symptom analysis for appropriate treatment.\u003c/div\u003e\n\u003cdiv id=\"Sec14\"\u003e\n \u003ch2\u003eGENDER DISTRIBUTION\u003c/h2\u003e\n \u003cp\u003eA study found a significant peak in lower respiratory tract infections among children aged 4\u0026ndash;6 years, with around 234 cases. Male children had a higher prevalence, with 115 cases compared to females. Age-specific trends showed that the incidence was moderate in the 1\u0026ndash;3 years age group, moderate in the 7\u0026ndash;9 years age group, and low among children aged 10 years and above. There is a need for increased surveillance measures in the 4\u0026ndash;6 age group and age-specific preventive measures among young male children.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTable 03:\u0026nbsp;\u003c/strong\u003e Factors associated with \u0026nbsp;acute LRTI in pediatrics (N=515)\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVARIABLE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCATEGORY\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNO.OF SUBJECTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEARSON CHI-SQUARE VALUE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e\u003cstrong\u003edf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-VALUE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncidence rate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eAge in years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003e1-3\u003c/p\u003e\n \u003cp\u003e4-6\u003c/p\u003e\n \u003cp\u003e7-9\u003c/p\u003e\n \u003cp\u003e10 \u0026amp; above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e131(25.4%)\u003c/p\u003e\n \u003cp\u003e227(44.3%)\u003c/p\u003e\n \u003cp\u003e104(20.1%)\u003c/p\u003e\n \u003cp\u003e53(10.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003ePeak IR 4 years\u003c/p\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e high in 5 years old\u003c/p\u003e\n \u003cp\u003eLowest-13 yars\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e274(53.2%)\u003c/p\u003e\n \u003cp\u003e241(46.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003eTribal(agency)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e169 (32.8%)\u003c/p\u003e\n \u003cp\u003e194 (37.3%)\u003c/p\u003e\n \u003cp\u003e152 (29.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e34.56%\u003c/p\u003e\n \u003cp\u003e34.95%\u003c/p\u003e\n \u003cp\u003e30.29%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eBirth weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003eBelow 2kg\u003c/p\u003e\n \u003cp\u003e2-3kg\u003c/p\u003e\n \u003cp\u003e3kg \u0026amp; above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e194 (37.7%)\u003c/p\u003e\n \u003cp\u003e213 (41.3%)\u003c/p\u003e\n \u003cp\u003e108 (21%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e36.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e37.7%\u003c/p\u003e\n \u003cp\u003e41.3%\u003c/p\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eMother education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003eUneducated\u003c/p\u003e\n \u003cp\u003e1-10\u003csup\u003eth\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003eInter\u003c/p\u003e\n \u003cp\u003eDegree/PG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e181(35.1%)\u003c/p\u003e\n \u003cp\u003e236(46.8%)\u003c/p\u003e\n \u003cp\u003e58 (11.2%)\u003c/p\u003e\n \u003cp\u003e40 (6.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e35.15%\u003c/p\u003e\n \u003cp\u003e46.8%\u003c/p\u003e\n \u003cp\u003e11.2%\u003c/p\u003e\n \u003cp\u003e6.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eNo.of siblings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e\u0026gt; 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e246 (47.8%)\u003c/p\u003e\n \u003cp\u003e250 (48.5%)\u003c/p\u003e\n \u003cp\u003e19 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e22.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003e01\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e\u0026gt; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e246 (47.8%)\u003c/p\u003e\n \u003cp\u003e250 (48.5%)\u003c/p\u003e\n \u003cp\u003e19 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e22.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.047%;\"\u003e\n \u003cp\u003eDuration of breastfeed\u003c/p\u003e\n \u003cp\u003e(months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.674%;\"\u003e\n \u003cp\u003e\u0026lt;6 months\u003c/p\u003e\n \u003cp\u003e6-12 months\u003c/p\u003e\n \u003cp\u003e12-18months\u003c/p\u003e\n \u003cp\u003e18 \u0026amp; more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8903%;\"\u003e\n \u003cp\u003e2(0.39%)\u003c/p\u003e\n \u003cp\u003e90(17.31%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;197(37.3%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;232(45.%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.7335%;\"\u003e\n \u003cp\u003e23.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.8527%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.1066%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.6959%;\"\u003e\n \u003cp\u003e0.39%\u003c/p\u003e\n \u003cp\u003e17.31%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;37.3%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;45.%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cdiv\u003eThe age-specific distribution of acute lower respiratory tract infections (ARRIs) in children is such that they peak at 4\u0026ndash;6 years of age and taper off with increasing age. The highest incidences in preschool and early school-age children, 4\u0026ndash;6, are decreasing. Preventive measures should be age-oriented with intervention strategies set around the younger pediatric population, and education to parents on early childhood.\u003c/div\u003e\n \u003cp\u003eThe study reveals an equal burden of LRTI in the major residential areas, with minimum cases being reported from tribal areas. Most cases are reported among mothers with education, high among illiterate mothers. The research underlines the significance of maternal education in preventing LRTI, along with the need for equity in healthcare access to focus on less-educated populations for preventive strategies.\u003c/p\u003e\n \u003cp\u003eThis indicating breastfeeding duration patterns in pediatric ALRTI cases at Government Teaching General Hospital Rajahmundry, the following is a key discussion:\u003c/p\u003e\n \u003cp\u003eThe data reveals an inverse relationship between the duration of breastfeeding and prevalence of acute lower respiratory tract infections (ALRTI):\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eThe duration of breastfeed highest cases (230) were reported in infants who were breastfed for up to 6 months, suggesting that early breastfeeding protection was inadequate.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eCases decreased (190) in the 6\u0026ndash;12 month group, indicating potential protective effects of continued breastfeeding\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eFurther reduction (90) in 12\u0026ndash;18 month group demonstrates extended breastfeeding\u0026apos;s protective role\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eNotably absent cases in 18\u0026thinsp;+\u0026thinsp;months category supports WHO recommendations for extended breastfeeding\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n \u003cp\u003eThese results demonstrates immunological benefits of breast milk. Implication for strengthening breastfeeding promotion in the first 6 months. Continued breastfeeding beyond 6 months for prevention of ALRTI. The importance of maternal education on optimal breastfeeding duration. Improve lactation support services particularly for mothers with infants aged\u0026thinsp;\u0026lt;\u0026thinsp;6 months. Institute educational programs on benefits of extended breastfeeding. Direct preventive efforts towards infants whose breastfeeding duration is less.\u003c/p\u003e\n \u003cp\u003eThe analysis of 234 pediatric pneumonia patients using the CURB-65 scale the following distribution:\u003c/p\u003e\n \u003cp\u003eRisk Category Summary:\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eScore 0: 19 patients (8.11%) - Very low risk\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eScore 1: 114 patients (48.5%) - Low risk\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eScore 2: 67 patients (28.5%) - Moderate risk\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eScore 3: 29 patients (12.84%) - Severe risk\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eScore 4: 5 patients (2.1%) - Very severe risk\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eScore 5: 0 patients (0%) - Highest risk\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n \u003cp\u003e\u003cstrong\u003eTable 04;\u0026nbsp;\u003c/strong\u003eCURB Scale results distributions\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;S.N\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSCORE CATEGORY\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNO.OF SUBJECTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; PERCENTAGE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;RISK CATEGORY\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003col\u003e\n \u003cli\u003e\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Score 0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 19 patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 8.11 % \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Very low risk\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003e\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Score 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;114 patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 48.5% \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Low risk\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003e\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Score 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 67 patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;28.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Moderate risk\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003e\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Score 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 27 patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 12.84 % \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Severe risk\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003e\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Score 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 03 patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.1 % \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Very severe risk\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.84%;\"\u003e\n \u003col start=\"6\"\u003e\n \u003cli\u003e\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Score 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.16%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 0 patients\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.08%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0 % \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.76%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Highest risk\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eThe majority of patients (56.6%) fall into the very low \u0026amp; low-risk category, suggesting good prognosis for most cases\u003c/li\u003e\n \u003cli\u003eNearly one-third of patients (28.5%) require moderate intervention\u003c/li\u003e\n \u003cli\u003eA significant minority (12.8%) present with severe pneumonia requiring intensive care\u003c/li\u003e\n \u003cli\u003eNo patients scored the maximum of 5 points, which is expected in a pediatric population\u003c/li\u003e\n \u003c/ol\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eAge Profile: Peak incidence at 4\u0026ndash;6 years (44.3% of cases), suggesting a vulnerable age due to an underdeveloped immune system and increased exposure in daycare/school environments.\u003c/p\u003e \u003cp\u003eIncidence decreases with age, suggesting improved immune maturation and reduced contact exposure with pathogens in confined environments.\u003c/p\u003e \u003cp\u003eGender Profile: Male children were more prone, with a prevalence of 53.2%, which may be attributed to biological and environmental factors that impact vulnerability.\u003c/p\u003e \u003cp\u003eSymptoms: High prevalence of cough (96.5%), cold/runny nose (76.67%), and fever (57.86%) underscores the common presentation of ALTAI. The presence of low saturation of oxygen (23.4%) and tachycardia (40.6%) underscores the severity of respiratory distress in some cases. Early treatment of common presentations such as cough and fever can prevent the condition from turning serious.\u003c/p\u003e \u003cp\u003eMaternal education emerged as a very significant predictor: Higher prevalence in children of mothers with lesser educational background. Health education and related programs need to be targeted toward reducing the LIT risk. Residential Distribution: It was similar between rural and urban settings, signifying balanced exposure, though fewer cases were seen in tribal settings. Duration of Breastfeeding Prolonged breastfeeding for more than six months was inversely proportional to the occurrence of ALTAI. Strengthening the WHO recommendations on extended breastfeeding for better protection against respiratory infections.\u003c/p\u003e \u003cp\u003eSeverity Evaluation (CURB-65 Scale)\u003c/p\u003e \u003cp\u003eThe majority of patients, 57.3%, were at low risk and required less intervention. The severe cases were few, only 13.6%, and thus required high-level care. Early diagnosis is essential.\u003c/p\u003e \u003cp\u003ePreventive Measures and Advice Immunization: Flu and pneumococcal vaccines to reduce bacterial and viral infections. Education: Healthcare providers should be trained and educated about symptom identification and management in the community. Nutrition and Hygiene Promotion of improved breastfeeding and nutrition along with hygiene measures for prevention Access to health care Equal access should be made available in all residential zones. 8. Future Work Studying symptom patterns and their relationship with seasonal fluctuations and severity Investigating gender-specific susceptibility and intervention to achieve better results Development of more precise diagnostic methods and treatment plans for complex cases with co-infections.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003ePneumonia is the most prevalent disease, accounting for 45.4% of cases, largely due to delayed healthcare, low vaccination rates, poor hygiene, overcrowding, poor nutrition, and indoor air pollution, with age-related risk factors.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eALRTI\u003c/strong\u003e \u0026ndash; Acute Lower Respiratory Tract Infection\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eCRP\u003c/strong\u003e \u0026ndash; C-Reactive Protein\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eCURB-65\u003c/strong\u003e \u0026ndash; Clinical scoring system for pneumonia severity\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIEC\u003c/strong\u003e \u0026ndash; Institutional Ethics Committee\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIRB\u003c/strong\u003e \u0026ndash; Institutional Review Board\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eLRTI\u003c/strong\u003e \u0026ndash; Lower Respiratory Tract Infection\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003ePCR\u003c/strong\u003e \u0026ndash; Polymerase Chain Reaction\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003ePRG\u003c/strong\u003e \u0026ndash; Pontine Respiratory Group\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eRSV\u003c/strong\u003e \u0026ndash; Respiratory Syncytial Virus\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSPSS\u003c/strong\u003e \u0026ndash; Statistical Package for the Social Sciences\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eWHO\u003c/strong\u003e \u0026ndash; World Health Organization\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eVentre K, Randolph A. Ribavirin for respiratory syncytial virus infection of the lower respiratory tract in infants and young children. Cochrane Database of Systematic Reviews. 2010 May 12;2010(5).\u003c/li\u003e\n\u003cli\u003eTrifonova I. viral pathogens causing acute lower respiratory tract infections in children under 5 years old in bulgaria [Internet]. Morressier; 2018 May [cited 2024 Sep 5].Available from: http://dx.doi.org/10.26226/morressier.5ad774dcd462b80296ca66bc. \u003c/li\u003e\n\u003cli\u003eDangor Z, Verwey C, Lala SG, Mabaso T, Mopeli K, Parris D, et al. Lower Respiratory Tract Infection in Children: When Are Further Investigations Warranted? Frontiers in pediatrics. 2021 Jul 28;9:708100.\u003c/li\u003e\n\u003cli\u003eNguyen L, Moore L. Early-life Respiratory Tract Infections and the Risk of School-age Lower Lung Function and Asthma: a Meta-analysis of 150\u0026thinsp;000 European Children. Pediatrics. 2023 Dec 1;152(Supplement 3):S44\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eStockman JA III. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Yearbook of Pediatrics. 2012 Jan;2012:530\u0026ndash;1.\u003c/li\u003e\n\u003cli\u003eOnakpoya IJ, Hayward G, Heneghan CJ. Antibiotics for preventing lower respiratory tract infections in high-risk children aged 12 years and under. Cochrane Database of Systematic Reviews. 2015 Sep 26;2015(9). \u003c/li\u003e\n\u003cli\u003eLower Respiratory Tract Infections. In: Comprehensive Pediatric Hospital Medicine [Internet]. Elsevier; 2007 [cited 2024 Sep 5]. p. 382\u0026ndash;93. Available from: http://dx.doi.org/10.1016/b978-032303004-5.50071-5.\u003c/li\u003e\n\u003cli\u003eVan Woensel JBM. Viral lower respiratory tract infection in infants and young children. British Medical Journal. 2003 Jul 3;327(7405):36\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eAbha P, Deepti P. Risk factors of acute lower respiratory tract infection: a study in hospitallized central Indian children under 5 year age. MOJ Current Research \u0026amp;amp; Reviews. 2018 Jun 12;1(3):129\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eDe Benedictis FM, Bush A. Recurrent lower respiratory tract infections in children. British Medical Journal. 2018 Jul 12;327(7):k2698. \u003c/li\u003e\n\u003cli\u003eMirkarimi M, Alisamir M, Saraf S, Heidari S, Barouti S, Mohammadi S. Clinical and Epidemiological Determinants of Lower Respiratory Tract Infections in Hospitalized Pediatric Patients. International Journal of Pediatrics. 2020 Nov 17;2020(2):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eNohynek H. The Causes of Hospital-Treated Acute Lower Respiratory Tract Infection in Children. Archives of Pediatrics \u0026amp;amp; Adolescent Medicine. 1991 Jun 1;145(6):618. \u003c/li\u003e\n\u003cli\u003eTrisorus T, Samransamraujkit R, Deerojanawong J, Sritippayawan S, Prapphal N. Clinical severity and iPFT compare between subgroups of respiratory syncytial virus in children hospitalized with acute lower respiratory tract infection. Paediatric Respiratory Reviews. 2012 Jun;13(9):S59. \u003c/li\u003e\n\u003cli\u003eKhalid S, Ghani E. Study on Etiology of Viral Lower Respiratory Tract Infections in Children Under 10 Years of Age. Journal of Virology \u0026amp; amp; Antiviral Research. 2016;05(04). \u003c/li\u003e\n\u003cli\u003eKevin Purcell\u003csup\u003e \u003c/sup\u003e, Jaime Fergie concurrent serious bacterial infections in 2396 infants and children hospitalized with respiratory syncytial virus lower respiratory tract infections. The Pediatric Infectious Disease Journal. 2002 Sep;21(9):889\u0026ndash;90. \u003c/li\u003e\n\u003cli\u003eRama krishnan K, Harish PS. Hemoglobin level as a risk factor for lower respiratory tract infections. The Indian Journal of Pediatrics. 2006 Oct;73(10):881\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eChoi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, et al. The Association of Newly Identified Respiratory Viruses with Lower Respiratory Tract Infections in Korean Children, 2000\u0026ndash;2005. Clinical Infectious Diseases. 2006 Sep;43(5):585\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003eJartti T, S\u0026ouml;derlund-Venermo M, Hedman K, Ruuskanen O, M\u0026auml;kel\u0026auml; MJ. New molecular virus detection methods and their clinical value in lower respiratory tract infections in children. Paediatric Respiratory Reviews. 2013 Mar;14(1):38\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eLiu Y, Liu J, Chen F, Shamsi BH, Wang Q, Jiao F, et al. Impact of meteorological factors on lower respiratory tract infections in children. Journal of International Medical Research. 2015 Dec 10;44(1):30\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eSismanlar T, Aslan AT, Gulbahar O, Ozkan S. The effect of vitamin D on lower respiratory tract infections in children. T\u0026uuml;rk Pediatri Arşivi. 2016 May 4;51(2):94\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eCazan C. vitamin d deficiency as risk factor for severity of acute lower respiratory tract infections. [Internet]. Morressier; 2016 Oct [cited 2024 Sep 5]. Available from: http://dx.doi.org/10.26226/morressier.57d034d2d462b80292383887. \u003c/li\u003e\n\u003cli\u003eVitamin D Status and Lower Respiratory Tract Infections. AAP Grand Rounds. 2016 Jul 1;36(1):9\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eGreenbaum AH, Chen J, Reed C, Beavers S, Callahan D, Christensen D, et al. Hospitalizations for Severe Lower Respiratory Tract Infections. Pediatrics. 2014 Sep 1;134(3):546\u0026ndash;54. \u003c/li\u003e\n\u003cli\u003eCampbell A, Kerkar N. Reduced respiratory syncytial virus lower respiratory tract infections and hospitalizations in pediatric liver transplant recipients with palivizumab. Transplantation. 2008 Jul 27;86(2S):715. \u003c/li\u003e\n\u003cli\u003ePatria MF, Esposito S. Recurrent Lower Respiratory Tract Infections in Children: A Practical Approach to Diagnosis. Paediatric Respiratory Reviews. 2013 Mar;14(1):53\u0026ndash;60.\u003c/li\u003e\n\u003cli\u003eIsaacs D, Clarke JR, Tyrrell DA, Valman HB. Selective infection of lower respiratory tract by respiratory viruses in children with recurrent respiratory tract infections. British Journal of medicine. 1982 Jun 12;284(6331):1746\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eBaer G, Baumann P, Buettcher M, Heininger U, Berthet G, Sch\u0026auml;fer J, et al. Procalcitonin Guidance to Reduce Antibiotic Treatment of Lower Respiratory Tract Infection in Children and Adolescents (ProPAED): A Randomized Controlled Trial. PLOS ONE. 2013 Aug 6;8(8). \u003c/li\u003e\n\u003cli\u003eFranz A, Adams O, Willems R, Bonzel L, Neuhausen N, Schweizer-Krantz S, et al. Correlation of viral load of respiratory pathogens and co-infections with disease severity in children hospitalized for lower respiratory tract infection. Journal of Clinical Virology. 2010 Aug;48(4):239\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eAkkoc G. Evaluation of viral respiratory pathogens in children aged under five hospitalized with lower respiratory tract infections. Northern Clinics of Istanbul. 2021;2(1). \u003c/li\u003e\n\u003cli\u003eEski A, Ozturk GK, Gulen F, \u0026Ccedil;ecek C, Demir E. Risk Factors for Influenza Virus Related Severe Lower Respiratory Tract Infection in Children. Pediatric Infectious Disease Journal. 2019 Nov;38(11):1090\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eSommer C. Risk Factors for Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection. The Open Microbiology Journal. 2011 Dec 30;5(1):144\u0026ndash;54.\u003c/li\u003e\n\u003cli\u003eHussain SQ. Low Hemoglobin Level a Risk Factor for Acute Lower Respiratory Tract Infections (ALRTI) in Children. journal of clinical and diagnostic research. 2014;145(6).\u003c/li\u003e\n\u003cli\u003eChinawa A, Chinawa J, Nduagubam O, Chukwu B, Nwokoye I, Amadi O, et al. Clinical Profile, Severity Pattern and Socio-demographic Risk Factors of Acute Lower Respiratory Tract Infection (ALRTI) in Children in Enugu, Nigeria. Current Respiratory Medicine Reviews. 2021 Jan 18;16(2):123\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003eMalla T, Pathak OK, Malla KK. Is Low Hemoglobin Level a Risk Factor for Acute Lower Respiratory Tract Infections? Journal of Nepal Paediatric Society. 2009 Dec 25;30(1):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eXavier H, Turner S. Epidemiology of lower respiratory tract infections. In: ERS Handbook of Paediatric Respiratory Medicine [Internet]. The European Respiratory Society;2021p.797\u0026ndash;805. http://dx.doi.org/10.1183/9781849841313.003219. \u003c/li\u003e\n\u003cli\u003eYıldırım S, Sarı K, Ko\u0026ccedil; M, \u0026Ouml;cal Demir S. Evaluation of Etiologic Agents of Lower Respiratory Tract Infections in Children Hospitalized Just Before Normalization of COVID-19. The Journal of Pediatric Academy. 2024 Mar 6;327(9). \u003c/li\u003e\n\u003cli\u003eAcute Lower Respiratory Tract Infection. In: Medical Management of Pulmonary Diseases [Internet]. CRC Press; 1999 [cited 2024 Sep 5]. p. 323\u0026ndash;4. Available from: http://dx.doi.org/10.1201/9781482276756-68. \u003c/li\u003e\n\u003cli\u003eYanagihara K. The role of molecular diagnosis in acute respiratory tract infection. Respiratory Investigation. 2019 Nov;57(6):511. \u003c/li\u003e\n\u003cli\u003eJoseph P Mizgerd\u003csup\u003e \u003c/sup\u003eAcute Lower Respiratory Tract Infection. Pediatric Infectious Disease Journal. 2008 Jun;27(6):577. \u003c/li\u003e\n\u003cli\u003eWorld health organization(WHO) , October 03 2024, https://www.who.int/home/search-results?indexCatalogue=genericsearchindex1\u0026amp;searchQuery=LOWER%20RESPIRATORY%20TRACT\u003cbr\u003e%20INFECTION\u0026amp;wordsMode=AnyWord. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"VIKAS INSTITUTE OF PHARMACEUTICAL SCIENCES ","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":false,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute Lower Respiratory Tract Infection, Pneumonia, Bronchiolitis, Pediatric Health, Risk Factors, Prevention","lastPublishedDoi":"10.21203/rs.3.rs-6164269/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6164269/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003eAcute Lower Respiratory Tract Infection (LRTI) remains a major health concern among pediatric patients, significantly contributing to morbidity and mortality. This study assesses the prevalence, distribution patterns, and key socio-demographic factors influencing LRTI incidence in children in and around Rajahmundry, Rampachodavaram, and West Godavari.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e 515 pediatric patients were included in this prospective cohort study from August 2024 to January 2025. Pneumonia was the most common condition (45.4%, n=234), followed by bronchiolitis (23.3%, n=120), bronchitis (18.3%, n=94), and acute bronchitis (13%, n=67). Males (53.2%) were affected slightly more than females (46.8%). The highest incidence was observed in children aged 4-6 years (44.3%). Key socio-demographic risk factors included low maternal education, inadequate breastfeeding duration, and low birth weight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003ePneumonia is the most prevalent LRTI in this region. Socioeconomic factors, including maternal education, birth weight, and breastfeeding practices, play a crucial role in disease incidence. Addressing these factors through targeted interventions can help reduce the burden of LRTI in pediatric populations. The study findings provide valuable insights for healthcare providers and policymakers to enhance preventive strategies and pediatric healthcare services.\u003c/p\u003e","manuscriptTitle":"Assessment and Prevalence of Acute Lower Respiratory Tract Infections in Pediatrics in Tertiary Care Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-11 07:19:45","doi":"10.21203/rs.3.rs-6164269/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"891c4ca0-4753-4acb-a152-5646edc048b5","owner":[],"postedDate":"March 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":45337572,"name":"Pediatrics"}],"tags":[],"updatedAt":"2025-03-11T07:19:46+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-11 07:19:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6164269","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6164269","identity":"rs-6164269","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}