Gamal Yasser, Mahmoud Asmaa O, Mohamed Sherif A A, I Mohamed Jaafar, Raheem Yasser F Abdel
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
Eur J Pediatr. 2023 Oct;182(10):4583-4593. doi: 10.1007/s00431-023-05138-2. Epub 2023 Aug 5.
Malnutrition has adverse impacts on under-five children with pneumonia. The purpose of this study was to address the prevalence and impact of malnutrition on under-five years children with pneumonia, admitted to a tertiary large children hospital in Upper Egypt. This study is a prospective case-control study. All under-five children diagnosed with pneumonia who were admitted to Assiut University Children's Hospital (AUCH) from January 1 to December 31st, 2021, were enrolled. Based on their nutritional assessment, the studied participants were classified into 2 groups: (1): Children with pneumonia and with nutritional deficiency considered as cases, and (2): Children with pneumonia and without nutritional deficiency considered as controls. Three hundred-fifty cases and 154 control subjects were enrolled, respectively. 93.4%, 31.1%, and 61.7% of the cases had underweight, stunting, and wasting, respectively. Among those cases, there were significant differences between survivors and non-survivors with regard to some clinicodemographic factors, laboratory parameters, and anthropometric parameters. Lack of compulsory vaccination, presence of sepsis, and blood transfusion (OR 2.874, 95% CI 0.048 - 2.988, p = 0.004, 2.627, 0.040 - 2.677, p = 0.009, and 4.108, 0.134 - 3.381, p < 0.001, respectively) were significant independent predictors for mortality among malnourished children with pneumonia. Conclusion: Malnutrition has a high prevalence in under-five children with pneumonia in our locality. It has adverse effects on the outcomes and in-hospital mortality of those children. Lack of compulsory vaccination, presence of sepsis, and blood transfusion were significant independent predictors of mortality in malnourished children with pneumonia. Larger multicenter studies are warranted. What is Known: • Malnutrition has adverse impacts on under-five children with pneumonia. • Malnutrition could be a reason for in-hospital mortality among under-five children with pneumonia. What is New: • Malnutrition has a high prevalence in under-five children with pneumonia in Upper Egypt, with its adverse effects on the outcomes and mortality of those children. • Lack of vaccination, presence of sepsis, and blood transfusion are significant independent predictors of mortality in malnourished children with pneumonia in Upper Egypt.
营养不良对五岁以下患肺炎儿童有不利影响。本研究的目的是探讨营养不良在上埃及一家大型三级儿童医院收治的五岁以下肺炎儿童中的患病率及其影响。本研究是一项前瞻性病例对照研究。纳入了2021年1月1日至12月31日期间入住阿斯尤特大学儿童医院（AUCH）的所有诊断为肺炎的五岁以下儿童。根据营养评估，将研究参与者分为两组：（1）患有肺炎且有营养缺乏的儿童作为病例组，（2）患有肺炎但无营养缺乏的儿童作为对照组。分别纳入了350例病例和154例对照。病例组中分别有93.4%、31.1%和61.7%的儿童体重不足、发育迟缓及消瘦。在这些病例中，幸存者和非幸存者在一些临床人口统计学因素、实验室参数和人体测量参数方面存在显著差异。未进行强制疫苗接种、存在败血症和输血（比值比分别为2.874，95%置信区间0.048 - 2.988，p = 0.004；2.627，0.040 - 2.677，p = 0.009；4.108，0.134 - 3.381，p < 0.001）是营养不良的肺炎儿童死亡的显著独立预测因素。结论：在我们当地，营养不良在五岁以下肺炎儿童中患病率很高。它对这些儿童的预后和住院死亡率有不利影响。未进行强制疫苗接种存在败血症和输血是营养不良的肺炎儿童死亡的显著独立预测因素。有必要开展更大规模的多中心研究。已知信息：• 营养不良对五岁以下患肺炎儿童有不利影响。• 营养不良可能是五岁以下肺炎儿童住院死亡的一个原因。新发现：• 在上埃及，营养不良在五岁以下肺炎儿童中患病率很高，对这些儿童的预后和死亡率有不利影响。• 未接种疫苗、存在败血症和输血是上埃及营养不良的肺炎儿童死亡的显著独立预测因素。
