Prevalence and Outpatient Clinical Diagnostic Approaches for Common Acute Respiratory Tract Infections in Children Under Five Years of Age: A Cross-Sectional Study

Abstract

Background

Acute respiratory tract infections are among the leading causes of child morbidity and mortality worldwide. Although the diagnosis of acute respiratory tract infections requires simple outpatient medical techniques and care, it is still misdiagnosed among primary care physicians, leading to delayed treatment and increased mortality. This study described the prevalence of common acute respiratory tract infections and simple techniques that effectively detect and diagnose children presenting with acute respiratory symptoms to primary healthcare physicians in remote settings.

Patients and Methods

This descriptive cross-sectional study was conducted at the pediatric outpatient clinic of a tertiary hospital in western Uganda in April, May and June 2019. A total of 896 children aged 2–59 months attending the clinic were recruited consecutively into the study and examined for the presence of acute respiratory infection. Participants’ sociodemographic and clinical data were collected through history taking and clinical examination using a validated Uganda Ministry of Health Uganda outpatient clinical checklist (FORM 5). The outcome variable was the presence of an acute upper or lower respiratory condition. Data was analyzed using STATA version 13.0 (StataCorp, College Station, USA) and summarized using descriptive statistics.

Results

The overall period prevalence of acute respiratory tract infections among children aged 2 to 59 months was 36.9% (36,942 per 100,000 population). Upper respiratory tract infections with a prevalence of 24.8% were more common than lower respiratory tract infections. The most frequent upper respiratory tract infection in this setting was common cold (52%), followed by tonsillopharyngitis (10.7%), while pneumonia (26%) was the most frequent lower respiratory tract infection.

Conclusion

Acute respiratory tract infections contribute to the high burden of disease in pediatric outpatient clinics. Simple, affordable, and approved diagnostic clinical techniques that involve physical examination of the upper and lower respiratory systems can precisely diagnose acute respiratory tract infections in resource-limited settings where there is no access to sophisticated diagnostic equipment.

Keywords:

• acute respiratory tract infections
• outpatient diagnosis
• children aged 2 to 59 months

Abbreviations

ARIs, Acute Respiratory Infections; WHO, World Health Organization; IMCI, Integrated Management of Childhood Illnesses; GINA, Global Initiative for Asthma; REC, Research Ethics Committee.

Data Sharing Statement

The dataset will be shared by the corresponding author upon request.

Ethical Considerations

Ethical approval was obtained from the research ethics committee (REC) of Kampala International University (No: UG-REC-023/201902). Informed consent was sought from each child’s parent/caretaker, and the purpose of the study was well explained to the parents/caregivers before administering the questionnaire. The study was conducted in accordance with the ethical principles and regulations set in the Declaration of Helsinki regarding biomedical research involving human subjects.

Acknowledgment

We thank the radiologists and nursing staff of Kampala International University Teaching Hospital who helped with patient clerkship, chest radiography and interpretation. This research article is part of the Thesis for the Award of Masters of Medicine in Pediatrics and Child Health; therefore, we thank all other pediatricians at Kampala International University Teaching Hospital for their guidance throughout the study.

This research article is the second of the article series of the Pneumonia Study conducted at Kampala International University Teaching Hospital.³¹

Author Contributions

All authors made substantial contributions to the conception and design of the study, acquisition of data, or data analysis and interpretation, took part in drafting the article or revising it critically for important intellectual content, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that there is no conflict of interest regarding the publication of this paper.

Additional information

Funding

There was no funding for this research; it was part of the thesis for the award of Masters of Medicine in Pediatrics and Child Health of Kampala International University.