Modifiable Demographic Factors that Differentiate Bronchiolitis from Pneumonia in Nepalese Children Less Than Two Years – A Hospital Based Study

Abstract

Background
Bronchiolitis and pneumonia is an important cause of mortality and morbidity in children. Various risk factors make these children more prone for this illness. There is limited data on the risk factors from this part of the world. Moreover there is a significant clinical overlap between bronchiolitis and pneumonia thus necessitating the need for evaluating their demographic difference.

Objective
To evaluate the modifiable demographic risk factors for bronchiolitis and pneumonia in children less than 2 years.

Method
A prospective, comparative hospital based study undertaken during March 2012- March 2013 in Manipal Teaching Hospital, Pokhara. Altogether 200 cases of bronchiolitis and 200 cases of pneumonia, in the age group of 2 to 24 months, were randomly selected for comparison of risk factors as per a predesigned proforma. A ‘p’ value of <0.05 was considered statistically significant. Data was analyzed by using SPPS version 16.

Result
The significant risk factors for bronchiolitis were age < 6 months (p<0.001), prematurity (p<0.001),male(P<0.04), younger maternal age (p< 0.009), poor maternal knowledge (p<0.013), air pollution and lack of ventilation (p<0.001), exposure to cooking fuel – kerosene (p<0.007), firewood (p<0.001) , tobacco smoke (p<0.001), overcrowding (0.008), winter season (p<0.015), domestic pets (p<0.003), low birth weight (p<003), use of animal milk (p<0.001).The significant risk factors for pneumonia were age 13 months- 24 months, maternal age 26- 35 yrs (p<0.009), female (p< 0.04), malnutrition, lack of Vitamin A supplementation and immunization (p<0.001).

Conclusion
Most of the risk factors for bronchiolitis and pneumonia identified in this study were modifiable; hence could be prevented to decrease the burden of both the diseases.

Kathmandu University Medical Journal Vol.12(3) 2014; 175-180