Clinico-etiological profile and outcome of pneumonia in under five children with special reference to severe acute malnutrition

Pneumonia is the leading cause of morbidity and mortality in children in developing countries. Pneumonia is the most common cause of death in under-five children, responsible for 18% deaths in this age-group and more than 50% percent of death associated with malnutrition. According to UNICEF in 2018 over 800000 children death due to pneumonia and around 2200 per day and in south east Asia 2500 case per 100000 childeren. In India pneumonia killed more than127000 under five children in 2018 and 50% death associated with severe acute malnutrition (SAM). To know the incidence, prevalence, clinical presentation etc. of pneumonia in SAM and various factors affecting its outcome. After getting clearance from the institutional clearance committee this hospital based observational study was done in the Nutritional Rehabilitation Centre of SVP PG Institute of Pediatrics & SCB Medical College, Cuttack from October 2019 to September 2021. The overall prevalence of pneumonia in SAM children in our study was 46.2%. Children aged 6-12 months (40% of total study population) were more vulnerable group for pneumonia with SAM. The most organisms isolated from blood cultures are Staphylococcus aureus followed by klebsiella, streptococcus, GDS, acinetobactor, pseudomonas, CONS, . 114 patients (93.4%) were cured and discharged with variable number of admission days and 8 patients (mortality 6.6%) died due to various complications with pneumonia. Protein Energy Malnutrition and Pneumonia associated with protein energy malnutrition is very much prevalent in this region of our country and its severe form can contribute to significant mortality and morbidity for the under-five children in general and 6-12 month of age in particular. The hospital stay prolonged in pneumonia with SAM children as compared to SAM children with other morbidity.