Kathmandu University Hospital, Nepal
Abstract:
Background: Lower respiratory tract infection (LRTI) is the leading cause of morbidity in children under five and contributes to long?term impairment in pulmonary function. The aim of this study was to evaluate 12-month outcomes of LRTI by pathogen detected in upper airway, assessed by pulmonary function tests and recurrent respiratory symptoms.
Methods: This prospective cohort study including children 1-59 months of age, included 250 LRTI and 210 healthy controls from Oct 2023 to Oct 2025 at a tertiary hospital in Dhulikhel, Nepal. Participants underwent clinical examinations and nasopharyngeal swabs tested 23 respiratory pathogens. Respiratory symptoms were prospectively documented over 12 months, and pulmonary function was assessed using tidal breathing flow?volume loops (TBFVL) in children under 24 months.
Results: Children with LRTI represented families with lower education, higher levels of indoor pollution and poorer housing conditions compared to the healthy group. Health facility visits for respiratory illness within 12 months were 43.3% and 44.8% after respiratory syncytial virus (RSV) and rhinovirus (RV) detection compared to 25.9 and 27.5 % after other pathogens or no pathogen detection, respectively. Obstructive breathing pattern was indicated in TBFVL by a tPTEF/tE ratio <20%, observed in 37.5% of RSV, 42.9% of RV, p- values 0.06 and 0.04 compared to other LRTIs (7.1 %).
Conclusion: This study identified disadvantageous sociodemographic and environmental factors in children with LRTI compared to healthy children. At 12?month follow?up, those with RSV or RV detection during LRTI more frequently exhibited recurrent respiratory symptoms and obstructive breathing patterns.
Keywords: Lower?respiratory tract infection, risk factor, recurrent infection, pulmonary function test, tidal breath flow-volume loops
Biography:
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