Clinical profile and risk factors of recurrent pneumonia in children at Qena governorate, Egypt.

Background: There is a scarce research study on recurrent pneumonia in children, particularly in the developing world. This study aimed to analyse the clinical characteristics, risk factors and underlying causes of recurrent pneumonia in children.

Methods: It was a case-control study involved 87 children with ≥2 episodes of radiographically confirmed pneumonia in a single year or ≥3 episodes at any time with a radiographic clearing of densities between attacks. Controls were 87 age and gender-matched children who had never suffered pneumonia. Demographic and clinical characteristics of patients and controls were compared and evaluated for the detection of possible underlying conditions that may be the incriminated risk factor of pneumonia recurrence.

Results: During one-year study, 763 patients were admitted with pneumonia and 87 (11.4%) of them met the definition of recurrent pneumonia. There were 48 (55.2%) males and 39 (44.8%) females. The mean age at diagnosis of recurrent pneumonia was 7.15 ± 1.72 years. Prematurity, small birth weight and presence of respiratory distress at birth were significantly different between patients and controls. Aspiration, congenital heart disease, gastroesophageal reflux, oro-motor incoordination, wheezing and asthma were significant risk factors for recurrent pneumonia.

Conclusion: Our study showed that 11.40% of children with pneumonia had recurrent form and that most of them had an underlying illness. The most common detected risk factors for recurrent pneumonia were rural residence, low socioeconomic standard, over-crowding, prematurity and presence of respiratory distress at birth. Aspiration, congenital heart diseases, wheezing and asthma were found to be the main underlying illnesses associated with pneumonia recurrences.