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Volume 9 Journal of Community Medicine & Health Education Public Health Congress 2019
May 15-16, 2019
May 15-16, 2019 Singapore
7th World Congress on
Public Health, Nutrition & Epidemiology
Mohammod Jobayer Chisti et al., J Community Med Health Educ 2019, Volume 9
DOI: 10.4172/2161-0711-C3-059
Pneumonia in severely malnourished children: Etiology, diagnosis, management and future direction
Mohammod Jobayer Chisti, Abu S M Sayeem, K M Shahunja and Tahmeed Ahmed
International Centre for Diarrhoeal Disease Research, Bangladesh
Background: Management of pneumonia in severely malnourished children is critically important in reducing deaths in
such children. Understand the etiology of pneumonia in severely malnourished children is one of the essential components
of appropriate management. Diagnosis of pneumonia in children with severe malnutrition is also intriguing. Etiology and
diagnosis of pneumonia in Severe Acute Malnutrition (SAM) is not well described in medical literature. Data on management
of pneumonia in such children are also lacking.
Methods: We have done a systematic review using specific search criteria in PubMed to evaluate the overall role of severe
malnutrition in children with pneumonia in SAM children.
Results: Among a total of 215 isolates 26% were Klebsiella and 25% S. aureus species, 18% Pneumococcus, 8% each E. coli and
Salmonella species. A recent study conducted in Bangladesh found 87/385 (23%) MTB as the bacterial etiology of pneumonia
in SAM children. In SAM children, the sensitivity of fast breathing as a predictor of radiographically proven pneumonia ranged
from 14% to 76% and specificity from 66% to 100%. Surprisingly, metabolic acidosis found to have no impact on the diagnostic
clinical features of pneumonia in SAM children having diarrhea. Studies revealed that as a first line therapy ampicillin and
gentamicin are more effective against enteric G ram-negative bacilli than chloramphenicol in SAM children with pneumonia.
Both the groups received in addition to diet, micronutrients, vitamins and minerals.
Conclusion: The currently available data suggests that the spectrum and frequency of causative agents of pneumonia in severely
malnourished children differ from that observed in well-nourished children. Clinical signs are relatively poor predictors of
pneumonia in severely malnourished children. However, injectable antibiotics in addition to diet, micronutrients, vitamins
and minerals are the sine qua non. High prevalence of pulmonary tuberculosis in severely malnourished children having acute
pneumonia underscores the importance of further research that may help to evaluate the determinates of TB in such children.
Biography
Mohammod Jobayer Chisti has been working in International Centre for Diarrhoeal Disease Research, Bangladesh since 1998 as a Clinician as well as Researcher.