ACUTE RESPIRATORY-TRACT INFECTIONS IN PAT IENTS AT THE BOBO-DIOULASSOPEDIATRIC HOSPITAL (BURKINA-FASO)

Background. - Acute lower respiratory tract infections are the primary cause of morbidity in developing countries. Population and methods. - Six hundred and sixty seven children (379 boys, 288 girls, aged 0-30 months) admitted for lan:er respiratory tract infections from January 1990 to March 1991 were included in the study. Immediate medical histo ry was collected from the mother. The weight, height, temperature and clinical manifestations, plus tire results of chest X-rays, parasitolo gic and bacteriological examination of stools, and blood smear for mal aria were recorded for each patient. Sero-immunologic study for HIV in fection of 473 of the patients aged 12-36 months and their mothers als o took part in a sero-immunological study for HIV infection. Results. - Lower respiratory tract infections were the second major cause of ad mission (16.8%) after malaria (28.7%). Infections peaked between 6 and 11 months of age (29.5%). The main diseases were pneumonia find bronc hial pneumonia (54%) followed by bronchiolitis (21.7%). Almost half th e patients were admitted during the hot, dry season. Two hundred and e ighty seven patients (43.4%) were referred only after they had been su ffering from the disease for 3 to 9 days, partly explaining the high l evel of mortality. One hundred and twenty one patients (20.9%) died; t he main cause of death was staphylococcal pneumonia (57.9%), followed by pneumonia and bronchial pneumonia (29.3%). Some criteria for severi ty could he identified based on pulmonary signs and symptoms and assoc iated manifestations (dehydration malnutrition, convulsions, anemia). Twenty two patients were positive for HIV-1 infection. Conclusions. - This study confirms that acute lower respiratory tract infections rema in a public health problem. Early diagnosis and treatment are necessar y to reduce mortality.