ACUTE LOWER RESPIRATORY-INFECTION IN ARGENTINEAN CHILDREN - A 40 MONTH CLINICAL AND EPIDEMIOLOGIC-STUDY

In a total of 1,003 children (805 inpatients and 198 outpatients) with acute lower respiratory infections (ALRI), clinical, social, and envi ronmental data were analyzed. The major clinical entities were bronchi olitis, pneumonia, bronchitis, and laryngitis. The first two of these predominated in inpatients; pneumonia and bronchitis were more common in older children, while bronchiolitis was observed in infants. Respir atory rates of >50/min. were more common in younger children and in ca ses with bronchiolitis and bronchitis. Retractions showed markedly les s age-dependent variations and were present in all severe cases with d ifferent clinical diagnoses. Retractions alone or associated with cyan osis were the best indicators for severity of ALRI. Among outpatients, fever and wheezing were more common; inpatients were younger, more fr equently malnourished, and from a lower socioeconomic level; family hi story of chronic bronchitis, crowding, and parental smoking also preva iled in this group. Family asthma and exposure to domestic aerosols wa s more common among outpatients. Prematurity rate (1 7 and 15%) of all ALRI cases was twice that of the general pediatric population and a s ignificant difference existed between in- and outpatients under 6 mont hs of age when perinatal respiratory pathologies predominated among in patients. It is suggested to consider the need for assessing personal, family, and environmental risk factors in addition to clinical signs and symptoms when severe cases of ALRI are evaluated. (C) 1993 Wiley-L iss, Inc.