Objective: To analyze the trends and determinants of changes in respiratory rate and multivariate decomposition over time among under-five pneumonia patients. Material and Methods: Poisson (Log-based) decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 14 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling technique and non-response. Results: The medical cards of 453 pediatric pneumonia patients out of 1572 pediatric pneumonia patients have been reviewed and all of these 453 patients were hospitalized at least for six days. Among respiratory rate of pneumonia patients decreased from 59 on average from Day 1 to 51 on average in Day 3 and 41 on average in Day 6. The decomposition analysis indicated that 13% of the overall change in respiratory rate was due to difference in patients' characteristics. Changes in the composition of young pneumonia patients' characteristics according to body temperature, treatment type, weather, vomiting history and cough were the major sources of this decrease. The remaining 87% of the decrease in respiratory rate was due to difference in coefficients. Most importantly, the decrease was due to change in respiratory rate change among the fully immunized (55%) and exclusively breast-fed (39%). Conclusion: Respiratory rate change among pediatric pneumonia patients has showed a remarkable decrease over the three consecutive measures. Programmatic interventions targeting body temperature, body weight, vomiting history, immunization status, breastfeeding type and family disease history would help to maintain the decreasing trend in respiratory rate change.
Keywords: Respiratory rate; pneumonia; under-five children and multivariate decomposition
Amaç: Beş yaşın altındaki pnömoni hastalarında solunum hızındaki zaman içindeki eğilimleri ve belirleyicilerini ve çok değişkenli dekompozisyonunu incelemek. Gereç ve Yöntemler: Son değişikliklere katkıda bulunan faktörleri incelemek için Poisson (log-dayalı) dekompozisyon analizi tekniği kullanıldı. Verilerin yönetilmesi ve analizi için STATA 14 kullanıldı. Bu makalede sunulan tüm hesaplamalar örnekleme tekniği ve yanıt vermeme için ağırlıklandırılmıştır. Bulgular: Toplam 1572 pediatrik pnömoni hastası içinden 453'ünün tıbbi kayıtları gözden geçirildi ve bu 453 hastanın hepsi en az altı gün hastanede yatmıştı. Hastaların solunum hızı birinci gün 59 iken üçüncü gün 51'e, altıncı gün 41'e düştü. Dekompozisyon analizi solunum hızındaki tüm değişikliklerin %13'ünün hasta özelliklerine bağlı olduğunu gösterdi. Vücut sıcaklığı, tedavi tipi, hava, kusma öyküsü ve öksürük bu azalmanın başlıca kaynaklarıydı. Solunum hızındaki geriye kalan %87'lik azalma katsayılardaki farklılıklara bağlıydı. En önemlisi, solunum hızındaki değişikliğe bağlı azalma tam aşılı (%55) ve tamamen anne sütüyle beslenenlerde (%39) idi. Sonuç: Pediatrik pnömoni hastalarında solunum hızı değişiklikleri üç ardışık ölçüm arasında belirgin azalma gösterdi. Vücut sıcaklığını, vücut ağırlığını, kusma öyküsünü, aşılanma durumunu, anne sütüyle beslenme durumunu ve ailede hastalık öyküsünü hedefleyen girişimler solunum hızı değişimindeki azalma eğilimini sürdürmeye yardımcı olacaktır.
Anahtar Kelimeler: Solunum hızı; pnömoni; beş yaşın atındaki çocuklar ve çok değişkenli dekompozisyon
- Izurieta HS, Thompson WW, Kramarz P, Shay DK, Davis RL, DeStefano F, et al. Influenza and the rates of hospitalization for respiratory disease among infants and young children. N Engl J Med. 2000;342(4):232-9. [Crossref] [PubMed]
- Maganga ER. Pneumonia case fatality rate in children under-five: understanding variations in district hospitals in Malawi. 2004. https://www.duo.uio.no/bitstream/handle/10852/30103/oppgavexEllubeyxRachelxMaganga.pdf?sequence=2&isAllowed=y
- Garenne M, Ronsmans C, Campbell H. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries. World Health Statistics Quarterly. 1992;45(2/3):180-91.
- World Health Organization. Health Situation Analysis in the African Region Atlas of Health Statistics, 2011. World Health Organization: India, Replika Press Pvt. Ltd; 2011. p.85.
- Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226-34. [Crossref] [PubMed]
- Organization, W.H., Global Health Risks-Mortality and burden of disease attributable to selected major risks. The Lancet, 2015.
- National scale-up of integrated community case management in rural Ethiopia: implementation and early lessons learned. Ethiop Med J. 2014;52(Suppl 3):15-26. [PubMed]
- Armstrong JRM, Campbell H. Indoor airpollution exposure and lower respiratory infections in young Gambian children. Int J Epidemiol. 1991;20(2):424-9. [Crossref] [PubMed]
- Cerqueiro MC, Murtagh P, Halac A, Avila M, Weissenbacher M. Epidemiologic risk factors for children with acute lower respiratory tract infection in Buenos Aires, Argentina: a matched case-control study. Rev Infect Dis. 1990;12(Suppl 8):S1021-8. [Crossref] [PubMed]
- Tupasi TE, Manguba NV, Sunico ME, Magdangal DM, Navarro EE, Leonor ZA, et al. Malnutrition and acute respiratory tract infections in Filipino children. Rev Infect Dis. 1990;12(Suppl 8):S1047-54. [Crossref] [PubMed]
- Victora CG. [Risk factors for acute lower respiratory infections]. In: Benguigui Y, Antu-ano FJL, Schmunis G, Yunes J, eds. Infecciones Respiratorias En Ni-os. Serie HCT/AIEPI-1. Washington, D.C.: Pan American Health Organization; 1999: p.41-58.
- Smith TA, Lehmann D, Coakley C, Spooner V, Alpers MP. Relationships between growth and acute lower-respiratory infections in children aged less than 5 y in a highland population of Papua New Guinea. American J Clin Nutr. 1991;53(4):963-70. [Crossref] [PubMed]
- Cruz JR, Pareja G, de Fernández A, Peralta F, Cáceres P, Cano F. Epidemiology of acute respiratory tract infections among guatemalan ambulatory preschool children. Rev Infect Dis. 1990;12(Suppl 8):S1029-34. [Crossref] [PubMed]
- Selwyn B. The epidemiology of acute respiratory tract infection in young children: comparison of findings from several developing countries. Coordinated Data Group of BOSTID Researchers. Rev Infect Dis. 1990;12(Suppl 8):S870-88. [Crossref] [PubMed]
- Victora CG, Smith PG, Barros FC, Vaughan JP, Fuchs SC. Risk factors for deaths due to respiratory infections among Brazilian infants. Int J Epidemiol. 1989;18(4):918-25. [Crossref] [PubMed]
- Graham NM. The epidemiology of acute respiratory infections in children and adults: a global perspective. Epidemiol Rev. 1989;12:149-78. [Crossref] [PubMed]
- WHO, UNICEF, World Bank. State of the world's vaccines and immunization. 3rd ed. Geneva: World Health Organization; 2009. p.156.
- Cameron AC, Trivedi PK. Regression Analysis of Count Data. 2nd ed. Vol. 53. Cambridge: Cambridge University Press; 2013. p.587.
- Powers DA, Yoshioka H, Yun MS. mvdcmp: multivariate decomposition for nonlinear response models. Stata Journal. 2011;11(4):556-76. [Crossref]
- Cameron AC, Johansson P. Count data regression using series expansions: with applications. Journal of Applied Econometrics. 1997;12(3):203-23. [Crossref]
- Wingerter SL, Bachur RG, Monuteaux MC, Neuman MI. Application of the world health organization criteria to predict radiographic pneumonia in a US-based pediatric emergency department. Pediatr Infect Dis J. 2012;31(6):561-4. [Crossref] [PubMed]
.: İşlem Listesi