Role of rickets in recovery from pneumonia in pediatric inpatient population: Secondary data analysis of a case control study.

Abstract

Background: Nutritional rickets is associated with adverse clinical outcomes and prolongation of clinical symptoms in children with pneumonia which results in frequent antibiotic change. Both pneumonia and rickets are highly prevalent in our population and contribute to significant morbidity but very limited literature is available regarding effects of rickets on clinical parameters and resolution of pneumonia. Hence, this study is designed to determine the effect of rickets on clinical course in pneumonia by comparing key signs and symptoms among pediatric patients with and without rickets.

Methods: This study was a secondary data analysis of a previous case control study by the same PI, which looked at the effect of rickets on resolution of tachypnea in patients of pneumonia. Additional cases were added from hospital clinical records to improve the sample size. Hence, altogether this study included 121 pediatric patients with pneumonia including 48 patients with rickets (cases) and 73 patients without rickets (controls).  Data was analyzed using SPSS version 21.

Results: The median age of patients was 10 months and predominant gender was male. Comparison of clinical progress of hospitalized children of pneumonia with rickets showed a prolonged clinical illness as compared to pneumonia without rickets. This study found statistically significant differences in the duration of stabilization from fever, tachypnea, cough and resumption of optimal feeding among pneumonia patients with and without rickets (p= <0.05).

Conclusion: Rickets results in prolonged clinical illness and delayed recovery from pneumonia in children aged 1 month to 5 years. The possible reason is delayed clearance of infection as evident from delayed resolution of fever in this study.

Key Words: Pneumonia, Rickets, Disease progression, Treatment outcome.