PP28 RECURRENT PNEUMONIA AMONG CHILDREN: CAUSES, SOCIOECONOMICS AND ENVIRONMENTAL FACTORS

Asiah Kassim1,2, Nur Izyani Abdul Halim1, N. Fafwati Faridatul Akmar Mohammad2, Shin Lam Koo1, Ching Hai Lee1, Fatimah Az Zaharah Suhaimi1

1. Clinical Research Centre, Hospital Tunku Azizah Kuala Lumpur
2. Paediatric Department Hospital Tunku Azizah Kuala Lumpur

Introduction
Recurrent Pneumonia (RP) is defined as two or more episodes of pneumonia in 12 months or three episodes with radiographic clearance in between. Socioeconomic factors increase children's vulnerability to developing RP.

Methodology
A retrospective study of referred RP cases to the Pediatric Respiratory Unit, Hospital Tunku Azizah, Kuala Lumpur, between 2019 and 2023.

The objectives of this study were to determine the causes of RP among children, their socioeconomic and environmental factors.

Results
A total of 327 subjects with RP, with a median age of 12 months (1,180), male (64%), Malay (85.6%) and term gestation (77.3%). The first recurrent episode occurred within 6 months of their first episode (79%), and 84.1% had 2 to 5 pneumonia episodes. Common causes of pneumonia were lower airway pathology (163, 49.8%), Asthma/wheezing (47, 14.4%), upper airway diseases (32,9.8%)chronic lung diseases (31, 9.5%), environment (17, 2.5%) and recurrent aspiration (17, 5.2%). The majority of their household income group was from the B40. Most children were cared for at home (61.9%), by babysitters (24%), and in nursery facilities (12.8%). They lived in a flat-type housing (70.2%), single-storey (17.2%) and double-storey homes (11.6%). Nuclear families constituted 78.9% of them, urban areas (86.2%), but only 23% lived in an overcrowded area. Tobacco smoke exposure was reported in 49.7%. About 34.1% did not receive an update on their immunization status, including 21.4% from the B40 socioeconomic group.

Conclusion
Children with recurrent pneumonia must be investigated for their causes. The plan of management depends on the underlying cause.