BASIC IMMUNIZATION STATUS CORRELATED TO MORBIDITY AND MORTALITY OF SEVERE PNEUMONIA IN TODDLERS

Main Article Content

Authors

Eddy Teguh Pribadi
Sri Martuti
Hari Wahyu Nugroho
Keywords:
Morbidity , Mortality , Basic immunization, Severe pneumonia

Abstract

Text size

Pneumonia is an acute lung infection that often affects toddlers and is a major cause of morbidity and mortality. Routine immunization is an important preventive measure. This study aims to analyze the relationship between immunization status and morbidity and mortality of toddlers with severe pneumonia in the PICU of Dr. Moewardi Regional Hospital. The retrospective cross-sectional analytical study design used medical record data and the Menuju Sehat Card in 34 toddlers. Immunization status was considered complete if appropriate for age. Morbidity was seen from the length of hospitalization, mortality from the status of alive/dead. Analysis used chi-square/Fisher and logistic regression. The results showed that 90% of toddlers with complete immunization were hospitalized for <10 days, while 82.6% with incomplete immunization were hospitalized for ≥10 days (p<0.001). Mortality was higher with incomplete immunization (90.0%) than with complete immunization (45.8%) (p=0.024). DPT3 and smallpox immunization were associated with morbidity, while polio and smallpox were associated with mortality. Conclusion: Basic immunization is an independent predictor of morbidity and mortality in severe pneumonia in toddlers after controlling for age, exclusive breastfeeding, and cigarette smoke exposure.

Article Details

References

Greenberg D, Givon-Lavi N, Ben-Shimol S, Ziv JB, Dagan R. Impact of PCV7/PCV13 introduction on community-acquired alveolar pneumonia in children <5 years. Vaccine. 2015;33(36):4623–9.

Ebeledike C, Ahmad T. Pediatric pneumonia. In: StatPearls - NCBI Bookshelf. 2022. p. 1–8.

Goyal JP, Kumar P, Mukherjee A, Das R, Bhat JI, Ratageri V, et al. Risk Factors for the Development of Pneumonia and Severe Pneumonia in Children. Indian Pediatr. 2021;58(11):1036–9.

Jahan Y, Rahman AA. Case report on management of severe childhood pneumonia in low resource settings. Respir Med Case Rep. 2018;58(11):192–5.

Cillóniz C, Torres A, Niederman MS. Management of pneumonia in critically ill patients. BMJ [Internet]. 2021;375:e065871. Available from: doi:10.1136/bmj-2021-065871

Nolley EP, Sahetya SK, Hochberg CH, Hossen S, Nager DN, Brower RG, et al. Outcomes Among Mechanically Ventilated Patients With Severe Pneumonia and Acute Hypoxemic Respiratory Failure From SARS-CoV-2 and Other Etiologies. JAMA Netw Open. 2023;6(1):e2250401.

Sari L. Mom’s Knowledge and Practice on Prevention Pneumonia in Toddlers. Indones J Glob Heal Res [Internet]. 2022;4(4):769. Available from: doi:10.37287/ijghr.v4i4.1254

Anwar A, Dharmayanti I. Pneumonia pada Anak Balita di Indonesia. Kesmas Natl Public Heal J [Internet]. 2014;8(8):359.

UNICEF. The Integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD). 2013. 10 p.

Pusdiklatnakes Kemenkes RI. Buku Ajar Imunisasi [Internet]. 2015. Available from: [http://www.pdpersi.co.id/pusdiknakes/](http://www.pdpersi.co.id/pusdiknakes/)

Mukherjee S, Subramaniam R, Chen H, Smith A, Keshava S, Shams H. Boosting efferocytosis in alveolar space using BCG vaccine to protect host against influenza pneumonia. PLoS One. 2017;12(7).

Bawankule R, Singh A, Kumar K, Shetye S. Does measles vaccination reduce the risk of Acute Respiratory Infection (ARI) and diarrhea in children: A multi-country study? PLoS One. 2017;12(1).

Dagan R, Juergens C, Trammel J, Patterson S, Greenberg D, Givon-Lavi N, et al. Modeling pneumococcal nasopharyngeal acquisition as a function of anticapsular serum antibody concentrations after pneumococcal conjugate vaccine administration. Vaccine. 2016;34(36):4313–20.

Putra AE. Pemilihan Rumus dan Perhitungan Besar Sampel. Published Online; 2018. 1–15 p.

Anam C, Putri NA, Ramadhani R, Musfirah A. Case distribution and survival rate in Pediatric Intensive Care Unit (PICU) at Banjarmasin, Indonesia. PSJ. 2022;2(2):44–7.

Roussel Y, Raoult D. The worldwide impact of vaccination programs on hospitalization and mortality from childhood pneumonia: A global perspective. Int J Infect Dis. 2020;96:558–563.

Madhi SA, Klugman KP. A role for Streptococcus pneumoniae in virus-associated pneumonia. Nat Med. 2004;10(8):811–3.

Dagan R, Pelton SI, Bakaletz LO, Cohen R. Prevention of respiratory infections by vaccines: current status and future directions. Pediatr Infect Dis J. 2016;35(12):1324–6.

Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405–16.

Gavi Alliance. The public health impact of measles vaccination [Internet]. Geneva: Gavi Vaccine Alliance; 2020. Available from: [https://www.gavi.org/](https://www.gavi.org/)

Lassi ZS, Naseem A, Salam RA, Siddiqui FJ, Das JK. The Impact of the COVID-19 Pandemic on Immunization Campaigns and Programs: A Systematic Review. Int J Environ Res Public Heal. 2021;18(3):988.

Centers for Disease Control and Prevention. Pertussis (Whooping Cough): Vaccine Effectiveness [Internet]. Atlanta: CDC; 2019. Available from: [https://www.cdc.gov/pertussis/vaccines.html](https://www.cdc.gov/pertussis/vaccines.html)

Jain S, Williams DJ, Arnold SR, Ampofo K, Bramley AM, Reed C. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015;372(9):835–45.

Ginsburg AS, Izadnegahdar R, Berkley JA, Walson JL, Rollins N, Klugman KP. Undernutrition and pneumonia mortality. Lancet Glob Heal. 2015;3(12):e735–6.