Current clinical profiles of acute respiratory tract infections in children

Abstract

Background: Acute respiratory tract infections (ARTIs) remain a leading cause of morbidity and mortality among children, particularly in low- and middle-income countries such as Bangladesh. Understanding the clinical profile, seasonal distribution, and risk factors associated with severe disease is essential for improving early diagnosis, management, and prevention strategies. Aim of the study: To describe the clinical profiles, etiological patterns, seasonal variation, and risk factors associated with severity of acute respiratory tract infections among children attending a tertiary care hospital in Bangladesh. Methods: This hospital-based cross-sectional study was conducted in the pediatric department of a tertiary care center in Bangladesh. A total of 120 children aged 0–12 years presenting with acute respiratory symptoms of ≤14 days duration were enrolled. Demographic characteristics, nutritional status, immunization status, clinical features, diagnoses, seasonal occurrence, and etiological patterns were recorded using a structured questionnaire and clinical examination. ARTIs were classified based on standard WHO and pediatric guidelines. Multivariable logistic regression was performed to identify factors associated with severe ARTI. Result: The mean age of participants was 4.8 ± 3.1 years, with the majority belonging to the 1–5-year age group (41.67%) and a male predominance (56.67%). Cough (91.67%) and fever (85.00%) were the most common presenting symptoms. Upper respiratory tract infection was the most frequent diagnosis (41.67%), followed by pneumonia (29.17%) and bronchiolitis (16.67%). ARTIs occurred most commonly during winter (37.50%), and viral infections predominated overall (70.00%). Multivariable analysis identified age <2 years (OR = 3.2), incomplete immunization (OR = 2.95), underweight status (WAZ ≤ −2; OR = 3.5), and viral-bacterial co-infection (OR = 4.8) as significant risk factors for severe ARTI. Conclusion: Acute respiratory tract infections in children are predominantly viral and show marked seasonal variation, with higher occurrence during winter months. Younger age, poor nutritional status, incomplete immunization, and co-infection significantly increase the risk of severe disease. Strengthening immunization coverage, improving nutritional status, and early identification of high-risk children may reduce disease severity and improve outcomes.