Kematian Akibat Pneumonia Berat pada Anak Balita

Abstract

Pneumonia merupakan penyebab utama kesakitan dan kematian pada anak, terutama di negara berkembang. Angka kematian karena pneumonia di negara berkembang 10–15 kali lebih tinggi daripada di negara maju. Penelitian ini bertujuan untuk mengetahui angka kematian dan faktor risiko pada anak balita yang dirawat di rumah sakit karena pneumonia. Penelitian potong lintang ini dilakukan pada anak usia 1–59 bulan yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung karena pneumonia periode November 2007─Januari 2009. Tiga ratus delapan belas anak ikut serta dalam penelitian ini. Usia median anak 11‚6 bulan, sebanyak 237 (74‚5%) di antaranya berusia ≤12 bulan. Sembilan puluh tiga (29‚2%) anak didiagnosis pneumonia sangat berat dan 225 (70‚8%) anak pneumonia berat. Dua puluh tiga (7‚2%) penderita meninggal selama perawatan, 20 di antaranya dirawat dengan pneumonia sangat berat (p<0,001; OR 20,274; 95%IK: 5,855–70,197). Kelainan jantung bawaan (p=0,002; OR 5,795; 95%IK: 2,115–15,407) dan leukositosis (≥15.500/mm3; p=0,002; OR 3,879; 95%IK: 1,547–9,727) berhubungan erat dengan kematian. Kuman patogen ditemukan pada 11 dari 23 penderita yang meninggal. Simpulan, kematian karena pneumonia berat masih cukup tinggi. Pneumonia sangat berat, kelainan jantung bawaan, dan leukositosis merupakan faktor risiko yang meningkatkan kematian anak balita dengan pneumonia. [MKB. 2013;45(1):50–5]

Mortality Due to Severe Pneumonia in Under-Five Years Old Children

Pneumonia is one of the leading causes of morbidity and mortality in children, mainly in developing countries with a 10–15 times higher mortality rate than developed countries. The aim of the study was to know the mortality rate and its risk factors among under five years old children who were hospitalized due to severe pneumonia. This cross-sectional study was conducted to 1 to 59 months old children with pneumonia at the Department of Pediatric Dr. Hasan Sadikin Bandung Hospital from November 2007 to January 2009. Three hundred and eighteen children were enrolled in this study. The median age was 11.16 months, and 237 (74.5%) were ≤12 months of age. Very severe pneumonia was diagnosed in 93 (29.2%) and severe pneumonia in 225 (70.8%) children. Twenty three (7.2%) children died during hospitalization, 20 were hospitalized with very severe pneumonia (p<0.001, OR 20.274, 95%CI: 5.855─70.197). Congenital heart disease (p=0.002, OR 5.795, 95%CI: 2.115–15.407) and leucocytosis (≥15,500/mm3, p=0.002, OR 3.879, 95%CI: 1.547–9.727) were significantly associated to the mortality. Pathogenic bacteria were identified in 11 of 23 patients. In conclusions, the mortality of severe pneumonia is still high. Very severe pneumonia, congenital heart disease and leucocytosis are factors that increase mortality among under-five years old children with pneumonia. [MKB. 2013;45(1):50–5]

DOI: http://dx.doi.org/10.15395/mkb.v45n1.140