Oral

INTRODUCTION:
Finding underlying cause of recurrent pneumonia (RP) in children is a challenge to clinicians. Despite availability of immunization program across the globe, RP occurs in 7.7-9% of all children with pneumonia.  

OBJECTIVES:
To identify possible risk factors in children with recurrent pneumonia admitted to Hospital Tunku Azizah Kuala Lumpur.

METHODS:
A retrospective review of medical records of children under 12 years of age, admitted with pneumonia, between 1^st April 2019 through 31^st March 2020, at Hospital Tunku Azizah Kuala Lumpur. RP was defined as at least 2 episodes of pneumonia in 1 year or 3 episodes separated by an asymptomatic period of a month or clear chest x-rays.

RESULTS:
A total of 753 children hospitalised with pneumonia were identified and RP was found in 399 of them (52.9%). The median age of a first pneumonia was 9 months (0-birth, 132) while a median age of RP diagnosis was at 19 months old (144).  About 64% was in the age group of 1 to 5 years old and 55% of these were male. Fifteen percent was bo premature with a median birth weight of 2.9 kg (0.78, 5.06).  Comorbidities were found in almost 60% of children with RP namely cardiac(10.1%), neurological disease (5.3%), dysmorphism(5.5%), asthma(12.3%) and atopy(10.3%). Amongst them, recurrent wheeze in a child (52.6%), with or without the pre-diagnosis of asthma was most significant. 96% of these children with RP had updated immunisation but only 16% had pneumococcal vaccine and 6% had Influenza vaccine. Risk factors such as overcrowding, exposure to tobacco smoke and care of child in nursery/babysitter were found to be not significant in our population of children with RP.

CONCLUSION:
Recurrent pneumonia is not uncommon, particularly among children less than 5 years of age and those with comorbidities, primarily in those with recurrent wheeze.