Clinical and Radiologic Profile of Acute Lower Respiratory Tract Infections in Hospitalized Children in the Bamenda Regional Hospital

Acute lower respiratory tract infections (ALRTIs) remain a major cause of hospitalization among children and are a leading contributor to mortality in children under five years. Globally, there are approximately 156 million new cases annually, with over 151 million occurring in low-resource settings. This study aimed to describe the clinical and radiologic presentation, associ-ated risk factors, and outcomes of ALRTIs in hospitalized pediatric patients. A prospective cohort study was conducted between January and May 2024. Data were gathered on demographics, comorbid conditions, clinical signs, chest radiographic findings, and patient outcomes. Descriptive statistics such as frequencies and percentages were used to present the results. Associations were analyzed using adjusted odds ratios (aOR) with 95% confidence intervals (CI); a p-value of less than 0.05 was considered statistically significant. Among 440 pediatric admissions at the Bamenda Regional Hospital, A total of 105 children with acute lower respiratory tract infections (ALRTIs) were analyzed, with the majority aged 7 - 36 months (48.6%) and 58.1% being male. Most children resided in urban areas (61.9%), and parental education was predominantly secondary or tertiary. Pneumonia was the most common ALRTI (81.0%, prevalence 19.3%), followed by bronchiolitis (10.5%) and bronchitis (8.6%). The most frequent symptoms included cough (100%), fever (93.3%), difficulty breathing (69.5%), and noisy breathing (52.4%), with systemic inflammatory response syndrome and respiratory distress syndrome being common. Radiological findings showed alveolar consolidation in 96.7% and bilateral lung involvement in 45%. Bivariate analysis revealed that maternal age > 20 years significantly reduced the odds of severe ALRTIs (OR = 0.27, p = 0.043), while malnutrition increased severity risk (p = 0.025). Multivariate analysis confirmed maternal age > 20 years (AOR = 0.21, p = 0.030) as protective and malnutrition (AOR = 1.91, p = 0.045) as a significant risk factor. Gastroenteritis showed borderline significance in bivariate analysis (p = 0.049) but was not significant after adjustment (AOR = 0.84, p = 0.825). Overall, 97.1% of children were successfully treated and discharged, while 2.9% died. ALRTIs accounted for 24.0% of pediatric hospitalizations. SIRS, consolidation, and respiratory distress were the main clinical syndromes, while alveolar consolidation and bronchial thickening were the primary radiologic findings. Maternal age and acute malnutrition significantly influenced disease severity.