MODERN FEATURES OF PNEUMONIA COURSE IN CHILDREN DEPENDING ON ANAMNESTIC FACTORS

Abstract

Relevance. Pneumonia is a polyetiological disease; its risk and severity depend on the infectious agent, age-related and comorbid factors, as well as on socioeconomic and environmental conditions. The etiology of pneumonia varies depending on climatic and geographical features, seasonality, and vaccination coverage, although certain patterns remain stable — viral pathogens dominate in children under 2 years old, while bacterial agents prevail in severe and secondary mixed infections. Objective. To study the role of anamnestic risk factors and the clinical course of acute pneumonia in children aged 3 months to 3 years. Materials and Methods. The study was conducted at the Clinical Base No. 2 of Tashkent State Medical University. A pro- and retrospective analysis of inpatient medical records of 110 patients aged 3 months to 3 years, hospitalized and treated in the department for infants from January to September 2025, was performed. Among them, there were 66 boys (55.0%) and 54 girls (45.0%). Results. Analysis of medical histories and parent interviews showed that 90% of children aged 3 months to 3 years had a history of frequent acute respiratory infections (≥3 times per year). The majority (60%) belonged to the first group, and 30% — to the second group. Most children were admitted in severe condition, characterized by endogenous intoxication, respiratory failure, and microcirculatory disturbances. In the first group, 98.3% of children were hospitalized within 3–5 days of disease onset; 50% had a history of prior respiratory infections. In the second group, 53.4% were admitted on days 5–7, and 46.6% — on day 10 of illness. Analysis of pneumococcal vaccination coverage showed that in the first group, 24 (37.5%) children received a full course of vaccination according to the National Immunization Schedule (Pneumo-1, -2, -3). Partially vaccinated children included 12 (18.7%) who received only the first dose (Pneumo-1), 19 (29.6%) — the second and third doses, and 9 (14.6%) — only the third dose. In the second group, 19 (33.9%) children completed the full course, 25 (44.6%) received two doses, and 7 (12.5%) — a single dose. A high level of vaccination coverage reflects the effectiveness of national preventive measures. However, incomplete vaccination still maintains the risk of severe pneumonia and recurrent bronchitis in young children. Conclusions. The course of pneumonia in young children is determined by the multifactorial nature of predisposition, where perinatal complications, nutritional factors, immune status, and comorbidities play a major role. The identified patterns help predict disease severity, optimize prevention, and personalize therapeutic strategies.