Prevalence of Post-Pandemic Pneumonia in Children Under 10 Years of Age at Ambato General Hospital

Abstract

Introduction: community-acquired pneumonia (CAP) remains a significant cause of pediatric hospitalization in Latin America. Following the COVID-19 pandemic, changes in the seasonality of respiratory viruses and a predominance of viral etiologies have been observed. Local factors such as altitude and the rainy season in the Andean region of Ecuador may influence incidence and severity.
Methods: a retrospective case series study was conducted based on the clinical records of children <10 years old hospitalized for pneumonia at Ambato General Hospital between March 2023 and January 2024. The denominator comprised total pediatric discharges (n = 1,720). Cumulative prevalence, temporal distribution, and demographic, clinical, etiologic, and therapeutic variables were calculated using descriptive statistics.
Results: ninety-five cases were identified (5.52% of pediatric discharges). Cases were concentrated between September 2023 and January 2024, peaking in December. The median age was 3.9 years; 61.1% were female, and 67% were <5 years old. The most frequent symptoms were respiratory distress (70.5%), wet cough (69.5%), and hypoxemia (52.6%). The main etiologic agents were influenza A (33.7%) and rhinovirus/enterovirus (15.8%). Two-thirds of patients required oxygen, and the majority received empiric antibiotics. No deaths were recorded.
Conclusions: post-pandemic pediatric pneumonia in Ambato presented moderate prevalence, delayed seasonality, and viral predominance. Most patients had favorable outcomes. The study, limited by its retrospective and single-center design, highlights the urgency of strengthening vaccination, optimizing antibiotic use guided by biomarkers, and improving seasonal surveillance, recommending prospective multicenter research for results validation.
Recommendations: Under the One Health approach, it is urgent to restore vaccination coverage and implement integrated surveillance to anticipate seasonal peaks.