Study on parental perception and approach regarding community acquired pneumonia in preschool children from Romania
Authors:   “Sf. Pantelimon” Emergency Clinical Hospital, Bucharest, Romania, Guta Alexandra , Craiu Mihai ,   Emergency Department (ED) of the “Alessandrescu Rusescu” National Institute for Mother and Child Health, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: May 2020

Introduction. Community acquired pneumonia is a common disease that accounts for 16% of all deaths in children aged 5 years or younger. The purpose of the study was to identify potential modifiable factors in relation with parental perception of pneumonia management in children. Outlining such factors would allow development of approaches in order to reduce pneumonia-associated morbidity. Methods. A cross-sectional study was conducted between 25th and 27th August 2016. It consisted in distributing a Google Form to parents of children aged between 4 months and 5 years via online social platforms. The questionnaire was structured in 5 sections with 26 questions. Data collection and statistical analysis were done using Microsoft Office Excel Worksheet. Results. 1083 parental answers were received and analyzed. Regarding vaccinal status we received following data: 973 (89.8%) children were vaccinated according to Romanian Ministry of Health Schedule and 90 children are incompletely vaccinated or unvaccinated. 378 children were never breastfed or exclusively breastfed for less than 4 months. 32% (352) were complementary fed before the age of 4 months and 19% (201) after 6 months. 46.91% (508) of children had experienced in the past Acute Respiratory Tract Infections and 42.41% (215) of them were admitted. The most frequent two symptoms that would cause parents to generate an unscheduled ED visit were fever [in 47.83% (518)] and cough [in 19.58% (212)]. 38.87% (421) of respondents gave their child medication without physician’s advice and 61.3% (358) used analgesics and antipyretics. Pneumonia has been recognized as a serious illness, potentially life threatening, by 69.07% (748) of parents. Discussion. There is evidence of correlation between morbidity and mortality in childhood pneumonia and parental educational and socio-economic status. Aim of our study was to explore other factors that impact parental perception, in this era of significant changes in social behavior and communication. Conclusion. The decrease in the vaccine coverage rate in Romania (89% in this group selected by patients with access to Social Media) led to a decrease below the threshold for maintaining herd immunity. Romanian parents responding to this questionnaire achieved a good score in symptom recognition and severity assessment of pneumonia. A large number of respondents surveyed in a short time is an indicator of parental desire to be informed and involved in decision-making. This recent change in parental behavior in our country could generate alternatives to existing educational strategies. Developing medical information platforms for Social Media, translated in local language, could impact parental perception and child pneumonia morbidity in our country.