Objective: To determine the prevalence of bronchiolitis in children up to 2 years of age presenting to Tehsil Headquarter (THQ) Hospital Dogar, Central Kurram.
Study design: A retrospective study.
Duration and place of study: The study was conducted in THQ Hospital Dogar over a one-year period from January to December 2024.
Methodology: This retrospective study reviewed and analyzed medical records of 600 children aged 0–24 months who were clinically diagnosed with bronchiolitis at Tehsil Headquarter Hospital Dogar during the specified period. Data collected included demographic variables such as age and gender, seasonal variations, hospitalization rates, intensive care unit (ICU) admissions, need for mechanical ventilation, mortality, and average length of hospital stay. For statistical analysis, patients were further categorized into three distinct age groups to identify risk distribution and trends more accurately.
Results: The findings revealed that bronchiolitis cases showed a clear seasonal pattern, with the highest incidence during winter months (40%). The majority of affected children were infants aged 3–5 months (50%). Hospitalization was required in 66.7% of patients, while 25% needed ICU admission. Among these, 10% required mechanical ventilation, and the mortality rate was recorded at 2.5%. The lowest case numbers were observed during the summer season.
Conclusion: Bronchiolitis remains a common respiratory illness in young infants, particularly those between 3 and 5 months of age, with a marked peak during winter. Strengthening preventive measures, early recognition, and effective management strategies are essential to minimize hospitalizations and reduce disease burden in this vulnerable population.

Bronchiolitis, Infants, Prevalence, Hospitalization, Seasonal Variation, Respiratory Infection, Respiratory synctional virus.

Bronchiolitis, primarily caused by the respiratory syncytial virus (RSV), is a leading cause of respiratory distress in infants and young children, imposing a significant burden on healthcare systems, particularly in developing countries. Globally, RSV is responsible for substantial morbidity and mortality among children under five years of age, with one in every 50 deaths in this age group attributable to the virus.[1] In Pakistan, lower respiratory tract infections are a major contributor to pediatric morbidity and mortality, accounting for approximately 20% to 30% of all deaths in children under five.[2] The burden is especially pronounced in rural areas where access to healthcare is limited, exacerbating the impact of these infections.[3] Despite the high prevalence, there is a paucity of comprehensive data on the epidemiology of bronchiolitis in Pakistan, particularly in underserved regions. A study conducted in Karachi highlighted the significant mortality burden of RSV in early infancy, emphasizing the need for targeted interventions.[4] The objective of this study is to determine the prevalence and epidemiological characteristics of bronchiolitis among children up to two years of age at THQ Hospital Dogar, Central Kurram. Understanding local trends is crucial for developing targeted interventions aimed at the prevention and effective management of bronchiolitis in this region.

A retrospective analysis was conducted on medical records of 600 children aged 0–24 months diagnosed with bronchiolitis at Tehsil Headquarter Hospital Dogar between January 1 and December 31, 2024. The age distribution was as follows: 3–5 months (300 cases, 50%), 6–15 months (150 cases, 25%), and 16–24 months (150 cases, 25%). Collected data encompassed age, gender, seasonal variation, hospitalization rate, length of stay, ICU admissions, and mortality. Patients were categorized into the specified age groups to analyse seasonal trends, and descriptive statistics were utilized to summarize the findings. This methodological approach aligns with similar studies conducted in Karachi, Pakistan, which have investigated the epidemiology and clinical spectrum of RSV-associated hospitalizations in children, highlighting the significance of age distribution and seasonal patterns in bronchiolitis cases.[5] Additionally, research from India has examined the clinical profiles and outcomes of bronchiolitis in children under two years, emphasizing the importance of detailed data collection on demographics and clinical outcomes.[6] Furthermore, studies in the United Arab Emirates have assessed epidemiology, seasonality, comorbidities, treatment patterns, and healthcare resource utilization in pediatric RSV infections, underscoring the value of comprehensive data analysis in understanding disease burden.[5-7]

Bronchiolitis cases were most common in infants aged 3-5 months (50%), followed by 6-15 months (25%) and 16-24 months (25%). The incidence peaked in winter (November–January, 40%) and was lowest in summer (June–August). Out of the total cases, 66.7% (400) required hospitalization, with 25% (100) admitted to the ICU. Among hospitalized cases, 10% (40) needed mechanical ventilation, and the mortality rate was 2.5% (15 cases).

Figure 1: Distribution of bronchiolitis cases by age group

Our findings align with both national and global data, indicating that bronchiolitis primarily affects infants under six months and peaks during winter months. A study in Mardan, Pakistan, reported that 56.5% of bronchiolitis cases occurred in infants younger than six months, with increased incidence during winter and spring.[8] Similarly, research in Karachi identified RSV as a significant contributor to infant mortality, particularly in those under six months.[3] These patterns underscore the need for preventive measures, such as maternal RSV immunization. The recent World Health Organization (WHO) prequalification of the first maternal RSV vaccine offers a promising strategy to protect infants during their most vulnerable early months.[9] Additionally, promoting breastfeeding and ensuring timely medical interventions are crucial to mitigating the impact of bronchiolitis on pediatric healthcare systems.

Bronchiolitis significantly impacts children under two in Central Kurram, particularly infants aged 3-5 months, with peak incidence during winter months. This pattern aligns with studies in Multan, Pakistan, where the highest cases occurred from December to February.[10] Preventive strategies are crucial to reducing hospitalizations. Implementing good hygiene practices, such as regular hand washing and cleaning of toys and surfaces, can mitigate virus transmission.[11] Additionally, avoiding exposure to tobacco smoke is essential, as passive smoking increases the risk of bronchiolitis.[12] Furthermore, administering the RSV vaccine during pregnancy can protect infants during their first six months, reducing severe bronchiolitis cases.[12,13] These interventions can effectively decrease bronchiolitis-related hospitalizations in the region.

We sincerely thank Tehsil Headquarter Hospital Dogar for granting us access to the medical records.

This research was self-funded by the authors without any external financial assistance. All costs related to data collection, analysis, and manuscript preparation were personally covered by the researchers. No institutional or external grants were received for this study.

Corresponding Author:
Bilal Noor
Department of Pediatrics
THQ Hospital Central Kurram Dogar, Kurram, Pakistan
Email: Bilalzk261@gmail.com

Co-Authors:
Mohammad Ibrahim
Department of Hospital Administration
Naseerullah Baber Hospital Peshawar, Pakistan

Hamid Iqbal
Department of Pediatric Medicine
PMO Nasir Ullah Babar Memorial Hospital, Peshawar, Pakistan

Muhammad Suliman
Department of Pathology
THQ Hospital Central Kurram Dogar, Kurram, Pakistan

Rabya Gul
Department of Community Medicine
Gandhara Medical University, Peshawar, Pakistan

Naveed Iqbal
Department of Dentistry
Ayub Medical College, Abbottabad, Pakistan

Dr. Bilal Noor led the study design and provided overall supervision of the project. Dr. Hamid Iqbal was responsible for data collection. Muhammad Suliman performed the statistical analysis. Burhan U Din contributed to the drafting of the manuscript. Sadia Nasir provided critical review and oversight throughout the study.

Ethical approval for the study was granted by the hospital Ethical Committee of THQ Hospital, Central Kurram Dogar (Ref No:0825). Data was collected after taking written consent from the parents of the enrolled children in our study.

The authors declare no conflicts of interest.

None

https://doi.org/10.63096/medtigo3062339

Noor B, Ibrahim M, Suliman M, Iqbal H, Gul R, Iqbal N. Prevalence of Bronchiolitis in Children up to Two Years of Age Presented to Tehsil Headquarter Hospital Dogar, Central Kurram. medtigo J Med. 2025;3(3):e3062339. doi:10.63096/medtigo3062339 Crossref