Risk factors of severe pneumonia among children aged 2-59 months in western Kenya: a case control study

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Dickens Onyango¹, Gideon Kikuvi, Evans Amukoye

¹Field Epidemiology and Laboratory Management Training Program, Ministry of Public Health and Sanitation, Kenya.

The Pan African Medical Journal

|January 19, 2013

Insights

Severe pneumonia in Kenyan children is linked to comorbidities, delayed treatment, and respiratory infections. Early antibiotic treatment at home showed protective effects against severe pneumonia in children under five.

Area of Science:

Pediatrics
Infectious Diseases
Public Health

Background:

Pneumonia is a leading cause of under-five mortality globally and the second leading cause in Kenya.
Over 30,000 deaths annually in Kenya are attributed to pneumonia in children under five.
Identifying risk factors for severe pneumonia is crucial for targeted interventions.

Purpose of the Study:

To identify risk factors associated with severe pneumonia in children under five years of age in Kenya.

Main Methods:

A case-control study was conducted with 103 cases of severe/very severe pneumonia and 103 controls with non-severe pneumonia.
Data on socio-demographics, nutritional status, and environmental factors were collected via structured questionnaires.
Statistical analysis was performed using Epi Info with a significance level of 0.05.

Main Results:

Comorbidity (OR=3.8), delayed treatment (≥3 days) (OR=2.3), and upper respiratory tract infection (URTI) contact (OR=2.7) were significant risk factors for severe pneumonia.
Receiving antibiotics at home demonstrated a protective effect (OR=0.4).

Conclusions:

Comorbidity, URTI contact, and delayed healthcare seeking are key risk factors for severe childhood pneumonia.
Health education on appropriate healthcare seeking and community health worker engagement are recommended for prevention and control.

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Abstract

Introduction:

Globally, pneumonia is the leading cause of death in children under the age of 5 years. In Kenya, it is the second leading cause of mortality, accounting for greater than 30,000 deaths in this age group annually. This study sought to identify risk factors for severe pneumonia in children under the age of five years.

Methods:

We conducted a case control study. Cases were children aged 2 to 59 months with severe pneumonia or very severe pneumonia and controls were those with non-severe pneumonia as defined by the integrated management of childhood illnesses classification. We administered structured questionnaires to mothers of participants to obtain data on socio-demographics, nutritional status and potential environmental risk factors. Data was analyzed using Epi Info; significance level was set at 0.05.

Results:

We recruited 103 cases and 103 controls. The median age of cases was 14.0 (Range 3-58) months and of controls 14.0 (Range 2-54) months. Comorbidity (Odds Ratio = 3.8, Confidence Interval 1.4-10.6), delay in seeking treatment for three days or more (Odds Ratio = 2.3, Confidence Interval 1.2-4.2) and contact with upper respiratory tract infection (Odds Ratio = 2.7, Confidence Interval 1.1-6.5) were independent risk factors for severe pneumonia. Receiving antibiotics at home (Odds Ratio = 0.4, Confidence Interval 0.2-0.8) was protective.

Conclusion:

Co-morbidity, contact with upper respiratory tract infection and delay in seeking treatment are risk factors for severe pneumonia. We recommend health education regarding appropriate health seeking and engaging community health workers in pneumonia prevention, control and treatment.

Keywords:

Risk factors children under five severe pneumonia western Kenya

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