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Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study
Juliana Coelho Pina1, Suzana Alves de Moraes2, Isabel Cristina Martins de Freitas3
1PhD, Adjunct Professor, Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Insights
Improving primary health care quality can reduce childhood pneumonia hospitalizations. Key factors include vaccination, nutrition, and prenatal care, while factors like daycare attendance increase risk.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Pneumonia is a leading cause of hospitalization in children under five.
- Understanding factors associated with pneumonia hospitalization is crucial for prevention.
- Primary Health Care (PHC) plays a vital role in child health outcomes.
Purpose of the Study:
- To evaluate the association between primary health care quality and other factors with pneumonia hospitalization in children under five.
- To identify protective and risk factors for childhood pneumonia requiring hospitalization.
Main Methods:
- A hospital-based, case-control study involving 345 cases and 345 controls.
- Data collected via questionnaire and the Primary Care Assessment Tool.
- Multivariate logistic regression analysis was employed.
Main Results:
- Protective factors included higher family income, adequate weight gain during pregnancy, good quality PHC, gastro-esophageal reflux, being overweight, and longer birth intervals.
- Risk factors identified were high parity, outdated vaccination status, undernutrition, history of wheezing, daycare attendance, and recent medication use.
Conclusions:
- Prioritizing PHC services, including nutritional monitoring, immunization, and prenatal care, is essential for preventing childhood pneumonia hospitalizations.
- Addressing identified risk factors and promoting protective factors can significantly impact child health.
Objective::
to evaluate the association of primary health care and other potential factors in relation to hospitalization due to pneumonia, among children aged under five years.
Method::
epidemiological study with a case-control, hospital-based design, which included 345 cases and 345 controls, matched according to gender, age and hospital. Data were collected using a pre-coded questionnaire and the Primary Care Assessment Tool, analyzed by means of multivariate logistic regression, following the assumptions of a hierarchical approach.
Results::
the protective factors were: family income >US$216.12 (OR=0.68), weight gain during pregnancy ≥10 kg (OR=0.68), quality of Primary Health Care (OR for scores >3.41=0.57; OR for scores >3.17 and ≤3.41=0.50), gastro-esophageal reflux (OR=0.55), overweight (OR=0.37) and birth interval ≥48 months (OR=0.28). The risk factors included: parity (2 childbirths: OR=4.60; ≥3 childbirths: OR=3.25), out-of-date vaccination (OR=2.81), undernutrition (OR=2.53), history of wheezing (≥3 episodes OR=2.37; 1 episode: OR=2.13), attendance at daycare center (OR=1.67), and use of medicines over the past month (OR=1.67).
Conclusion::
primary health care and its child health care practices, such as nutritional monitoring, immunization, care to prevalent illnesses, prenatal care and family planning need to be prioritized to avoid child hospitalization due to pneumonia.
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