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Modifiable risk factors for community-acquired pneumonia in children under 5 years of age in resource-poor settings:
James Samwel Ngocho1, Marien Isaäk de Jonge2, Linda Minja3
1Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Insights
Community-acquired pneumonia (CAP) in young children is linked to not exclusively breastfeeding for six months, being underweight, using unclean cooking fuel, and low income. Vaccination status did not affect CAP risk in this study.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Pneumonia remains a leading cause of death in children under five, despite available vaccines and antibiotics.
- Identifying modifiable risk factors is crucial for reducing childhood mortality from community-acquired pneumonia (CAP).
Purpose of the Study:
- To identify modifiable risk factors for community-acquired pneumonia (CAP) in children under five within a vaccinated population.
Main Methods:
- A case-control study was conducted from January to December 2017.
- Cases were children aged 2-59 months with X-ray-confirmed pneumonia; controls were healthy community children.
- Multivariable logistic regression was used to determine modifiable risk factors for CAP.
Main Results:
- Key predictors of CAP included lack of exclusive breastfeeding for six months (aOR=1.7), underweight (aOR=2.1), unclean cooking fuel (aOR=1.8), and low income (aOR=2.9).
- No association was found between vaccination status and CAP.
- One death occurred post-enrollment among 113 CAP cases and 350 controls.
Conclusions:
- Children lacking exclusive breastfeeding and those from low-income families are at higher risk for CAP.
- Addressing CAP mortality requires a collaborative, multi-sectoral approach involving health, agriculture, and development sectors due to complex risk factors.
Objective:
Despite the availability of vaccines and antibiotics, pneumonia remains the leading cause of mortality among children under 5 years of age. The objective of this study was to identify modifiable risk factors for community-acquired pneumonia (CAP) in children under 5 years of age in a vaccinated population.
Methods:
A case-control study was conducted between January and December 2017. The cases included children aged 2-59 months with X-ray-confirmed pneumonia, whereas the controls were children from the community with no history of respiratory infection. A multivariable logistic regression model was used to determine the modifiable risk factors for CAP.
Results:
A total of 113 children with X-ray-confirmed pneumonia and 350 healthy children were enrolled in this study. The median ages for the cases and controls were 13.7 (IQR = 7.2-25.3) and 13.4 (IQR = 6.0-24.8) months respectively. One (0.9%) child died after the enrolment. The independent predictors of CAP included a lack of exclusive breastfeeding for 6 months (aOR = 1.7, 95% CI = 1.0-2.9), underweight (aOR = 2.1, 95% CI = 1.0-4.5), unclean cooking fuel (aOR = 1.8, 95% CI = 1.0-3.3) and low income (aOR = 2.9, 95% CI = 1.6-5.4). No association was found between vaccination status and CAP.
Conclusion:
In addition to a lack of exclusive breastfeeding, children from families of low-economic status were at risk of contracting CAP. Since the risk factors are complex, the study results call for more concerted efforts by and collaboration among the health, agriculture and development sectors to address mortality caused by CAP.
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