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Risk factors for severe pneumonia in children in south Kerala: a hospital-based case-control study
N Shah1, V Ramankutty, P G Premila
1Department of Pediatrics, SAT Hospital, Medical College Hospital, Trivandrum, India.
Insights
Young age, immunization status, delayed weaning, and shared bedrooms are key risk factors for severe pneumonia in children under five. Addressing these can help reduce severe acute respiratory infection (ARI) mortality.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Severe pneumonia is a leading cause of mortality in children under five globally.
- Identifying specific risk factors is crucial for effective prevention and intervention strategies.
Purpose of the Study:
- To identify significant risk factors associated with severe pneumonia in children under five years of age in South Kerala, India.
Main Methods:
- A case-control study was conducted with 400 children under five.
- Cases were defined as inpatients with severe pneumonia (WHO criteria).
- Controls were outpatients with non-severe acute respiratory infections.
Main Results:
- Significant risk factors identified include young age, immunization status, delayed weaning, and sharing of bedrooms.
- Univariate analysis revealed parental education, environmental pollution, breastfeeding discontinuation, malnutrition, hypovitaminosis A, low birth weight, prior severe ARI, treatment non-responsiveness, and non-allopathic medicine use as significant.
- Four key factors emerged as most significant: young age, immunization, delayed weaning, and shared bedrooms.
Conclusions:
- Several modifiable factors contribute to severe pneumonia in young children.
- Interventions targeting these risk factors, such as improved nutrition, timely immunization, and better hygiene, may reduce severe acute respiratory infection (ARI) mortality.
Abstract:
A case-control study was undertaken in 400 children under 5 years of age in South Kerala, India, to identify the risk factors for severe pneumonia. Cases were in-patients with severe pneumonia as ascertained by WHO criteria, while controls were out-patients with non-severe acute respiratory infections. Only four from many probable risk factors emerged as being significant, viz. young age, immunization, delayed weaning, and sharing of bedroom. The significant factors on univariate analysis were parental education, environmental pollution, discontinuation of breastfeeding in young infants, malnutrition, hypovitaminosis A, low birth weight, previous history of severe ARI, unresponsiveness to earlier treatment, and use of non-allopathic medicine. Correction of these factors can probably reduce mortality due to ARI.