Incidence and Risk Factors for Severe Pneumonia in Children Hospitalized with Pneumonia in Ujjain, India

Sunil Kumar Kasundriya,Ashish Pathak,Aditya Mathur,Mamta Dhaneria

doi:10.3390/ijerph17134637

Abstract

Childhood pneumonia is a major public health problem. The aim of this prospective hospital-based study is to determine the incidence and risk factors for community-acquired severe pneumonia in children in Ujjain, India. The study includes 270 children, 161 (60%) boys and 109 (40%) girls, aged between 2 months and 5 years with World Health Organization defined and radiologically confirmed severe pneumonia. Considering the 270 children, 64% (95% confidence interval (CI) 57.9–69.4) have severe pneumonia. The following are identified as risk factors for severe pneumonia from the generalized logistic regression model: Born premature (adjusted odds ratio (AOR) 7.50; 95% CI 2.22–25.31; p = 0.001); history of measles (AOR 6.35; 95% CI 1.73–23.30; p = 0.005); incomplete vaccination (AOR 2.66; 95% CI 1.09–6.48; p = 0.031); acyanotic congenital heart disease (AOR 9.21; 95% CI 2.29–36.99; p = 0.002); home treatment tried (AOR 3.84; 95% CI 1.42–10.39; p = 0.008); living in a kuchha house (AOR 3.89; 95% CI 1.51–10.01; p = 0.027); overcrowding (AOR 4.50; 95% CI 1.75–11.51; p = 0.002);poor ventilation in living area (AOR 16.37; 95% CI 4.67–57.38; p < 0.001); and practicing open defecation (AOR 16.92; 95% CI 4.95–57.85; p < 0.001). Awareness of these risk factors can reduce mortality due to severe pneumonia.

Highlights

Pneumonia is the most common illness affecting infants and children globally
The acute respiratory infections (ARIs) control program is dependent on the early identification and treatment of children with signs and symptoms suggestive of pneumonia, presuming a bacterial etiology
Considering the 270 children, 172 children were diagnosed with severe pneumonia, and the remaining 98 children had pneumonia according to the World Health Organization (WHO) classification

Summary

Introduction

Pneumonia is the most common illness affecting infants and children globally. It is the most common cause of under-5 (U-5) mortality and contributes to 15% of U-5 mortality in 2017, killing an estimated808,920 children [1]. Pneumonia is the most common illness affecting infants and children globally. It is the most common cause of under-5 (U-5) mortality and contributes to 15% of U-5 mortality in 2017, killing an estimated. During the Millennium Development Goal era from 2000 to 2015, the WHO-led ARI control program reduced the burden of pneumonia deaths from 1.7 million annual cases to 0.9 million, a 30% decrease in burden [2]. The pneumonia mortality rate decreased by nearly 51% [3,4]. The ARI control program is dependent on the early identification and treatment of children with signs and symptoms suggestive of pneumonia, presuming a bacterial etiology. The WHO and United Nations Children’s Fund (UNICEF), in 2013, published the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD), which outlined a framework for ending preventable child

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