Risk Of Pneumonia In Children Research Articles

Pneumonia Induced Mortality and Risk of Pneumonia in Children with Cerebral palsy with Scoliosis Treated with and without Surgery

Pneumonia Induced Mortality and Risk of Pneumonia in Children with Cerebral palsy with Scoliosis Treated with and without Surgery

Meta-Analysis: Effects of Exposure to Tobacco Smoke and Malnutrition on the Risk of Pneumonia in Children

Background: Exposure to tobacco smoke (ETS) and poor nutritional status affect the risk of pneumonia in children. The purpose of this study was to analyze and estimate the effect of exposure to tobacco smoke and nutritional status in children on the risk of pneumonia. Subjects and Method: The meta-analysis was carried out using the PRISMA flowchart and the PICO model. Population: children under five. Intervention: exposure to tobacco smoke and poor nutritional status. Comparison: no exposure to tobacco smoke and no malnutrition status. Outcome: Pneumonia. The online databases used are Google Scholar, PubMed, and Scient Direct with the keywords “Pneumonia” AND “Exposure to tobacco smoke” AND “Poor nutritional status” AND “Children under five years” AND “Multivariate” AND “Cross-sectional”. The inclusion criteria were full-text, cross-sectional study, and published in English. The data were analyzed by RevMan 5.3. Results: A meta-analysis included 14 cross-sectional studies from Hong Kong, Nepal, Mongolia, Morocco, Uganda, Cameroon, Ethiopia, Nigeria, Egypt, and China. The total sample was 52,863 children under five. The results of the meta-analysis showed that exposure to tobacco smoke was 2.08 times more at risk of developing pneumonia than children under five who were not exposed (aOR=2.08; Cl 95%=1.30 to 3.32; p= 0.002). The presence of poor nutritional status is 2.00 times more at risk of experiencing pneumonia than children under five with no malnutrition status. (aOR=2.00; 95% Cl=1.31 to 3.06; p= 0.001). Conclusion: Exposure to tobacco smoke and poor nutritional status in toddlers can increase the risk of pneumonia. Keywords: exposure to tobacco smoke, poor nutritional status, children under five years pneumonia. Correspondence:Atika Dwi Minawati. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: dwiminawatiatika@gmail.com. Mobile: +625212613303.

Analyzing the epidemic situation and influencing factors of childhood pneumonia during the COVID-19 epidemic period in Laiwu, China.

This study aimed to analyze the trends of childhood pneumonia before and after the corona virus disease 2019 (COVID-19) pandemic in Laiwu, China, and explore the associated risk factors to provide a reference for the prevention, control, and treatment of childhood pneumonia. In this cross-sectional study, data were collected from 11,716 children aged 3 to 12 years who underwent chest radiography/computed tomography from January 2018 to December 2021 in Laiwu, China. The generalized estimating equation model was used to analyze the time trend of the pneumonia detection rate. Multivariate logistic regression analysis was used to analyze the risk factors for pneumonia in children. The overall pneumonia detection rate was 40.3% (4721/11,716). The pneumonia detection rate was 41.5% and 39.5% in 2018 and 2019, respectively, before the COVID-19 pandemic, which decreased to 38.1% in 2020 during the pandemic and increased to 40.7% in 2021 after the pandemic. Multivariate logistic regression analysis showed that preterm birth (odds ratio [OR] = 1.68), frequent exposure to secondhand smoke (OR = 1.79), hospitalization ≥ 1 time in half a year (OR = 2.13), and history of allergic rhinitis (OR = 2.14) were risk factors for pneumonia in children. Wearing masks when outdoors (OR = 0.89) and engaging in regular physical activity (OR = 0.65) were protective factors. The pneumonia detection rate in children showed a decreasing trend during the COVID-19 pandemic in 2020 but an increasing trend after the pandemic in 2021. Premature birth, exposure to secondhand smoke, frequent hospitalization, and allergic rhinitis were risk factors for pneumonia in children. Wearing masks when outdoors and exercising may reduce the risk of pneumonia in children.

Risk Factors for the Development of Pneumonia Below 2 Years of Age

Acute respiratory tract illness is the leading cause of death in the developing countries. This case control study was endeavored with an aim to assess the factors that can increase the risk of pneumonia in children. Methodology: This Case-Control study was carried out at the Paediatrics Department of Jalalabad Ragib Rabeya Medical College Hospital (JRRMCH) in Sylhet from January 2018 to July 2018.This study involved 200 children of 6 to 24 months age, among them 100 children who was hospitalized in JRRMCH for pneumonia during the study period as case. The control group included 100 children who was selected purposively came for immunization at JRRMCH EPI centre and at OPD for other problem but free from pneumonia. Sample were selected according to the inclusion & exclusion criteria. A case definition for pneumonia as outlined by the WHO(2014) was used as the criteria for case inclusion. Children with history of low birth weight, congenital cardiovascular or respiratory malformation, chromosomal abnormalities, recurrent wheeze, were excluded from the study. Data were collected by interviews of the parents using a structured questionnaire. Pneumonia (a child with cough or difficult breathing and fast breathing and or chest in-drawing with recently developed radiological pulmonary shadowing)1 affected 100 children included in case group and 100 children free of pneumonia included in control group. SPSS version 22 were used to analyze the data. Independent sample‘t’ test and Chi (x2 ) square test were done. Results: Residential area, socio-economic status, maternal education, H/A score, formula feeding, types of complimentary feeding, passive smoking, birth order >2, family member, crowding index and birth spacing are significantly associated with development of pneumonia. Conclusion: Children belonged to rural area, poor maternal education, low socio-economic status, stunting height for age, formula feeding, types of complimentary feeding, exposure to passive smoking, birth order>2, birth spacing, family member and crowding index were significantly (p<0.05) associated with pneumonia.

Bagaimana Menurunkan Risiko Pneumonia Komunitas pada Anak-Anak Berusia <5 Tahun yang Tinggal di Hunian Padat?

Overcrowding is one of the factors that contribute to respiratory diseases transmission, including pneumonia. Pneumonia is an infectious disease commonly found and is the most important cause of death for children aged <5. Generally, pneumonia was found in low-income residents from houses overcrowded. This study aims to identify the most dominant risk factors for community pneumonia in children aged <5 years who live in crowded housing in the Work Area of the North Larangan Public Health Center, Tangerang. A case-control study was conducted, with a ratio of cases and controls of 1:1, namely 25 cases and 25 controls. The sampling technique of cases is total sampling, and the control is purposive sampling. This study used univariate, bivariate with chi-square test, and regression logistic for multivariate analysis. Multivariate analysis showed that the risk factors associated with the incidence of pneumonia in children under five who lived in dense housing were exclusive breastfeeding (OR=7.65 (95% CI:1.27-46.07)) and nutritional status (OR=8.79 (95%CI:1.05-73.78)). Reducing the lack of exclusive breastfeeding and improving the underweight dietary status of children can minimize the risk of pneumonia in children under five living in dense housing.

Association between proton pump inhibitor use and risk of pneumonia in children: nationwide self-controlled case series study in Sweden

ObjectiveTo evaluate the association between use of proton pump inhibitors (PPIs) and risk of pneumonia in children.DesignNationwide register-based self-controlled case series study.SettingSweden, July 2006 to December 2016.ParticipantsChildren aged <18 years...

Risk Assessment for Postoperative Pneumonia in Children Living With Neurologic Impairments.

Approximately one-third of all pediatric hospital charges are attributable to the care for children living with neurologic comorbidities. These children often require various surgical procedures and may have an elevated risk of lower respiratory infections because of poor neuromuscular coordination, poor cough, uncoordinated swallowing, and poor oral hygiene. Our objective was to evaluate the risk of pneumonia in children presenting with neurologic comorbidities. We performed a retrospective study of children (<18 years) who underwent inpatient surgery between 2012 and 2018 in hospitals participating in the National Surgical Quality Improvement Program. Our primary outcome was the time to incident pneumonia within the 30 days after surgery. We identified 349 163 children, of whom 2191 developed pneumonia (30-day cumulative incidence: 0.6%). The presence of a preoperative neurologic comorbidity conferred approximately twofold higher risk of postoperative pneumonia (hazard ratio [HR]: 1.91, 95% confidence interval [CI]: 1.73-2.11). We explored the risk of pneumonia conferred by the components of neurologic comorbidity: cerebral palsy (HR: 3.92, 95% CI: 3.38-4.56), seizure disorder (HR: 2.93, 95% CI: 2.60-3.30), neuromuscular disorder (HR: 2.63, 95% CI: 2.32-2.99). The presence of a neurologic comorbidity was associated with a longer length of hospital stay (incidence rate ratio: 1.26, 95% CI: 1.25-1.28). The risk of postoperative pneumonia was almost twofold higher in children with neurologic comorbidity. The magnitude of these associations underscores the need to identify areas of research and preventive strategies to reduce the excess risk of pneumonia in children with preoperative neurologic conditions.

Serum Vitamin D Levels and the Risk of Pneumonia in Children

This systematic review and meta-analysis aimed to evaluate the association between serum vitamin D concentrations and the risk of pneumonia in children. Human studies reporting serum vitamin D levels in children with pneumonia and healthy controls were collected from different databases. The standardized mean difference and 95% confidence interval were calculated to evaluate the relationship between risk incidence of pneumonia and serum vitamin D levels. The results of analysis showed that serum vitamin D levels in children with pneumonia were significantly lower than those in healthy control children.

Positive Effect of Single-Dose Measles Vaccination in Reducing the Incidence of Pneumonia in Children with Measles.

Measles is a worldwide common, highly infectious and vaccine-preventable contagious disease with high morbidity and mortality rates. We investigated the effects of administering single-dose measles vaccination in children with measles on the incidence of pneumonia and hospitalization. We retrospectively analysed the hospital records of children aged 0-18 years who were diagnosed with measles within a year before the study in a training and research hospital in Mogadishu, Somalia. We compared the measles vaccine ratios, hospitalization rates, hospitalization duration and pneumonia development rates. We found that 34 (15.6%) patients had received measles vaccination, while 184 (84.4%) did not receive the vaccination. All the vaccinated patients received only a single dose of the vaccine. The proportion of those who had received pneumonia vaccine (14/34, 41.2%) was significantly lower than that of those who had never received a dose of measles containing vaccine (179/184, 97.3%) (p = 0.001). Moreover, patients who were immunized [n = 3 (3.1%)] had a significantly lower hospitalization rate than those who were not immunized [n = 94 (96.9%)] (p = 0.001). The risk of pneumonia in children with measles vaccination, rate of hospitalization and length of hospital stay was significantly lower in children who had received even a single dose of the vaccine when compared with that in those who had not vaccinated. The results of this study reiterate the need for more effective global measles vaccination.

A Meta-Analysis of the Effects of Secondhand Smoke Exposure toward the Incidence of Pneumonia in Children Under Five

Background: Pneumonia is an acute respira­tory infection in which the alveoli are filled with pus and fluids that cause painful respiration and limit oxygen intake. Pneumonia is the main cause of death among children under five in the world, killing more than 800,000 children under five each year, or about 2,200 per day. One of the risk factors for pneumonia in chil­dren under five is exposure to secondhand smoke. This study aimed to estimate the magni­tude of the effect of exposure to secondhand smoke on the incidence of pneumonia in chil­dren under five. Subjects and Method: This study used a syste­matic review and meta-analysis technique. There were three article search databases in­cluding Google Scholar, Pubmed, and Science Direct with a publication period from 2009-2020. The article search was carried out by con­si­dering the eligibility criteria defined using the PICO model. P: children under five, I: ex­po­sed to secondhand smoke, C: not exposed to second­hand smoke, and O: pneumonia. The key­­words for searching the articles were (risk factors OR passive smoking OR secondhand smoking) AND (pneumonia) AND (children under five). The articles included in this study were full-text articles, articles in English, arti­cles with cross-sectional study design and case-con­trol, articles with adjusted odds ratio re­sults. Articles were collected using PRISMA flow diagrams and analyzed using RevMan 5.3 application. Results: The total of 12 articles were reviewed in this study. A meta-analysis of three cross-sectional studies showed that exposure to second­hand smoke increased the risk of pneu­monia in children under five (aOR= 1.66; 95% CI= 1.38 to 2.01; p <0.001). A meta-ana­lysis of nine case-control studies showed that exposure to secondhand smoke increased the risk of pneumonia in children under five years (aOR= 2.15; 95% CI=1.25 to 3.68; p=0.005). Conclusion: Exposure to secondhand smoke in­­crea­ses the incidence of pneumonia in chil­dren under five. Keyword s : The exposure to secondhand smoke, pneumonia, children under five. Correspondence: Maya Ayu Riestiyowati. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami, Pucangsawit, Jebres, Surakarta 57125, Central Java, Indonesia. Email: maaya.­ayuu.­ma­­­@gmail.com. Journal of Epidemiology and Public Health (2020), 05(04): 410-419 https://doi.org/10.26911/jepublichealth.2020.05.04.03

The Effects of Non-Exclusive Breastfeeding on the Risk of Pneumonia in Children under Five: Meta-Analysis

Background: Pneumonia is an inflammation of the lung parenchyma caused by pathogenic microorganisms such as bacteria, viruses, fungi, and parasites that can occur together with lower respiratory tract infections. Pneumonia is the cause of death for more than 800,000 children under worldwide in 2017. One of the risk factors for is a history of (ASI). This study aimed to esti­mate the effect of non-exclusive breastfeed­ing on the risk of in children under five. Subjects and Method: This meta-analysis was conducted by systematically reviewing similar primary articles from PubMed, Google Scholar, and Springer Link. The articles that were analyzed by the meta-analysis were arti­cles published from 2011 to 2019. PICO com­piled the problem formulation: Population: children under five, Intervention: non-exclusive breastfeeding, Comparison: breast­feeding, Outcome: pneumonia. Keywords for searching articles: exclusive breastfeeding OR breast milk AND exclusive breastfeeding AND pneumonia children under five AND multivariate AND case con­trol. The inclusion criteria used were full paper, used English and Indonesian, and the case-control study design. The results were reported with adjusted odds ratio. Articles were collected using PRISMA diagrams and analyzed using Review Manager 5.3. Results: A total of 9 primary articles were ana­lyzed using meta-analysis with a total sample size of 2,837 children under five. The meta-analysis of case-control studies showed that non-exclusive increased the risk of in children under (aOR= 4.00; 95% CI= 2.75 to 5.81). Conclusion: Non-exclusive increases the risk of in children under five. Keyword s : non-exclusive breastfeeding, pneumonia, meta-analysis Correspondence: Putu Anggi Widia Karmany. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: putuanggiwidiakarmany@gmail.com. Journal of Epidemiology and Public Health (2020), 05(04): 393-401 https://doi.org/10.26911/jepublichealth.2020.05.04.01

Contextual Effect of Village on the Risk of Pneumonia in Children Under Five in Magetan, East Java

Background : Pneumonia is a major cause of illness and death in children under five worldwide. Studies into the contextual effect of village are lacking in Indonesia. This study aimed to determine contextual effect of village on the risk of pneumonia in children under five in Magetan, East Java. Subje cts an d Met hod : This was a case control study conducted in Magetan, East Java, from October 2018 to December 2018. A sample of 225 children under five from 25 villages was selected by fixed disease sampling. The dependent variable was pneumonia. The independent variables were nutritional status, vitamin A intake, maternal stress, maternal education, family income, family smoking, cooking fuel, house physical environment, and the presence of children in the kitchen when cooking. The data were collected by questionnaire and analyzed by a multilevel logistic regression. Results : Maternal stress (b= 1.91; 95% CI= 0.75 to 3.06; p= 0.001), family smoking habits (b = 1.39; 95% CI = 0.46 to 2.32; p = 0.003), cooking fuel (b= 1.51; 95% CI= 0.46 to 2.55; p= 0.005), and the presence of children in the kitchen when cooking (b= 1.37; 95% CI = 0.38 to 2.35; p= 0.007) increased the risk of pneumonia in children under five. The risk of pneumonia was reduced by good nutritional status (b= -1.74; 95% CI= -2.70 to -0.78; p <0.001), complete vitamin A status (b= -1.14; 95% CI= -2.04 to -0.24; p= 0.013), high maternal education (b= -1.41; 95% CI= -2.45 to -0.37; p= 0.008), high family income (b= -0.91; 95% CI= -1.80 to -0.02; p= 0.045), and healthy home physical environment (b= -1.86; 95% CI= -3.20 to -0.52; p= 0.007). Village had a strong contextual effect on pneumonia among children under five with ICC= 21.32%. Conclusions : Maternal stress, family smoking habits, cooking fuel, and the presence of children in the kitchen when cooking increase the risk of pneumonia in children under five. It is reduced by good nutritional status, complete vitamin A status, high maternal education, high family income, and healthy home physical environment. Village has a strong contextual effect on pneumonia among children under five Keywords : pneumonia, children under five, biopsychosocial, environmental, determinants, multilevel analysis Correspondence: Yola Alqorien Mustikarani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java 57126, Indonesia. Email: yolla.mstika@gmail.com. Mobile: +6285856122288 Journal of Epidemiology and Public Health (2019), 4(2): 117-126 https://doi.org/10.26911/jepublichealth.2019.04.02.07

Understanding the effect of indoor air pollution on pneumonia in children under 5 in low- and middle-income countries: a systematic review of evidence

Exposure to indoor air pollution increases the risk of pneumonia in children, accounting for about a million deaths globally. This study investigates the individual effect of solid fuel, carbon monoxide (CO), black carbon (BC) and particulate matter (PM)2.5 on pneumonia in children under 5 in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and grey full-text documents without restrictions to study design, language or year of publication using nine databases (Embase, PubMed, EBSCO/CINAHL, Scopus, Web of Knowledge, WHO Library Database (WHOLIS), Integrated Regional Information Networks (IRIN), the World Meteorological Organization (WMO)-WHO and Intergovernmental Panel on Climate Change (IPCC). Exposure to solid fuel use showed a significant association to childhood pneumonia. Exposure to CO showed no association to childhood pneumonia. PM2.5 did not show any association when physically measured, whilst eight studies that used solid fuel as a proxy for PM2.5 all reported significant associations. This review highlights the need to standardise measurement of exposure and outcome variables when investigating the effect of air pollution on pneumonia in children under 5. Future studies should account for BC, PM1 and the interaction between indoor and outdoor pollution and its cumulative impact on childhood pneumonia.

Evaluation of Iron Profileasan Assistant Diagnostic Tests for Children with Pneumonia

Back ground: Iron is required by most organisms as an essential cofactor in many important biological processes. There are controversies regarding the role of nutrients especially iron in respiratory tract infections in childhood. Furthermore, iron deficiency is also associated with impaired immunocompetence and therefore can lead to increased morbidity.Objective: the aim of this study was to testthe possibility of using the iron profile as a laboratory and diagnostic tests for pneumonia in children.Methodology: Case-control study was designed to hypothesize that lower iron, ferritin, and TIBC would be associated with a greater risk of pneumonia in children. The study was performed on 150 children with ages between (6 - 72) months, 100 children with pneumonia (57% male) and (43% female,) and 50 control (54% female) and (46% female) in pediatric department of Samarra general hospital from September 2015 till March 2017. The data were analyzed through the SPSS V.20 application, descriptive data analysis was done through frequency, percentage, mean, standard deviation in addition to T-test to compare results. Results: The results showed there was a significant decreased in the levels of Iron, ferritin, andhemoglobin when compared to control group(66.48±15.9, 3.99±2.06 and 9.4±1.10 vs 75.86±1.87,5.79±1.66 and 12.23±1.07 respectively), while there was no significant difference of TIBC in study groupwhen compared to control group(390.93±47.78 vs 393.74±34.64, respectively).Conclusion: The results of this study were concluded that the pneumonia in children lead to significantdecrease on iron levels, hemoglobin and ferritin while don't effect on TIBC.Recommendations:The use early and accurate measurements of iron profile that which includes iron,ferritin and certain compound which contain iron such as hemoglobin as a laboratory diagnostic tests addto the diagnostic tool for pneumonia in children.

Multilevel Analysis on the Biological, Social Economic, and Environmental Factors on the Risk of Pneumonia in Children Under Five in Klaten, Central Java

Background: Pneumonia is one of the leading causes of death in children under five in the world, particularly in the developing countries including Indonesia. Imbalance between host, agent, and environment, can cause the incidence of pneumonia. This study aimed to examine the biological, social economic, and environmental factors on the risk of pneumonia in children under five using multilevel analysis with village as a contextual factor. Subjects and Method: This was an analytic observational study with case control design. The study was conducted in Klaten District, Central Java, from October to November, 2017. A total sample of 200 children under five was selected for this study by fixed disease sampling. The dependent variable was pneumonia. The independent variables were birth weight, exclusive breastfeeding, nutritional status, immunization status, maternal education, family income, quality of house, indoor smoke exposure, and cigarette smoke exposure. The data were collected by questionnaire and checklist. The data were analyzed by multilevel logistic regression analysis. Results: Birth weight ≥2.500 g (OR=0.13; 95% CI= 0.02 to 0.77; p= 0.025), exclusive breastfeeding (OR= 0.15; 95% CI= 0.02 to 0.89; p= 0.037), good nutritional status (OR=0.20; 95% CI= 0.04 to 0.91; p= 0.038), immunizational status (OR= 0.12; 95% CI= 0.02 to 0.67; p= 0.015), maternal educational status (OR= 0.18; 95% CI= 0.03 to 0.83; p= 0.028), high family income (OR= 0.25; 95% CI= 0.07 to 0.87; p= 0.030), and good quality of house (OR= 0.21; 95% CI= 0.05 to 0.91; p= 0.037) were associated with decreased risk of pneumonia. High indoor smoke exposure (OR= 8.29; 95% CI= 1.49 to 46.03; p= 0.016) and high cigarette smoke exposure (OR=6.37; 95% CI= 1.27 to 32.01; p= 0.024) were associated with increased risk of pneumonia. ICC= 36.10% indicating sizeable of village as a contextual factor. LR Test p= 0.036 indicating the importance of multilevel model in this logistic regression analysis. Conclusion: Birth weight, exclusive breastfeeding, good nutritional status, immunizational status, maternal educational status, high family income, and good quality of house decrease risk of pneumonia. High indoor smoke exposure and high cigarette smoke exposure increase risk of pneumonia. Keyword: pneumonia, biological, social economic, environmental factor, children under five Correspondence: Nurul Ulya Luthfiyana, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: ulya.luthfiyana@gmail.com. Journal of Epidemiology and Public Health (2018), 3(2): 128-142 https://doi.org/10.26911/jepublichealth.2018.03.02.03 Â

Effect of Climate Factors on the Childhood Pneumonia in Papua New Guinea: A Time-Series Analysis.

This study aimed to assess the association between climate factors and the incidence of childhood pneumonia in Papua New Guinea quantitatively and to evaluate the variability of the effect size according to their geographic properties. The pneumonia incidence in children under five-year and meteorological factors were obtained from six areas, including monthly rainfall and the monthly average daily maximum temperatures during the period from 1997 to 2006 from national health surveillance data. A generalized linear model was applied to measure the effect size of local and regional climate factor. The pooled risk of pneumonia in children per every 10 mm increase of rainfall was 0.24% (95% confidence interval: −0.01%–0.50%), and risk per every 1 °C increase of the monthly mean of the maximum daily temperatures was 4.88% (95% CI: 1.57–8.30). Southern oscillation index and dipole mode index showed an overall negative effect on childhood pneumonia incidence, −0.57% and −4.30%, respectively, and the risk of pneumonia was higher in the dry season than in the rainy season (pooled effect: 12.08%). There was a variability in the relationship between climate factors and pneumonia which is assumed to reflect distribution of the determinants of and vulnerability to pneumonia in the community.

The Association Between Maternal Education, Family Income, House Sanitation, and the Incidence of Acute Respiratory Tract Infection in Children Under Five

Background: It was estimated that the incidence of Acute Respiratory Tract Infection (ARTI), including pneumonia, was  10-20% in children under five in Indonesia. Therefore ARTI in children under five is a public health important that calls for control and prevention. The purpose of this study was to determine the association between maternal education, family income, house sanitation, and the incidence of ARTI in children under five. Subjects and Method: This was an analytic observational study with case control design . This study was conducted in Wono­giri 1 and Kismantoro Health Centers, Wono­giri, Central Java, from September to October, 2016. A total sample of 200 children under five were selected for this study by fixed disease sampling, consisting of 100 children with ARTI and 100 children without ARTI. The dependent variable was pneumonia. The independent variables were maternal education, family income, house component, and house sanitation. The data were collected by a set of questionnaire, checklist, and medical record at the health centers. The data were analyzed by multiple logistic regression. Results: Maternal education ≥senior high school (OR=0.09; 95% CI= 0.03 to 0.22; p&lt;0.001), house component meeting the required standard (OR=0.27; 95% CI= 0.13 to 0.57; p&lt;0.001), and good house sanitation (OR=0.15; 95% CI= 0.06 to 0.38; p&lt;0.001) were associated with decreased risk of pneumonia in children under five, and they were statistically significant. The association between family income and the risk of pneumonia was not statistically significant (OR=0.87; 95% CI= 0.42 to 1.79; p=0.703). Conclusion: Maternal education ≥senior high school, house component meeting the required standard, and good house sanitation are associated with decreased risk of pneumonia in children under five. Keywords: maternal education, family income, house sanitation, pneumonia, children under five Correspondence: Anita Sri Sulistyo. District Health Office Wonogiri, Central Java. Email: anitasrisulistyowati@yahoo.com Journal of Epidemiology and Public Health (2016), 1(3): 195-202 https://doi.org/10.26911/jepublichealth.2016.01.03.06 Â

Hierarchical spatial modelling of pneumonia prevalence when response outcome has misclassification error: Applications to household data from Malawi

Pneumonia remains a major cause of child mortality in less developed countries. However, the accuracy of its prevalence and burden remains a challenge because disease data is often based on self-reports, resulting in measurement error in a form of under- and over-reporting. We propose hierarchical disease mapping approaches that permit measurement error, through different prior distributions of sensitivity and specificity. Proposed models were used to evaluate spatial variation of risk of pneumonia in children in Malawi. Results show that the true prevalence was 0.50 (95 CI: 0.4–0.66), however, estimates were dependent on sensitivity and specificity parameters. The estimated sensitivity was 0.76 (95% CI: 0.68–0.95), whereas specificity was 0.84 (95% CI: 0.72–0.93). A lower specificity underestimated the true prevalence, while sensitivity and specificity of greater or equal to 0.75 provided reliable and stable prevalence estimates. The spatial variation in disease risk changed little; however, misclassification of areas as high risk was visible.

A Study on the Relationship between Nutritional Status and Prevalence of Pneumonia and Diarrhoea among Preschool Children in Kushtia

The prevalence of diarrhoea and pneumonia is quite alarming amongst children under 5 years of age who belong to low socioeconomic status. This study was carried out from January to December (2012) in Kushtia, and the total sample were boys (209) and girls (191). Anthropometric measurements were performed by standard methods National Centre for Health Statistics (NCHS). The prevalence of severe underweight, stunting and wasting (≤ -3 SD) were found in the sample data about 11%, 22% and 17% respectively; whereas the prevalence of pneumonia, diarrhea and both pneumonia & diarrhea was found 53%, 44.50% and 38.75% respectively. The high prevalence of pneumonia (62.72%) and frequency (1.85) were found in under 12 months age group, while diarrhea (48.86%) and both pneumonia & diarrhea (45.45%) were found in 13-24 months age group. A greatest relationship was found between mother and child health status. About 89.26% mothers with poor health status have a sick child. Among the mothers with good health, the percentage of sick children was 45.73%. In this study, 34.25% of children were found to be severe anemic, 40.25% of children were found to be moderately anemic and 25.50% were nonanemic. Our findings underscore the fact that even poor nutrition or marginal malnutrition can predispose children to pneumonia. Anemia also significantly increased the risk of pneumonia in children. Our study revealed that anemia might be a risk factor for lower respiratory tract infections including pneumonia; however further studies with statistical model is needed to confirm. This study also indicated that children with diarrhea were at increased risk of pneumonia.

Children with fever and cough at emergency care

To develop and validate a prediction model for the early identification of children with pneumonia in emergency care settings. This was a diagnostic study with derivation and validation of multivariate logistic regression models. This study was carried out on children aged 1 month-16 years presenting with fever and cough visiting the pediatric emergency department of the Erasmus MC-Sophia, Rotterdam, the Netherlands (derivation population, n=504); Pediatric Assessment Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK (validation population 1, n=420); Accident & Emergency Department, Queen's Medical Centre, Nottingham, UK (validation population 2, n=366). The outcome pneumonia is defined by the presence of pulmonary consolidations on chest radiograph or follow-up. In population 1, 78 (16%) children were diagnosed with pneumonia; in populations 2 and 3, this number was 58 (14%) and 27 (7%), respectively. A simple clinical decision rule on the basis of ill appearance, tachypnea, decreased oxygen saturation, and elevated serum C-reactive protein categorized children as being at a low (<5%) or a high (>16%) risk of pneumonia. The rule yielded a discriminative value of 0.79 (0.69-0.89) in the Rotterdam population and was validated well in the other two populations. The risk of pneumonia can be assessed using three key clinical characteristics - overall assessment of the severity of illness, breathing rate, and oxygen saturation. Serum C-reactive protein contributes to the prediction of an intermediate risk of pneumonia in children. Children with a low risk of developing pneumonia with vital signs in the normal range can be discharged with effective safety netting, requiring neither antibiotics nor radiographs.