J Pediatr Infect Dis 2013; 08(03): 131-138
DOI: 10.3233/JPI-130394
Georg Thieme Verlag KG Stuttgart – New York

Risk factors for mortality in childhood pneumonia in a rural West African region

Bankole Peter Kuti
a  Department of Pediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria
,
Samuel Ademola Adegoke
a  Department of Pediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria
,
Benard Ese Ebruke
b  Medical Research Council, Gambian Unit, Atlantic Boulevard, Fajara, Banjul, The Gambia
,
Stephen Howie
b  Medical Research Council, Gambian Unit, Atlantic Boulevard, Fajara, Banjul, The Gambia
,
Oyeku Akibu Oyelami
a  Department of Pediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria
,
Martin O.C. Ota
b  Medical Research Council, Gambian Unit, Atlantic Boulevard, Fajara, Banjul, The Gambia
› Institutsangaben

Verantwortlicher Herausgeber dieser Rubrik:
Weitere Informationen

Publikationsverlauf

25. März 2013

07. Juni 2013

Publikationsdatum:
28. Juli 2015 (online)

Abstract

Pneumonia is a major killer of children worldwide. It is responsible for 19% of under-five-year-old mortality, of which 70% occurs in sub-Saharan Africa and South East Asia. A substantial proportion of deaths attributed to pneumonia is caused by failure to recognise factors at presentation that affect prognosis. The present study was aimed to assess for factors at presentation that determine mortality among children with WHO ARI defined severe pneumonia. This was a prospective observational study of consecutive children aged 2 to 59 months admitted with severe pneumonia at a major health centre in rural Gambia to determine the risk factors for mortality using logistic regression analysis. Four hundred and twenty (27.6%) out of the 1517 under-five admissions during the study period fulfilled the criteria of severe pneumonia using the WHO ARI criteria. Fifteen of the 420 cases died giving case fatality of 36 per 1000 admissions, with pneumonia accounting for 21.4% of all 70 deaths during the period. Although age ranges 12–23 months and 36–47 months, overcrowding, hypothermia at presentation, oedematous PEM, severe wasting, grunting respiration, convulsion, somnolence and hypoxaemia were significantly associated with mortality (p < 0.05); only convulsions (OR = 16.64, 95% CI 1.028–1.033) and severe wasting (OR = 5.05, 95% CI 1.459–20.484,) were independent determinants of mortality. We conclude that children with severe pneumonia who in addition have severe wasting and convulsion are at increased risks of dying and should be managed in better equipped secondary or tertiary health facilities.