Determinants of community acquired pneumonia among 2 to 59 months of age children in Northeast Ethiopia: a case-control study

Childhood Pneumonia in Low- and Middle-Income Countries: A Systematic Review of Prevalence, Risk Factors, and Healthcare-Seeking Behaviors

Childhood pneumonia is a major contributor to illness and death in children under the age of five globally. Despite advancements in medical science, the burden of pediatric community-acquired pneumonia (CAP) remains high, particularly in low- and middle-income countries. This systematic review aims to synthesize existing literature on the prevalence, risk factors, and healthcare-seeking behaviors associated with pediatric CAP to inform the development of targeted community-based interventions. An extensive search of various databases such as Medline, EMBASE, Web of Science, Cochrane, PubMed, PubMed Central, Helinet, SpringerLink, Google Scholar, and Biomed Central was performed, resulting in 65 potentially relevant studies. After a thorough evaluation process, 25 studies were selected for the final analysis. These selected studies offered valuable information on the epidemiology, risk factors, and healthcare-seeking behaviors associated with childhood pneumonia. The review revealed that environmental factors such as indoor air pollution, overcrowding, and exposure to tobacco smoke are significant risk factors for pediatric pneumonia. Additionally, socioeconomic factors, including poverty and a lack of access to clean water and sanitation, contribute to the vulnerability of children to this disease. Poor healthcare-seeking behaviors, driven by limited knowledge and awareness of pneumonia symptoms and treatment, further exacerbate the situation. The review also highlighted the critical role of vaccination, particularly against Haemophilus influenzae type b (Hib) and pneumococcus, in preventing pneumonia. However, gaps in vaccination coverage and challenges in accessing healthcare services remain barriers to effective pneumonia control. In light of these findings, the review recommends the implementation of community-based interventions that address the multifaceted determinants of pediatric pneumonia. These interventions should focus on improving environmental conditions, enhancing access to preventive measures such as vaccination, and promoting better healthcare-seeking behaviors through education and awareness campaigns. It is essential for healthcare providers, policymakers, and community members to collaborate in developing and implementing culturally appropriate and sustainable interventions. This cooperation aims to lessen the impact of pneumonia on children and their families.

Determinants of under-five pneumonia in randomly selected health facilities at Aleta Wondo Woreda, Sidama Region Ethiopia: Case-control study

INTRODUCTION

Under-five mortality reduction due to pneumonia is not Signiant, particularly in developing countries. Pneumonia contributed to 27.5% to 31.3% of health facility visits by children 2 to 59 months in Aleta Wondo Woreda. Previous studies have shown inconclusive evidence on determinants of pneumonia in children.

METHODS

An institution-based unmatched case-control study was conducted to assess determinants of pneumonia among under-five children at Aleta Wondo Woreda, Sidama Region.

RESULT

One-hundred forty-five cases and 290 controls of children aged 2 to 59 months participated in the study. The mean ± (SD) age of the children was 18.81 months (2.1 ± 11.43) and 28.26 months (2.1 ± 16.007) for cases and controls, respectively. Only 56% (n = 145) of cases open house windows daily, whereas most 68.6% (n = 290) of controls house windows open daily. Ninety five (62.8%) of cases and 68.6% of controls were exclusively breastfed for 6 months. Household income ≥1500 Ethiopian birr (AOR = 0.45, 95% CI, 0.017-0.120, p < 0.000), child location outside of cooking house during cooking (AOR = 0.101, 95% CI, 0.43-0.238, p < 0.000), no formal education of the mother (AOR = 2.398, 95% CI, 1.082-5.316, p < 0.031), and presence of history of upper respiratory tract infections (URTIs) in last 2 weeks (AOR = 2.183, 95% CI, 1.684-5.273, P < 0.049) were determinants of pneumonia.

CONCLUSION

Determinants of pneumonia in under-five children were multifactorial (socioeconomic, nutritional, and environmental). Addressing these factors by involving all relevant stakeholders is important to reduce pneumonia-related morbidity and mortality among under-five children in the study area.

Risk factors for childhood pneumonia at Adama Hospital Medical College, Adama, Ethiopia: a case-control study

BACKGROUND

Pneumonia is an acute respiratory infection of the lungs. A child dies of pneumonia every 39 s globally. Even though pneumonia affects children worldwide, the risk and repercussions of the disease are more prevalent in poor and middle-income nations. Despite the initiatives by the Ethiopian government, there are still numerous instances and deaths caused by childhood pneumonia. Therefore, this study aimed to identify the risk factors for pneumonia among 2-59 months-old children visiting Adama Hospital Medical College, Adama, Ethiopia.

METHODS

An institution-based unmatched case-control study was conducted among 124 cases and 124 controls from January 1, 2021, to March 15, 2021. Cases were selected using a consecutive sampling technique. For each case, the next patient from the same pediatric outpatient room who met the inclusion criteria was taken as a control. Data were collected using a pretested, structured interviewer-administered questionnaire containing sociodemographic, environmental, and nutritional factors, comorbid illnesses, and related care practices. A multiple logistic regression model was fitted.

RESULTS

Family size of ≥ 5 compared to < 5 (Adjusted odds ratio (AOR): 3.08, 95% CI: 1.23, 7.71), household monthly income of < 2500 compared to > 5000 birr (AOR: 3.94, 95% CI: 1.06, 14.6), use of charcoal as the main fuel for cooking (AOR: 7.03, 95% CI: 2.38, 20.78), and wood or dung as the main fuel for cooking compared to electricity (AOR: 6.58, 95% CI: 2.07, 20.9), malnutrition compared to no malnutrition (AOR: 4.77, 95% CI: 1.89, 12.06), diarrhea compared to no diarrhea in the past 2 weeks (AOR: 3.3, 95% CI: 1.52, 7.14) and upper respiratory tract infection (URTI) compared to no infection in the past 2 weeks (AOR: 3.29, 95% CI: 1.31, 8.23) were found to be risk factors for pneumonia.

CONCLUSION

In this study, risk factors for pneumonia were family size, monthly income, type of energy used for cooking, malnutrition, and diarrhea or URTI in the past 2 weeks. Relatively simple interventions such as cooking with electricity, and other interventions like prevention, early detection and treatment of malnutrition, diarrhea, and URTI, and promotion of family planning are important.

Identification of Mycoplasma pneumoniae-associated pneumonia cases among hospitalized patients using CLART® microarray technology

Objectives

Community-acquired pneumonia (CAP) is a global health condition that affects populations from all age groups. The laboratory identification of Mycoplasma pneumoniae as a causative agent of CAP is challenging because of its atypical and fastidious nature. Therefore, this study assessed the diagnostic potential of PneumoCLART bacteria® in identifying M. pneumoniae as a causative agent of pneumonia in hospitalized adults.

Methods

This prospective study used a cross-sectional approach to assess the diagnostic potential of PneumoCLART bacteria® for detecting M. pneumoniae in sputum samples procured from 27 patients with pneumonia who required hospitalization.

Results

The PneumoCLART bacteria® results illustrated that 7 of 27 patients with pneumonia were positive for M. pneumoniae (26%). However, the quality of sputum varied among the M. pneumoniae-positive and M. pneumoniae-negative samples. Fifty percent of the specimens obtained from patients positive for M. pneumoniae were saliva-contaminated and unsuitable for analysis.

Conclusions

Because the leukocyte count was low and sputum specimens were saliva-contaminated, these findings require further validation to prove the utility of CLART® microarray technology for the identification of M. pneumoniae in pneumonia-positive patients. Conclusively, this prospective study included a small number of clinical samples, which likely affected its outcomes.