1. Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction.
- Author
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Saha, Shampa, Hasan, Md, Kim, Lindsay, Farrar, Jennifer L, Hossain, Belal, Islam, Maksuda, Ahmed, Asm Nawshad Uddin, Amin, M Ruhul, Hanif, Mohammed, Hussain, Manzoor, El-Arifeen, Shams, Whitney, Cynthia G, and Saha, Samir K
- Subjects
PNEUMONIA prevention ,PNEUMONIA-related mortality ,AGE distribution ,HOSPITAL care ,IMMUNIZATION ,PNEUMOCOCCAL vaccines ,PNEUMONIA ,WATER supply ,COMORBIDITY ,SEVERITY of illness index ,ODDS ratio - Abstract
Background: Pneumonia is the leading infectious cause of morbidity and mortality in young children in Bangladesh. We present the epidemiology of pneumonia in Bangladeshi children <5 years before 10-valent pneumococcal conjugate vaccine introduction and investigate factors associated with disease severity and mortality.Methods: Children aged 2-59 months admitted to three Bangladeshi hospitals with pneumonia (i.e., cough or difficulty breathing and age-specific tachypnea without danger signs) or severe pneumonia (i.e., cough or difficulty breathing and ≥1 danger signs) were included. Demographic, clinical, laboratory, and vaccine history data were collected. We assessed associations between characteristics and pneumonia severity and mortality using multivariable logistic regression.Results: Among 3639 Bangladeshi children with pneumonia, 61% had severe disease, and 2% died. Factors independently associated with severe pneumonia included ages 2-5 months (adjusted odds ratio [aOR] 1.60 [95% CI: 1.26-2.01]) and 6-11 months (aOR 1.31 [1.10-1.56]) relative to 12-59 months, low weight for age (aOR 1.22 [1.04-1.42]), unsafe drinking water source (aOR 2.00 [1.50-2.69]), higher paternal education (aOR 1.34 [1.15-1.57]), higher maternal education (aOR 0.74 [0.64-0.87]), and being fully vaccinated for age with pentavalent vaccination (aOR 0.64 [0.51-0.82]). Increased risk of pneumonia mortality was associated with age <12 months, low weight for age, unsafe drinking water source, lower paternal education, disease severity, and having ≥1 co-morbid condition.Conclusions: Modifiable factors for severe pneumonia and mortality included low weight for age and access to safe drinking water. Improving vaccination status could decrease disease severity. [ABSTRACT FROM AUTHOR]- Published
- 2016
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