Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction.

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.

• Authors: Shampa Saha, Md Hasan, Lindsay Kim, Jennifer L Farrar, Belal Hossain, Maksuda Islam, Asm Nawshad Uddin Ahmed, M Ruhul Amin, Mohammed Hanif, Manzoor Hussain, Shams El-Arifeen, Cynthia G Whitney, Samir K Saha
• Journal: BMC public health (BMC Public Health) Vol. 16 Issue 1 Pg. 1233 (12 07 2016) ISSN: 1471-2458 [Electronic] England
• PMID: 27927201 (Publication Type: Journal Article)

Chemical References

• 10-valent pneumococcal conjugate vaccine
• Drinking Water
• Pneumococcal Vaccines

Topics

• Age Factors
• Bangladesh (epidemiology)
• Child, Preschool
• Comorbidity
• Drinking Water (adverse effects)
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Infant
• Male
• Odds Ratio
• Pneumococcal Vaccines (administration & dosage)
• Pneumonia, Pneumococcal (etiology, mortality, prevention & control)
• Risk Factors
• Severity of Illness Index
• Vaccination (statistics & numerical data)