Jagdish Prasad Goyal1, Prawin Kumar2, Aparna Mukherjee3, Rashmi Ranjan Das4, Javeed Iqbal Bhat5, Vinod Ratageri6, Bhadresh Vyas7, Rakesh Lodha3. 1. Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan. Correspondence to: Dr. Jagdish Prasad Goyal, Professor, Department of Pediatrics, AIIMS, Jodhpur 340 003, Rajasthan. jpgoyal@rediffmail.com. 2. Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan. 3. Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi. 4. Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha. 5. Department of Pediatrics, Sher-i-Kashmir, Institute of Medical Sciences, Srinagar, Jammu and Kashmir. 6. Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, Karnataka. 7. Department of Pediatrics, MP Shah Government Medical College, Jamnagar, Gujarat.
Abstract
OBJECTIVE: To identify the risk factors for pneumonia and severe pneumonia in children. DESIGN: Prospective cohort study. SETTING: Five tertiary-care teaching hospitals in India. PARTICIPANTS: Children 2 to 59 months of age suffering from acute respiratory infection (ARI). MAIN OUTCOME MEASURES: Risk factors for the development of WHO defined pneumonia and severe pneumonia. RESULT: A total of 18159 children screened, and 7026 (39%) children with ARI were enrolled. According to the WHO criteria, 938 (13.4%) and 6088 (86.6%) of the enrolled children had pneumonia and no pneumonia, respectively. Out of 938 children with pneumonia, 347 (36.9%) had severe pneumonia. On univariate analysis, younger age, male gender and low weight for height, were significant risk factors for pneumonia. On multivariate analysis, one-unit increase in age in months (OR = 0.97; 95% CI: 0.97-0.98) and weight for height z-score (OR = 0.76; 95% CI: 0.72-0.79) had a protective effect. CONCLUSIONS: Young age and undernutrition (low weight for height/length) in children are significant independent risk factors for pneumonia.
OBJECTIVE: To identify the risk factors for pneumonia and severe pneumonia in children. DESIGN: Prospective cohort study. SETTING: Five tertiary-care teaching hospitals in India. PARTICIPANTS: Children 2 to 59 months of age suffering from acute respiratory infection (ARI). MAIN OUTCOME MEASURES: Risk factors for the development of WHO defined pneumonia and severe pneumonia. RESULT: A total of 18159 children screened, and 7026 (39%) children with ARI were enrolled. According to the WHO criteria, 938 (13.4%) and 6088 (86.6%) of the enrolled children had pneumonia and no pneumonia, respectively. Out of 938 children with pneumonia, 347 (36.9%) had severe pneumonia. On univariate analysis, younger age, male gender and low weight for height, were significant risk factors for pneumonia. On multivariate analysis, one-unit increase in age in months (OR = 0.97; 95% CI: 0.97-0.98) and weight for height z-score (OR = 0.76; 95% CI: 0.72-0.79) had a protective effect. CONCLUSIONS: Young age and undernutrition (low weight for height/length) in children are significant independent risk factors for pneumonia.