Childhood pneumonia and crowding, bed-sharing and nutrition: a case-control study from The Gambia

Howie, S.R.C. et al. (2016) Childhood pneumonia and crowding, bed-sharing and nutrition: a case-control study from The Gambia. International Journal of Tuberculosis and Lung Disease, 20(10), pp. 1405-1415. (doi: 10.5588/ijtld.15.0993) (PMID:27725055) (PMCID:PMC5019143)

Abstract

Setting: Greater Banjul and Upper River Regions, The Gambia. Objective: To investigate tractable social, environmental and nutritional risk factors for childhood pneumonia. Design: A case-control study examining the association of crowding, household air pollution (HAP) and nutritional factors with pneumonia was undertaken in children aged 2–59 months: 458 children with severe pneumonia, defined according to the modified WHO criteria, were compared with 322 children with non-severe pneumonia, and these groups were compared to 801 neighbourhood controls. Controls were matched by age, sex, area and season. Results: Strong evidence was found of an association between bed-sharing with someone with a cough and severe pneumonia (adjusted OR [aOR] 5.1, 95%CI 3.2–8.2, P < 0.001) and non-severe pneumonia (aOR 7.3, 95%CI 4.1–13.1, P < 0.001), with 18% of severe cases estimated to be attributable to this risk factor. Malnutrition and pneumonia had clear evidence of association, which was strongest between severe malnutrition and severe pneumonia (aOR 8.7, 95%CI 4.2–17.8, P < 0.001). No association was found between pneumonia and individual carbon monoxide exposure as a measure of HAP. Conclusion: Bed-sharing with someone with a cough is an important risk factor for severe pneumonia, and potentially tractable to intervention, while malnutrition remains an important tractable determinant.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Fornace, Dr Kimberly
• Authors: Howie, S.R.C., Schellenberg, J., Chimah, O., Ideh, R.C., Ebruke, B.E., Oluwalana, C., Mackenzie, G., Jallow, M., Njie, M., Donkor, S., Dionisio, K.L., Goldberg, G., Fornace, K., Bottomley, C., Hill, P.C., Grant, C.C., Corrah, T., Prentice, A.M., Ezzati, M., Greenwood, B.M., Smith, P.G., Adegbola, R.A., and Mulholland, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: International Journal of Tuberculosis and Lung Disease
• Publisher: International Union against Tuberculosis and Lung Disease
• ISSN: 1027-3719
• ISSN (Online): 1815-7920
• ISBN: 18157920 10273719
• Copyright Holders: Copyright © 2016 Howie et al.
• First Published: First published in International Journal of Tuberculosis and Lung Disease 20(10): 1405-1415
• Publisher Policy: Reproduced under a Creative Commons License