Pneumonia in Children at a University Hospital in Addis Ababa, Ethiopia: Analysis of Potential Risk Factors

Background: Pneumonia is the single most important cause of morbidity and mortality in children below 5 years in developing countries including Ethiopia. However, much is not known about the specific risk factors of childhood pneumonia.

Objective: To identify childhood, parental sociodemographic and household characteristics as risk factors of pneumonia in children under 5 years of age.

Methods: A case control study was conducted at a tertiary teaching hospital in Addis Ababa. Cases were children below 5 years with a diagnosis of pneumonia (n=67). For each case, two controls admitted for other reasons to the same hospital during the same period were selected.

Results: Children who were not vaccinated at all had a higher risk of developing pneumonia (OR=4.12). The odds of developing pneumonia in malnourished children was significantly high (OR=14.89). Children whose fathers were unemployed had 2.72 times higher risk of developing pneumonia compared to those whose fathers were employed. Low monthly income was also significantly associated with pneumonia. Use of cooking materials such as wood, charcoal, dung and kerosene were significantly associated with pneumonia.  The presence of acute respiratory infections in the household within two weeks of the occurrence of pneumonia was strongly associated with this acute lower respiratory tract infection (p=0.00001).

Conclusion: Malnutrition, presence of ARI in the household, use of cooking materials such as  wood, charcoal, kerosene in the household and paternal unemployment were found to be risk factors for childhood pneumonia. In addition to integrated effort with other sectors, strengthening the health extension program is recommended to apply interventions targeted at the identified risk factors.