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


Howie, SR; Schellenberg, J; Chimah, O; Ideh, RC; Ebruke, BE; Oluwalana, C; Mackenzie, G; Jallow, M; Njie, M; Donkor, S; Dionisio, KL; Goldberg, G; Fornace, K; Bottomley, C; Hill, PC; Grant, CC; Corrah, T; Prentice, AM; Ezzati, M; Greenwood, BM; Smith, PG; Adegbola, RA; Mulholland, K; (2016) Childhood pneumonia and crowding, bed-sharing and nutrition: a case-control study from The Gambia. The international journal of tuberculosis and lung disease , 20 (10). pp. 1405-1415. ISSN 1027-3719 DOI: 10.5588/ijtld.15.0993

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Abstract

Greater Banjul and Upper River Regions, The Gambia. To investigate tractable social, environmental and nutritional risk factors for childhood pneumonia. 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. 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. 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: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
PubMed ID: 27725055
Web of Science ID: 384393500026
URI: http://researchonline.lshtm.ac.uk/id/eprint/2965109

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