Indian Journal of Public Health (Jan 2020)
Risk factors for pneumonia mortality in under-five children in a tertiary care hospital of Darjeeling district of West Bengal: A prospective case–control study
Abstract
Background: Among children admitted with pneumonia, several modifiable predictors have been identified for deaths in children in hospitals. Despite the presence of a several national programs designed to address most of the risk factors directly or indirectly it is surprising that they continue to be common in children with pneumonia. Objectives: The objective is to determine the risk factors for pneumonia mortality in under-five children in a tertiary care hospital of Darjeeling district of West Bengal. Methods: An analytical study with case–control design was conducted between May 2016 and October 2017. Children aged 2–59 months admitted with the diagnosis of pneumonia were followed up after admission and who died were recruited as cases and two consecutive age- and sex-matched controls were recruited among children who were declared cured and discharged. A total of 95 cases and 190 controls were studied and the risk factors were compared in the pair matched groups by the conditional logistic regression. Results: Factors influencing childhood pneumonia mortality were severely underweight (adjusted odds ratio [AOR]: 3.66 [1.28,10.46]) unimmunized child (AOR 4.18 [1.53, 11.41]), lack of exclusive breast feeding (AOR: 3.12 [1.23, 7.91]), past history of diarrhea or acute respiratory infection in the last 3 months (AOR: 7.27 [3.68, 14.36]), hypoxemia on admission (AOR: 2.53 [1.14, 5.61]), sub-center as the first contact health facility (AOR: 6.49 [2.15, 19.67]), and antibiotic not received at first contact (AOR: 3.18 [1.36, 7.43]). Conclusions: Most of the risk factors for death in children between 6 and 59 months of age are directly or indirectly related to health service delivery and can be ameliorated through proper structural and administrative measures.
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