Assessment of Common Risk Factors for Pneumonia & Diarrhea Hospitalization among children in Chakaria, Cox’s Bazar

Abstract

Background: Pneumonia and diarrhea are the leading cause of death among children under 5 years of age. The high burden of morbidity and mortality among children living in developing countries remains unacceptable as both the diseases are preventative and mostly curative with available healthcare inventions. The aim of this analysis was to explore the common social and nutritional risk factors associated with childhood pneumonia and diarrhea for children (<3 years age) in Chakaria, Cox’s Bazar, Bangladesh.

Methods: The Chakaria health demographic surveillance system (CHDSS) data is used for this study to evaluate the risk factors for pneumonia and diarrhea hospitalization cases from 2012- 2018 for children under 3 years of age. Age, gender, socio economic status, distance from the sea coast were taken as socio demographic variables , water and sanitation were selected as WASH indicators, mid upper arm circumference (MUAC) measurement, breast feeding practice, vitamin A supplement were taken as nutritional predictors. Finally PCV (pneumococcal conjugate vaccine) coverage was compared with pneumonia hospitalizations. The frequency and percentage of hospitalization cases and mortality was calculated for pneumonia and diarrhea for children (<3 years old). The frequency distribution of predictor variables for pneumonia and diarrhea hospitalization cases was also evaluated. Logistic regression analyses (adjusted and unadjusted odds ratio) were performed for pneumonia and diarrhea hospitalization outcomes separately using all predictor variables.

Results: A total of 5,326 hospitalization cases were taken for the analysis, out of which 2292 cases were of pneumonia and 1929 cases were for diarrhea. An increased common risk of pneumonia and diarrhea was associated with severe malnutrition (p=0.04 &p < 0.0001), Vitamin A (p=0.02 &p=0.03), breads feeding (p < 0.0001), and distance from coast (p <0.0001). Other associated risk for pneumonia included gender (p=0.002), PCV (p=0.002), low socio economic status while tube well (p=0.03) was observed as a risk factor for diarrhea hospitalization. Conclusion: Malnutrition, Mixed feeding before six months age, lack of vitamin A supplementation, and household distance from the sea were the common associated risk factors of pneumonia and diarrhea hospitalization together. Prevention through PCV vaccination was also observed to be significant risk factor for pneumonia. Socio- demographic predictors did not have significant common risks for both diseases, but however remain important while considering health interventions to improve the status of childhood pneumonia and diarrhea in Chakaria, Cox’s Bazar.