Modifiable risk factors for community‐acquired pneumonia in children under 5 years of age in resource‐poor settings: a case–control study

Objective Despite the availability of vaccines and antibiotics, pneumonia remains the leading cause of mortality among children under 5 years of age. The objective of this study was to identify modifiable risk factors for community‐acquired pneumonia (CAP) in children under 5 years of age in a vaccinated population. Methods A case–control study was conducted between January and December 2017. The cases included children aged 2–59 months with X‐ray‐confirmed pneumonia, whereas the controls were children from the community with no history of respiratory infection. A multivariable logistic regression model was used to determine the modifiable risk factors for CAP. Results A total of 113 children with X‐ray‐confirmed pneumonia and 350 healthy children were enrolled in this study. The median ages for the cases and controls were 13.7 (IQR = 7.2–25.3) and 13.4 (IQR = 6.0–24.8) months respectively. One (0.9%) child died after the enrolment. The independent predictors of CAP included a lack of exclusive breastfeeding for 6 months (aOR = 1.7, 95% CI = 1.0–2.9), underweight (aOR = 2.1, 95% CI = 1.0–4.5), unclean cooking fuel (aOR = 1.8, 95% CI = 1.0–3.3) and low income (aOR = 2.9, 95% CI = 1.6–5.4). No association was found between vaccination status and CAP. Conclusion In addition to a lack of exclusive breastfeeding, children from families of low‐economic status were at risk of contracting CAP. Since the risk factors are complex, the study results call for more concerted efforts by and collaboration among the health, agriculture and development sectors to address mortality caused by CAP. Objectif Malgré la disponibilité des vaccins et des antibiotiques, la pneumonie reste la principale cause de mortalité chez les enfants de moins de cinq ans. L'objectif de cette étude était d'identifier les facteurs de risque modifiables pour la pneumonie acquise en communauté (PAC) chez les enfants de moins de cinq ans dans une population vaccinée. Méthodes Une étude cas‐témoins a été menée entre janvier et décembre 2017. Les cas concernaient des enfants âgés de 2 à 59 mois atteints de pneumonie confirmée par la radiographie, alors que les témoins étaient des enfants de la communauté sans antécédents d'infection respiratoire. Un modèle de régression logistique multivariée a été utilisé pour déterminer les facteurs de risque modifiables pour la PAC. Résultats Au total, 113 enfants atteints de pneumonie confirmée par la radiographie et 350 enfants en bonne santé ont été inclus dans