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Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting
Thesis (MMed) -- Stellenbosch University, 2022.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867613891021766656 |
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| access_status_str | Open Access |
| author | Mikhail Barday |
| author2 | Slogrove, Amy |
| author_browse | Mikhail Barday Slogrove, Amy |
| author_facet | Slogrove, Amy Mikhail Barday |
| author_sort | Mikhail Barday |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed) -- Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/126053 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:43:20.403Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/126053 Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting Mikhail Barday Slogrove, Amy Engelbrecht, Arnold Kling, Sharon Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Pneumonia in children Rural health services Pneumonia -- Environmental aspects Diseases -- Risk factors UCTD Thesis (MMed) -- Stellenbosch University, 2022. ENGLISH ABSTRACT: Title Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting Background Pneumonia remains a leading cause of death in South African children under 5 years of age. Known risk factors have been the focus of public health strategies to mitigate disease. This study aimed to determine adverse household environmental factors associated with severe pneumonia in children admitted to Worcester Provincial Hospital (WPH). We compared the odds of adverse household environmental factors with severe pneumonia to non-severe pneumonia in children under 5 years admitted to WPH. Methods We conducted a prospective case control study at WPH from the 1st of January 2019 to 31 December 2019 including children aged 0-59 months admitted with pneumonia. Using the WHO definition, children were categorised as having severe or non-severe pneumonia. Structured interviews with consenting primary caregivers were conducted in both groups on weekdays throughout the year. We compared demographic, social, maternal, infant, and household factors in children with severe pneumonia and non-severe pneumonia using multivariable logistic regression. Results A total of 305 children were assessed, comprising of 134 (43.9%) cases with severe pneumonia and 171 (56.1%) controls with non-severe pneumonia. Baseline characteristics of children including a median age of 6.9 months (IQR 2.5-17.5), exclusive breastfeeding practice (51.5%; n=157), term gestation at birth (65%; n=199), appropriate nutritional status (81.6%; n=249), appropriate immunisation status (86.9%; n=265), and HIV unexposed uninfected status (81.3%; n=248) were similar between groups. Caregiver characteristics were also comparable between groups including a median age of 28 years (IQR 23-33), South African citizenship (94.7%; n=288), some secondary schooling education (71.2%, n=217), and reported HIV negative status (81%; n=247). Univariable regression analysis did not demonstrate an association between severe pneumonia and adverse household environmental factors including indoor tobacco smoke exposure (unadjusted odds ratio (uOR) 0.73; 95% confidence interval (CI) 0.46-1.16), overcrowding (uOR 0.72; 95% CI 0.45-1.15) or indoor biomass fuel exposure (uOR 1.49; 95% CI 0.91-2.43). Multivariable analysis, adjusting for factors known to be associated with severe pneumonia in children (including age <3 months, birth weight <1500g, any breastfeeding, complete immunisation status, child’s HIV infection status, young maternal age, and caregiver education less than matric), did not demonstrate an association between severe pneumonia and adverse household environmental factors. However, children with severe pneumonia had at least a five times greater odds (aOR 5.42; 95% CI 1.10-26.65) of living in a household with a pit latrine toilet compared to any other toilet than children with non-severe pneumonia. Conclusion Within a fairly homogenous group of children admitted with pneumonia, few factors were found to be associated with pneumonia severity, except for living in a household with pit latrine toilet . Broadly, this may represent socioeconomic vulnerability and the risk associated with developing severe pneumonia and should be further explored in this setting. We did not identify any specific modifiable household environmental factors to be associated with severe pneumonia, however these factors could still be important risk factors for incident pneumonia, even if not associated with the severity of the pneumonia episode. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2022-11-17T10:19:05Z 2023-01-16T12:47:39Z 2022-11-17T10:19:05Z 2023-01-16T12:47:39Z 2022-01 Thesis http://hdl.handle.net/10019.1/126053 en_ZA Stellenbosch University xi, 64 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Pneumonia in children Rural health services Pneumonia -- Environmental aspects Diseases -- Risk factors UCTD Mikhail Barday Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| title | Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| title_full | Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| title_fullStr | Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| title_full_unstemmed | Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| title_short | Risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| title_sort | risk factors associated with the severity of pneumonia in a cohort of hospitalised children in a rural setting |
| topic | Pneumonia in children Rural health services Pneumonia -- Environmental aspects Diseases -- Risk factors UCTD |
| url | http://hdl.handle.net/10019.1/126053 |
| work_keys_str_mv | AT mikhailbarday riskfactorsassociatedwiththeseverityofpneumoniainacohortofhospitalisedchildreninaruralsetting |