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Volume 23, Number 8—August 2017

Risk for Death among Children with Pneumonia, Afghanistan

Rahmani Zabihullah1, Bhim G. Dhoubhadel1, Ferogh A. Rauf, Sahab A. Shafiq, Motoi Suzuki, Kiwao Watanabe, Lay M. Yoshida, Michio Yasunami, Salihi Zabihullah, Christopher M. Parry, Rabi Mirwais, and Koya AriyoshiComments to Author 
Author affiliations: Nagasaki University, Nagasaki, Japan (R. Zabihullah, B.G. Dhoubhadel, M. Suzuki, K. Watanabe, L.M. Yoshida, M. Yasunami, C.M. Parry, K. Ariyoshi); Abu Ali Sina Balkhi Regional Hospital, Mazar-e-Sharif, Afghanistan (F.A. Rauf, S.A. Shafiq, S. Zabihullah); London School of Hygiene and Tropical Medicine, London, UK (C.M. Parry); Public Health Department, Balkh Province, Afghanistan (R. Mirwais)

Main Article

Table 1

Characteristics and clinical outcomes for 639 children <5 years of age with pneumonia hospitalized at Ali Sina Balkhi Regional Hospital, Mazar-e-Sharif, Afghanistan, December 2012–March 2013

Characteristics No. (%)
M 411 (64.3)
228 (35.7)
Age, mo
<1 (newborn) 17 (2.7)
1–11 510 (79.8)
112 (17.5)
Maternal illiteracy
549 (85.9)
Duration of illness >7 d before hospitalization
102 (16.0)
Tajik 300 (46.9)
Pashtoon 123 (19.3)
Uzbek 77 (12.0)
Hazara 101 (15.8)
38 (6.0)
Received antimicrobial drugs before hospitalization
Yes 561 (87.8)
No 65 (10.2)
13 (2.0)
Vaccination status, vitamin A intake, and nutritional status
Bacillus Calmette–Guérin vaccine 545 (85.2)
>1 dose of pentavalent vaccine, n = 568 436 (76.8)
Measles vaccine, n = 171 107 (62.6)
>1 dose of vitamin A, n = 345
119 (34.5)
Detected 255 (39.9)
Not detected 381 (59.6)
Not evaluated
3 (0.5)
Detected 296 (46.3)
Not detected 220 (34.4)
Not evaluated
123 (19.3)
Both malnutrition and anemia, n = 514
126 (24.5)
Very severe pneumonia‡
532 (83.3)
Clinical outcome, n = 617
Discharged well 542 (87.9)
Death 75 (12.1)

*Defined by weight/age z score <–2, and the z score value was calculated by using World Health Organization Anthro software, version 3.2.2 9 (
†Defined according to the World Health Organization (4) and Janus et al. (5).
‡Severity classified according to World Health Organization (3). Very severe pneumonia is defined as cough or difficulty breathing with 1 of the following: central cyanosis, difficulty feeding, convulsions, lethargy, loss of consciousness, severe respiratory distress.

Main Article

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Main Article

1These authors contributed equally to this article.

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