Volume 23, Number 8—August 2017
Dispatch
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 Ariyoshi
Table 2
Risk factors for death from pneumonia among children <5 years of age hospitalized at Abu Ali Sina Balkhi Regional Hospital, Mazar-e-Sharif, Afghanistan, December 2012–March 2013
| Variable | Discharged, no. (%), n = 542 | Deceased, no. (%), n = 75 | Odds ratio (95% CI) | p value | Adjusted odds ratio (95% CI)* | p value |
|---|---|---|---|---|---|---|
| Sex | ||||||
| F | 186 (34.3) | 32 (42.7) | 1.42 (0.87–2.32) | 0.15 | 1.61 (0.96–2.71) | 0.06 |
| M |
356 (65.7) |
43 (57.3) |
1 |
1 |
||
| Age, mo | ||||||
| <1 (newborn) | 9 (1.7) | 8 (10.7) | 11.1 (3.36–36.6) | <0.01 | 13.1 (3.71–46.5) | <0.01 |
| 1–11 | 433 (89.9) | 59 (78.6) | 1.70 (0.78–3.67) | 0.17 | 1.59 (0.72–3.49) | 0.24 |
| >12 |
100 (18.4) |
8 (10.7) |
1 |
|||
| Maternal illiteracy | ||||||
| Literate | 83 (15.3) | 7 (9.3) | 0.56 (0.25–1.28) | 0.17 | 0.62 (0.26–1.45) | 0.27 |
| Illiterate |
459 (84.7) |
68 (90.7) |
1 |
|||
| Duration of illness, d | ||||||
| >7 | 80 (14.8) | 17 (22.7) | 1.56 (0.85–2.85) | 0.14 | 1.73 (0.92–3.25) | 0.08 |
| <7 |
462 (85.2) |
58 (77.3) |
1 |
|||
| Ethnicity | ||||||
| Tajik | 252 (46.5) | 35 (46.7) | 1 | |||
| Pashtoon | 105 (19.4) | 16 (21.3) | 1.09 (0.58–2.06) | 0.77 | 0.80 (0.40–1.60) | 0.54 |
| Uzbek | 62 (11.5) | 10 (13.3) | 1.16 (0.54–2.47) | 0.69 | 1.04 (0.47–2.31) | 0.91 |
| Hazara | 89 (16.4) | 11 (14.7) | 0.88 (0.43–1.82) | 0.75 | 0.81 (0.38–1.72) | 0.58 |
| Other |
34 (6.3) |
3 (4.0) |
0.63 (0.18–2.17) |
0.47 |
0.48 (0.13–1.75) |
0.27 |
| Received antimicrobial drugs before hospitalization | ||||||
| Yes | 476 (87.8) | 65 (86.7) | 1.09 (0.47–2.49) | 0.83 | ||
| No | 56 (10.3) | 7 (9.3) | 1 | |||
| Unknown |
10 (1.9) |
3 (4.0) |
2.4 (0.52–10.9) |
0.24 |
||
| Bacillus Calmette–Guérin vaccine | ||||||
| Received | 474 (87.4) | 55 (73.3) | 0.39 (0.22–0.69) | <0.01 | 0.47 (0.25–0.88) | 0.02 |
| Not received |
68 (12.6) |
20 (26.7) |
1 |
|||
| >1 dose pentavalent vaccine, n = 547† | ||||||
| Received | 380 (79.0) | 44 (66.7) | 0.53 (0.30–0.92) | 0.02 | ||
| Not received |
101 (21.0) |
22 (33.3) |
1 |
|||
| Measles vaccine, n = 165† | ||||||
| Received | 98 (64.9) | 6 (42.9) | 0.40 (0.13–1.23) | 0.11 | ||
| Not received |
53 (35.1) |
8 (57.1) |
1 |
|||
| Vitamin A, n = 336† | ||||||
| Received | 111 (37.1) | 7 (18.9) | 0.39 (0.16–0.92) | 0.03 | ||
| Not received |
188 (62.9) |
30 (81.1) |
1 |
|||
| Malnutrition‡ | ||||||
| Detected | 199 (36.7) | 41 (54.7) | 2.06 (1.26–3.35) | <0.01 | 2.06 (1.22–3.49) | <0.01 |
| Not detected |
340 (62.7) |
34 (45.3) |
1 |
|||
| Anemia | ||||||
| Detected | 246 (45.4) | 39 (52.0) | 1.32 (0.76–2.29) | 0.31 | ||
| Not detected | 192 (35.4) | 23 (30.7) | 1 | |||
| Not evaluated | 104 (19.2) | 13 (17.3) | 1.04 (0.50–2.14) | 0.90 | ||
*Age, sex, ethnicities and variables with p<0.2 in univariate analyses were included in multivariate analysis; blank cells indicate variables without p<0.2 in univariate analysis. Because they had collinearity, bacillus Calmette–Guérin vaccine was included with vaccines and vitamin A was included in multivariate analysis.
†No. children eligible for the vaccines or vitamin A.
‡3 children, whose nutritional status was unknown, were excluded.
1These authors contributed equally to this article.
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