| dc.description.abstract |
Background: Pneumonia is a leading cause of morbidity and mortality among adults
worldwide; however, the risk factors for community-acquired pneumonia in Africa are
not well characterized.
Methods: The authors recruited 281 cases of community-acquired pneumonia and 1202
hospital controls among patients aged ≥15 years who attended Kilifi District
Hospital/Coast Provincial General Hospital in Kenya between 1994 and 6. Cases were
admissions with an acute illness with ≥2 respiratory signs and evidence of consolidation
on a chest radiograph. Controls were patients without signs of pneumonia, frequency
matched by age, sex and hospital. Risk factors related to socio-demographic factors, drug
use, clinical history, contact patterns and exposures to indoor air pollution were
investigated by questionnaire, anthropometric measurements and laboratory assays.
Associations were evaluated using a hierarchical logistic regression model.
Results: Pneumonia was associated with human immunodeficiency virus (HIV)
infection (Odds Ratio [OR] 2.06, 95% CI 1.44-3.08), anemia (OR 1.91, 1.31-2.74),
splenomegaly (OR 2.04, 95% CI 1.14-3.41), recent history of pneumonia (OR 4.65, 95%
CI 1.66-12.5), history of pneumonia >2 years previously (OR 17.13, 95% CI 5.01-60.26),
coryza in the 2 weeks preceding hospitalization (OR 2.09, 95% CI 1.44-3.03), current
smoking (2.19, 95% CI 1.39-3.70), use of khat (OR 3.44, 95% CI 1.72-7.15), use of
snuff (OR 2.67, 95% CI 1.35-5.49) and contact with several animal species. Presence of
a Bacillus Calmette-Guerin (BCG) scar was associated with protection (OR 0.51, 95% CI
0.32-0.82). The risk factors varied significantly by sex.
Conclusion: Pneumonia in Kenyan adults was associated with global risk factors, such
as HIV and smoking, but also with specific local factors like drug use and contact with
animals. Intervention strategies should account for sex-specific differences in risk
factors. |
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