ArticleBMJ global health2019
Risk factors for death among children aged 5-14 years hospitalised with pneumonia: a retrospective cohort study in Kenya.
Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 7 of them syntheses that pooled it.
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17 citing papers in PubMed, 7 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Pooled it
- Pooled it
- Pooled it
- What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review.Journal of global health · 2023Pooled it
- A systematic review of the clinical features of pneumonia in children aged 5-9 years: Implications for guidelines and research.Journal of global health · 2022Pooled it
- Pooled it
- The Impact of the COVID-19 Pandemic on Immunization Campaigns and Programs: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Risk factors associated with disease severity among children hospitalised with community-acquired pneumonia in Angola.Journal of global health · 2026Observational
- Hospitalisation and critical care for pneumonia among children aged 5-9 years in Bangladesh: a 10-year retrospective analysis.Journal of global health · 2025Article
- Can Lung Ultrasound Act as a Diagnosis and Monitoring Tool in Children with Community Acquired Pneumonia? Correlation with Risk Factors, Clinical Indicators and Biologic Results.Journal of clinical medicine · 2025Article
- Ensemble of Deep Learning Architectures with Machine Learning for Pneumonia Classification Using Chest X-rays.Journal of imaging informatics in medicine · 2025Article
- Establishment and validation of a predictive model for severe pneumonia in children.African health sciences · 2025Article
- Characteristics of children readmitted with severe pneumonia in Kenyan hospitals.BMC public health · 2024Article
- Observational
- Incidence of Pneumonia and Predictors Among Human Immunodeficiency Virus Infected Children at Public Health Institutions in the Northwest Part of Ethiopia: Multicenter Retrospective Follow-Up Study.Pediatric health, medicine and therapeutics · 2022Article
- Employing learning health system principles to advance research on severe neonatal and paediatric illness in Kenya.BMJ global health · 2021Review
- Is the effect of COVID-19 on children underestimated in low- and middle- income countries?Acta paediatrica (Oslo, Norway : 1992) · 2020Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionThere were almost 1 million deaths in children aged between 5 and 14 years in 2017, and pneumonia accounted for 11%. However, there are no validated guidelines for pneumonia management in older children and data to support their development are limited. We sought to understand risk factors for mortality among children aged 5-14 years hospitalised with pneumonia in district-level health facilities in Kenya.
methodsWe did a retrospective cohort study using data collected from an established clinical information network of 13 hospitals. We reviewed records for children aged 5-14 years admitted with pneumonia between 1 March 2014 and 28 February 2018. Individual clinical signs were examined for association with inpatient mortality using logistic regression. We used existing WHO criteria (intended for under 5s) to define levels of severity and examined their performance in identifying those at increased risk of death.
results1832 children were diagnosed with pneumonia and 145 (7.9%) died. Severe pallor was strongly associated with mortality (adjusted OR (aOR) 8.06, 95% CI 4.72 to 13.75) as were reduced consciousness, mild/moderate pallor, central cyanosis and older age (>9 years) (aOR >2). Comorbidities HIV and severe acute malnutrition were also associated with death (aOR 2.31, 95% CI 1.39 to 3.84 and aOR 1.89, 95% CI 1.12 to 3.21, respectively). The presence of clinical characteristics used by WHO to define severe pneumonia was associated with death in univariate analysis (OR 2.69). However, this combination of clinical characteristics was poor in discriminating those at risk of death (sensitivity: 0.56, specificity: 0.68, and area under the curve: 0.62).
conclusionChildren >5 years have high inpatient pneumonia mortality. These findings also suggest that the WHO criteria for classification of severity for children under 5 years do not appear to be a valid tool for risk assessment in this older age group, indicating the urgent need for evidence-based clinical guidelines for this neglected population.
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