A STUDY OF RISK-FACTORS FOR PNEUMOCOCCAL DISEASE AMONG CHILDREN IN A RURAL AREA OF WEST-AFRICA

Background. Pneumoccal infection is one of the leading causes of pneum onia, meningitis and septicaemia in developing countries. We have inve stigated possible risk factors for pneumococcal disease among children living in a rural area of The Gambia. Methods. A prospective case-con trol study was conducted in which children with pneumococcal infection were identified from among children attending out-patient and under-f ives clinics and matched according to age with healthy children select ed randomly from the local community. A questionnaire was used to inve stigate possible nutritional, medical, socioeconomic and environmental risk factors for pneumococcal disease. Results. An increased risk of pneumococcal disease was associated with poor weight gain, a history o f serious illness in the previous 6 months, exposure to cigarette smok e or being carried on mother's back while cooking. The risk of pneumoc occal disease was reduced among children whose mothers had a personal source of income. Conclusions. The incidence of pneumococcal disease c ould be reduced by improving nutrition and taking steps to identify an d rehabilitate those children whose weight is faltering or falling. En couraging mothers to develop greater financial independence may also b e beneficial. Reduced exposure to smoke should be promoted by improvin g ventilation in kitchens, introducing more efficient and less polluti ng stoves, keeping children away from smoky environments and discourag ing parental smoking.