RISK-FACTORS FOR MORTALITY FROM ACUTE LOWER RESPIRATORY-TRACT INFECTIONS IN YOUNG GAMBIAN CHILDREN

A case-control study has been undertaken in a rural area of The Gambia to evaluate risk factors for death from acute lower respiratory tract infections (ALRI) in young children. On the basis of a post-mortem in terview 129 children aged < 2 years were thought to have died from ALR I. These cases were each matched according to age, sex, ethnic group, time and place of death with a child who had died from a cause other t han an ALRI and with two live control children. Cases and controls wer e well matched. Comparison of cases and live controls suggested that e xposure to smoke during cooking, parental smoking and exclusive, prolo nged breastfeeding were associated with an increased risk of death fro m ALRI whilst sharing a bed with siblings, use of antenatal and welfar e clinics and immunization were associated with a reduced risk of deat h from ALRI. No associations were found between mortality from ALRI an d maternal education and literacy, socioeconomic status or with the ag e of the mother. Comparison of children who died from causes other tha n ALRI with the live controls showed a similar pattern of associations and no significant differences were found in any of the risk factors studied between children whose deaths were attributed to ALRI and thos e whose death was attributed to another cause. Association of death wi th exposure to smoke during cooking was the strongest risk factor iden tified. This risk might be altered by reducing smoke exposure during c ooking.