Risk factors for mortality among children hospitalized because of acute respiratory infections in Bangui, Central African Republic

Background. Acute respiratory infections are the most common cause of death in children in developing countries. Little information is available on ri sk factors for mortality among African children presenting with symptoms co mpatible with acute respiratory infections. Objective. To identify risk factors for death among children hospitalized f or respiratory complaints who satisfy the WHO clinical definition for pneum onia or severe pneumonia. Methods. Children <5 years of age who presented with cough and/or difficult breathing and were hospitalized in Bangui during a 1-year period were inve stigated for risk factors for mortality. The study population consisted of 395 children who satisfied the WHO clinical definition for pneumonia/severe pneumonia. The associations between death and demographic, nutritional, so cioeconomic, laboratory and clinical variables were examined. Results. Of the 49 (12.4%) children who died, all but one had had indrawing of the chest which, in univariate analysis, was the risk factor most stron gly associated with death [odds ratio, 22.99; 95% confidence interval (CI), 3.81 to 935.2]. In a multivariate model the independent risk factors for d eath were indrawing of the chest [adjusted odds ratio (AOR) 8.35, CI 1.04 t o 66.82], hepatomegaly (AOR 6.72, CI 2.35 to 19.21), age between 2 and 11 m onths (AOR 6.37, CI 2.18 to 18.59), grunting (AOR 4.53, CI 1.96 to 10.45), a moderate/severe alteration of general status (AOR 3.23, CI 1.17 to 8.94) and acute malnutrition (AOR 2.74, CI 0.96 to 7.78). Conclusions. These findings could be used in flow charts for the management of children with respiratory complaints to identify children at increased risk of death who need to receive aggressive therapy.