Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study

BACKGROUND: Community-acquired pneumonia (CAP) is one of the five leading causes of death among children in developing countries, accounting for approximately three million deaths per year. Identification of the modifiable risk factors of CAP may help to reduce the burden of this disease. In this study, the impact of the socioeconomic status (SES) on the severity and outcome of CAP among Egyptian children was studied. METHODS: This was a prospective longitudinal cohort study which included 1,470 children diagnosed with CAP, aged two to 15 years (median age 5.4 years). The diagnosis of CAP was based on clinical and radiological findings. A structured questionnaire and the patients’ medical records were used for the data collection. The subjects were divided into two groups: mild and severe CAP. Social and demographic variables were compared, and a multivariate logistic regression analysis was performed. RESULTS: The multivariate analysis showed that a low maternal education level (OR: 3.8; 95% CI: 2.12 –6.70; P = .0001), unavailability of adequate medical care (OR: 3.1; 95% CI: 1.99 –4.88; P = .0001), a low family income (OR: 2.2; 95% CI: 0.99 –4.78; P = .047), and parents’ smoking habits (OR: 2.0; 95% CI: 1.15 –3.55; P = .014) were significant independent predictive risk factors for severe CAP among Egyptian children. CONCLUSION: Public health measures against these socio-demographic risk factors should be identified as priorities in order to help reduce the disease burden of deaths from severe CAP among Egyptian children.