Objective: To identify the risk factors for pneumonia and severe pneumonia in children.
Design: Prospective cohort study.
Setting: Five tertiary-care teaching hospitals in India.
Participants: Children 2 to 59 months of age suffering from acute respiratory infection (ARI).
Main outcome measures: Risk factors for the development of WHO defined pneumonia and severe pneumonia.
Result: A total of 18159 children screened, and 7026 (39%) children with ARI were enrolled. According to the WHO criteria, 938 (13.4%) and 6088 (86.6%) of the enrolled children had pneumonia and no pneumonia, respectively. Out of 938 children with pneumonia, 347 (36.9%) had severe pneumonia. On univariate analysis, younger age, male gender and low weight for height, were significant risk factors for pneumonia. On multivariate analysis, one-unit increase in age in months (OR = 0.97; 95% CI: 0.97-0.98) and weight for height z-score (OR = 0.76; 95% CI: 0.72-0.79) had a protective effect.
Conclusions: Young age and undernutrition (low weight for height/length) in children are significant independent risk factors for pneumonia.