Risk factors for community-acquired pneumonia among adults in Kenya: a case–control study
Abstract
BackgroundPneumonia is a leading cause of morbidity and mortality among adults worldwide; however, the risk factors for community-acquired pneumonia in Africa are not well characterized.MethodsThe authors recruited 281 cases of community-acquired pneumonia and 1202 hospital controls among patients aged ≥15 years who attended Kilifi District Hospital/Coast Provincial General Hospital in Kenya between 1994 and 6. Cases were admissions with an acute illness with ≥2 respiratory signs and evidence of consolidation on a chest radiograph. Controls were patients without signs of pneumonia, frequency matched by age, sex and hospital. Risk factors related to socio-demographic factors, drug use, clinical history, contact patterns and exposures to indoor air pollution were investigated by questionnaire, anthropometric measurements and laboratory assays. Associations were evaluated using a hierarchical logistic regression model.ResultsPneumonia was associated with human immunodeficiency virus (HIV) infection (Odds Ratio [OR] 2.06, 95% CI 1.44–3.08), anemia (OR 1.91, 1.31–2.74), splenomegaly (OR 2.04, 95% CI 1.14–3.41), recent history of pneumonia (OR 4.65, 95% CI 1.66–12.5), history of pneumonia >2 years previously (OR 17.13, 95% CI 5.01–60.26), coryza in the 2 weeks preceding hospitalization (OR 2.09, 95% CI 1.44–3.03), current smoking (2.19, 95% CI 1.39–3.70), use of khat (OR 3.44, 95% CI 1.72–7.15), use of snuff (OR 2.67, 95% CI 1.35–5.49) and contact with several animal species.…
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