Determinants of Pneumonia among Admitted Under-Five Children at Public Hospitals in East Hararghe, Eastern Ethiopia, 2025

Abstract

Background: Pneumonia remains a leading cause of under-five deaths globally, claiming 740,180 lives in 2019. In low- and middle-income countries, about 7 million children are hospitalized annually. In Ethiopia, high child pneumonia mortality is linked to malnutrition and household air pollution. This study aims to identify determinants of pneumonia among under-five children admitted to a public hospital in East Hararghe, Eastern Ethiopia.

Methods: The institutional-based unmatched case-control study was conducted in selected Eastern Hararghe Hospital, with target sample size of 255, consisting of 85 cases and 170 controls, maintaining a case-to-control ratio of 1 to 2. Consecutive sampling techniques were used to select samples for cases and controls among children admitted to the same wards. The data were entered into Epi-Info version 7 and exported to SPSS for analysis. Binary and multivariable logistic regression were calculated. Variable that had a p-value < 0.05 was used to declare associated factors.

Results: A total of 249 under-five children were enrolled in the study with a mean age of 21.7 months (SD ±15.4). Most participants 212 (85.14%) resided in rural areas. Multivariable logistic regression identified three significant determinants of pneumonia among admitted under-five children. Children living in urban areas were 2.5 times more likely to develop pneumonia (AOR = 2.57; 95% CI: 1.24, 5.20). Those from households with cigarette-smoking family members (AOR = 2.08; 95% CI: 1.05, 3.13) and those with a recent history of diarrhea (AOR = 1.85; 95% CI: 1.05, 3.13) also had higher odds of pneumonia.

Conclusion: Urban residence, family members who smoked cigarettes, and a recent history of diarrhea in the last two weeks are significant determinants of pneumonia among children under five admitted at public hospitals. Therefore, to reduce pneumonia incidence, targeted prevention should focus on promoting a smoke-free environment and enhancing hygiene and sanitation practices to prevent diarrhea and improve urban sanitation conditions.