Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction

Table 2 Factors associated with severe pneumonia rather than pneumonia^a: results of univariable and multivariable analysis

	Unadjusted odds ratio (OR)	95% confidence interval (CI)	Adjusted OR	95% CI
Age
2–5 months	1.91	1.63–2.26	1.60	1.26–2.01
6–11 months	1.21	1.04–1.43	1.31	1.10–1.56
12–59 months	ref	--	ref	--
Low weight for age	1.19	1.03–1.37	1.22	1.04–1.42
Unsafe water	1.92	1.46–2.51	2.00	1.50–2.69
No hygienic latrine	0.85	0.77–0.98	--	--
Father’s education^b
None	ref	--	ref	--
Some primary	0.69	0.48–0.98	--	--
Some secondary	0.88	0.71–1.08	--	--
Higher than secondary	1.14	0.92–1.42	1.34	1.15–1.57
Mother’s education^b
None	ref	--	ref	--
Some primary	0.81	0.57–1.17	--	--
Some secondary	0.76	0.59–0.97	0.74	0.64–0.87
Higher than secondary	1.11	0.84–1.45	--	--
Pentavalent vaccination status per parent’s report^c
None	ref	--	ref	--
Partially vaccinated for age	0.88	0.62–1.26	--	--
Fully vaccinated for age	0.46	0.33–0.64	0.64	0.51–0.82
Number of co-morbid conditions^d
0	ref	--	ref	--
1+	1.58	1.16–2.14	--	--

^aCase definitions: 1) Pneumonia: history of coughing or difficulty breathing and age-specific tachypnea without any of the following signs, including inability to drink or breastfeed, vomiting with a final discharge diagnosis code for pneumonia or severe pneumonia, convulsions, prostration/lethargy, chest indrawing, or stridor in a calm child); 2) Severe pneumonia: history of coughing or difficulty breathing and ≥1 of the aforementioned signs. Because the sign, “vomiting everything” was not specifically captured in the abstraction form, we included children with a history of vomiting who also had a final hospitalization diagnosis of pneumonia or severe pneumonia to improve specificity for this sign
^bEducation categories were defined as the following: some primary (1–4 years), some secondary (5–9 years), higher than secondary (10 years or more)
^cVaccination status for pentavalent vaccines was collected from parents by verbal report. To be included, the child had to be age-eligible for the vaccine
^dCo-morbid conditions: congenital heart disease, thalassemia, nephrotic syndrome, Down’s syndrome, protein energy malnutrition (PEM) and tuberculosis

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