High incidence of childhood pneumonia at high altitudes in Pakistan: a longitudinal cohort study

Abstract

Objective To determine the incidence of pneumonia and severe pneumonia among children living at high altitudes in Pakistan. Methods A longitudinal cohort study was conducted in which 99 female government health workers in Punial and Ishkoman valleys (Ghizer district, Northern Areas of Pakistan) enrolled children at home, conducted home visits every 2 weeks and actively referred sick children to 15 health centres. Health centre staff used Integrated Management of Childhood Illness criteria to screen all sick children aged 2-35 months and identify those with pneumonia or severe pneumonia. Findings Community health workers enrolled 5204 eligible children at home and followed them over a 14-month period, ending on 31 December 2002. Health centre staff identified 1397 cases of pneumonia and 377 of severe pneumonia in enrolled children aged 2-35 months. Among children reported with pneumonia, 28% had multiple episodes. Incidence rates per 100 child-years of observation were 29.9 for pneumonia and 8.1 for severe pneumonia. Factors associated with a high incidence of pneumonia were younger age, male gender and living at high altitude. Conclusion Pneumonia incidence rates in the Northern Areas of Pakistan are much higher than rates reported at lower altitudes in the country and are similar to those in high-altitude settings in other developing countries. More studies are needed to determine the causes of pneumonia in these high-mountain communities. However, early introduction of the vaccines that are known to prevent pneumonia should be considered. Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español.

Oxygen saturation of children in Pakistan's high mountain pastoral communities

“…While our data corroborate with data collected at similar altitudes elsewhere, based on the location of our study we foreground two additional issues:Pneumonia is a common cause of morbidity and mortality in children worldwide, including Pakistan's remote and resource-poor mountain communities 4. Monitoring of SaO 2 for respiratory illnesses could indicate when to administer oxygen.…”

“…Pneumonia is a common cause of morbidity and mortality in children worldwide, including Pakistan's remote and resource-poor mountain communities 4. Monitoring of SaO 2 for respiratory illnesses could indicate when to administer oxygen.…”

Mountain Child: Systematic Literature Review

“…Children living in mountain communities also face risks to their health related to their location, such as increased risk of pneumonia and respiratory infections at high altitudes (Khan et al [31], on Pakistan; literature review on child health at altitude by Niermeyer et al [45]); risks of injury (Shi et al [58], on South-west China); or the increased risks of natural disasters (Chohan [12], on the impact of flooding in Khyber Pakhtunkhwa and Punjab, Pakistan). Other risks to children’s health relate to the wider context of poverty in mountain communities, as discussed above [23].…”

Pengaruh Alfa Tokoferol pada Efek Ototoksik Sisplatin

“…Penelitian Khan dkk. 15 memiliki hasil yang serupa, hal ini mungkin disebabkan subjek yang diteliti berada pada satu kelompok usia, yaitu 2-59 bulan yang memperlihatkan gejala klinis, klasifikasi, kuman penyebab, dan tatalaksana yang sama. 16 Pada penelitian ini status gizi, antibiotik yang diberikan sebelumnya, dan diet sehari-hari sebagai faktor perancu.…”