{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T22:53:11Z","timestamp":1780959191337,"version":"3.54.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pneumonia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumonia is one of the leading causes of infant mortality globally, particularly in sub-Saharan Africa. In Uganda, pneumonia was the fourth leading cause of death in children\u2009&lt;5 years in 2018. Analysis of 2013\u20132022 data for children\u2009&lt;5 years from the District Health Information System indicated a high incidence of severe pneumonia in Kasese District, Uganda. We investigated to identify factors associated with severe pneumonia among children\u2009&lt;5 years in Kasese District to inform prevention and control strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a 1:1 hospital-based case-control study among children aged 2\u201359 months presenting with pneumonia at five high-volume facilities in Kasese District from January to April 2023. A case was defined as pneumonia with \u22651 of the following danger signs: low oxygen saturation, central cyanosis, severe respiratory distress, feeding difficulties, altered consciousness, and convulsions. Controls were outpatient children aged 2\u201359 months with a diagnosis of non-severe pneumonia. We reviewed medical records at facilities and used an interviewer-administered questionnaire with caregivers to obtain information on socio-demographic and clinical characteristics. Logistic regression was used to identify factors associated with severe pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 199 cases and 174 controls. The odds of severe pneumonia were higher among children with diarrhoea only (adjusted odds ratio [aOR]\u2009=\u20092.9, 95%CI: 1.7\u20134.9), or malaria and diarrhoea (aOR\u2009=\u20093.4, 95%CI: 2.0-5.9), than those without a co-existing illness at the time of pneumonia diagnosis. Not being exclusively breastfed for \u2265\u20096 months (aOR\u2009=\u20092.0, 95%CI: 1.1\u20133.3) and exposure to indoor air pollution from cooking combustion sources (aOR\u2009=\u20092.9, 95%CI: 1.8\u20134.7) increased odds of severe pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings highlight the significance of comorbidities, lack of exclusive breastfeeding, and exposure to indoor air pollution in the development of severe pneumonia. Promoting exclusive breastfeeding for \u2265\u20096 months and advocating for the use of clean energy sources, could mitigate morbidity attributable to severe pneumonia in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41479-024-00134-y","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T20:02:08Z","timestamp":1721851328000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors associated with severe pneumonia among children &lt;5 years, Kasese District, Uganda: a case-control study, January\u2013April 2023"],"prefix":"10.1186","volume":"16","author":[{"given":"Mercy Wendy","family":"Wanyana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Migisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham Kibaba","family":"Muhesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benon","family":"Kwesiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kadobera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Bulage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Riolexus","family":"Ario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"issue":"2","key":"134_CR1","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/S2352-4642(21)00311-4","volume":"6","author":"J Perin","year":"2022","unstructured":"Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. 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Am J Epidemiol. 1992;135(9):1019\u201328.","journal-title":"Am J Epidemiol"}],"container-title":["Pneumonia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41479-024-00134-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41479-024-00134-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41479-024-00134-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T20:02:58Z","timestamp":1721851378000},"score":1,"resource":{"primary":{"URL":"https:\/\/pneumonia.biomedcentral.com\/articles\/10.1186\/s41479-024-00134-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,25]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["134"],"URL":"https:\/\/doi.org\/10.1186\/s41479-024-00134-y","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3634297\/v1","asserted-by":"object"}]},"ISSN":["2200-6133"],"issn-type":[{"value":"2200-6133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,25]]},"assertion":[{"value":"19 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The MoH of Uganda through the office of the Director General Health Services gave the administrative clearance to carry out this investigation and access anonymised patient data. Additionally, the MoH has also granted the Uganda Public Health Fellowship Program permission to disseminate the information through scientific publications. In addition, the Office of the Associate Director for Science, US Centers for Disease Control and Prevention, determined that this study was not a human subjects research with the primary intent of guiding public health planning and practice. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.\u00a7 \u00a7See e.g., 45\u00a0C.F.R. part 46, 21\u00a0C.F.R. part 56; 42 U.S.C. \u00a7\u00a0241(d);","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The funders had no role in the study design, data collection, data analysis and decision to prepare or publish this manuscript.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}],"article-number":"13"}}