A Study of Risk Factors for Pneumococcal Disease among Children in a Rural Area of West Africa

Pneumococcal infection is a leading cause of pneumonia meningitis and septicemia in developing countries. The authors investigated possible risk factors for pneumococcal disease during 1989-91 among children living in the rural Upper River Division of The Gambia. A prospective case-control study approach was used in which 80 children with pneumococcal infection were matched according to age with 159 healthy children randomly selected from the local community. The subjects were of mean age 14.0-14.2 months. A questionnaire was used to identify possible nutritional medical socioeconomic and environmental risk factors for pneumococcal disease. The study found an increased risk of pneumococcal disease to be associated with poor weight gain a history of serious illness during the previous 6 months exposure to cigarette smoke or being carried upon a mothers back while she cooks. The risk of pneumococcal disease was reduced among children whose mothers had a personal source of income. The authors suggest reducing the incidence of pneumococcal disease by improving nutrition and growth monitoring encouraging mothers to develop greater financial independence and reducing childrens exposure to smoke.