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dc.contributor.authorKotloff, Karen L.
dc.contributor.authorLevine, Myron M.
dc.contributor.authorNataro, James P.
dc.creatorFerdous, F.
dc.date.accessioned2019-07-01T19:59:59Z
dc.date.available2019-07-01T19:59:59Z
dc.date.issued2018-05-25
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85047544957&origin=inward
dc.identifier.urihttp://hdl.handle.net/10713/9850
dc.description.abstractBackground: The present study aimed to examine the risk factors for death due to pneumonia in young children and healthcare behaviors of the guardians for children in rural Bangladesh. A prospective autopsy study was conducted among guardians of children aged 4 weeks to 59 months in Mirzapur, Bangladesh, from 2008 to 2012. Results: Pneumonia was the primary cause of death, accounting for 26.4% (n=81) of all 307 deaths. Of the pneumonia deaths, 58% (n=47) deaths occurred in younger infants (aged 4 weeks to <6 months) and 24.7% (n=20) in older infants (aged 6-11 months). The median duration of illness before pneumonia death was 8 days (interquartile range [IQR] 3-20 days). Prior to death, 91.4% (n=74) children with pneumonia sought treatment, and of those who sought treatment, 52.7% (n=39) sought treatment ≥2 days after the onset of disease. Younger infants of 4 weeks to <6 months old were at 5.5-time (95% confidence interval [CI] 2.5, 12.0) and older infants aged 6-11 months were at 3-time (1.2, 7.5) greater risk of dying from pneumonia than older children aged 12-59 months. Children with a prolonged duration of illness (2-10 days) prior to death were at more risk for death by pneumonia than those who died from other causes (5.8 [2.1, 16.1]). Children who died from pneumonia sought treatment 3.4-time more than children who died from other causes. Delayed treatment seeking (≥2 days) behavior was 4.9-time more common in children who died from pneumonia than those who died from other causes. Children who died from pneumonia more often had access to care from multiple sources (5.7-time) than children who died from other causes. Conclusions: Delay in seeking appropriate care and access to multiple sources for treatment are the underlying risk factors for pneumonia death in young children in Bangladesh. These results indicate the perplexity in guardians' decisions to secure appropriate treatment for children with pneumonia. Therefore, it further underscores the importance of focusing on mass media coverage that can outline the benefits of seeking care early in the progression of pneumonia and the potential negative consequences of seeking care late. © 2018 The Author(s).en_US
dc.description.sponsorshipThis research protocol was funded by The Bill & Melinda Gates Foundation (BMGF), grant number GR-00505 (OPP 1033572).en_US
dc.description.urihttps://www.doi.org/10.1186/s41182-018-0099-4en_US
dc.language.isoen_USen_US
dc.publisherBioMed Central Ltd.en_US
dc.relation.ispartofTropical Medicine and Healthen_US
dc.subjectDeathen_US
dc.subjectHealth careen_US
dc.subjectHealth facilitiesen_US
dc.subjectInfanten_US
dc.subjectPneumoniaen_US
dc.titlePneumonia mortality and healthcare utilization in young children in rural Bangladesh: A prospective verbal autopsy studyen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s41182-018-0099-4
dc.relation.volume46


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