Determination Of The Risk Factors Of Pneumonia And The Evaluation Of The Cost Effectiveness Of Current Treatment Approach For Bacterial Pneumonia In Children Five Years And Younger
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Date
2011-11
Authors
Abdulkader, Manhal A.
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Publisher
Universiti Sains Malaysia
Abstract
Pneumonia is a major cause of morbidity and mortality especially in developing countries. The prevention of pneumonia and its later disabilities can be achieved by the reduction of risk factors and evaluating subjects of high risk. Risk factors evaluation was one of the three aims of this retrospective age and gender matched case control study. A total of 260 children five years and younger diagnosed with pneumonia according to ICD-10 were involved, 43% of them (n = 113) having pneumonia of viral origin and 57% (n = 147) having bacterial pneumonia. Pneumonia risk factors were determined using Chi-square and Binary Logistic Regression. Incomplete immunization found to be the most significant risk predictor among all the analyzed factors (OR = 3.71, p< 0.001). The other factors that were significant in this study are day care attendance (p = 0.001), low weight for age (p =0.001), lack of breast feeding (p = 0.016) and paternal smoking (p = 0.04). The second objective of this study was to determine the most cost effective choice among the current antibiotics used for bacterial pneumonia management. The only two antibiotics that were evaluated are cefuroxime and C-penicillin according to the revealing samples of the both drugs. For the cefuroxime group the median of the total management cost is MYR 838.90 (IQR. 787.90, 1834.57), for the C-penicillin group the median is MYR 1153.85 (IQR. 791.61, 1523.9). Cefuroxime use resulted in better patient outcome (84% versus 73% treatment success rate) and at lower cost. The cost effectiveness ratio for cefuroxime and C-penicillin are 998.70 and 1580.60 respectively, this indicate that cefuroxime is more cost effective than C-penicillin.
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Keywords
Pneumonia is a major cause of morbidity and mortality , especially in developing countries