Prevalence and risk factors of bacteraemic community-acquired pneumonia in under-fives in Akwa Ibom State, Nigeria

Abstract

Background: Community-acquired pneumonia (CAP) is an important contributor to under-five mortality worldwide. Low- and middle-income countries (LMICs) like Nigeria have a high disease burden, with most children presenting with severe disease. Therefore, there is a need for a microbiologic diagnosis at presentation. This study aimed at determining the prevalence and risk factors of bacteraemia in radiologically confirmed CAP among under-fives in Akwa Ibom State, Nigeria.

Methodology: The study was cross-sectional and under-five children admitted into the Paediatric emergency unit of the University of Uyo Teaching Hospital, Uyo, South-south Nigeria, with clinical pneumonia were recruited consecutively until the sample size of 372 was achieved. Sociodemographic and clinical information were obtained using an interviewer-administered questionnaire. Chest radiographs were done for all participants, while blood culture was performed in those who had radiologically confirmed pneumonia.

Results: The prevalence of bacteraemia in radiologically confirmed CAP was 28.7%. The risk factors associated with bacteramia in these children included younger age (p=0.001), lack of exclusive breastfeeding (p=0.015), incomplete immunization status (p=0.009), duration from onset of symptom to presentation greater than five days (p=0.030) and neutrophilia (p=0.003).

Conclusion: The high prevalence of bacteraemia in this study underscores the need to have blood culture done for patients with radiologically confirmed pneumonia. This will ensure early identification of bacterial agents for culture-directed antibiotic administration, and reduce antimicrobial resistance.