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© 1996 Oxford University Press

research-article

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

T J D O'DEMPSEY*,, T F MCARDLE*, J MORRIS**, N LLOYD-EVANS{dagger}, BALDEH I*, B E LAURENCE*, O SECKA* and B M GREENWOOD*

*Research Council Laboratories PO Box 273, Banjul, The Gambia.
**Department of Epidemiology and Population Sciences, LondonSchool of Hygiene and Tropical Medicine Keppel St, London WC1E7HT, UK.
{dagger}Gambia Government/Medical Research Council Unit PO Box 273, Banjul, The Gambia.

Repnnt requests to: Dr T J D O'Dempsey, Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland.

BACKGROUND: Pneumoccal infection is one of the leading causes of pneumonia, meningitis and septicaemia in developing countries. We have investigated possible risk factors for pneumococcal disease among children living in a rural area of The Gambia.

METHODS: A prospective case-control study was conducted in which children with pneumococcal infection were identified from among children attending out-patient and under-fives clinics and matched according to age with healthy children selected randomly from the local community. A questionnaire was used to Investigate possible nutritional, medical, socioeconomic and environmental risk factors for pneumococcal disease.

RESULTS: An Increased risk of pneumococcal disease was associated with poor weight gain, a history of serious Illness in the previous 6 months, exposure to cigarette smoke or being carried on mother's back while cooking. The risk of pneumococcal disease was reduced among children whose mothers had a personal source of income

CONCLUSIONS: The incidence of pneumococcal disease could be reduced by improving nutrition and taking steps to identify and rehabilitate those children whose weight is faltering or falling. Encouraging mothers to develop greater financial independence may also be beneficial. Reduced exposure to smoke should be promoted by improving ventilation in kitchens, introducing more efficient and less polluting stoves, keeping children away from smoky environments and discouraging parental smoking.

Keywords pneumococcal disease, children, West Alrica

Revised 1 January 1996


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