ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Risk factors for pneumonia in small children: a systematic review and meta-analysis of case control studies


Introduction. Preventing new or recurrent episodes of acute respiratory tract infections in children under five years of age could improve antibiotic prescription practices and decrease unnecessary antibiotic use.
Objectives. This meta-analysis aimed at identifying the non-modifiable and modifiable risk factors for community-acquired pneumonia in small children.
Material and methods. Based on a comprehensive search of Cochrane and Medline databases, we included studies published between 2018 and 2022 that explored the cause and risk factors for community-acquired pneumonia in pediatric patients. The strength of this relationship was evaluated using odds ratios (ORs) with 95% confidence intervals (CIs).
Results. Overall, 11 studies involving 8255 participants were used for analysis after screening nearly 1831 abstracts. Indoor air pollution (OR=1.91; 95%CI: 1.58–2.30; Chi2=171.22; I2=96%), non- exclusive breastfeeding (OR=1.34; 95%CI: 1.11–1.60; Chi2=49.10; I2 = 90%), incomplete immunization (OR=1.74; 95%CI: 1.33–2.26; Chi2=72.91; I2= 95%) and prematurity (OR=2.56; 95%CI: 1.63–4.02; Chi2=0.07; I2=0%) were associated with community-acquired pneumonia in small children in a consistent manner across studies.
Conclusions. These results may allow clinicians and health policymakers to develop prompt assessment and correction of modifiable risk factors which could have profound effects on quality of life, primary care workload and pediatric morbidity caused by community-acquired pneumonia.
Keywords: pneumonia, pediatric population, risk factor.

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Department of Pediatrics, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Division of Rheumatology, PHMI Mother and Child Institute, Chisinau, Republic of Moldova
E-mail:; Phone: +373 68889926


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Revenco N, Balanuta AM, Bujor D, Horodisteanu-Banuh A , Savoschin D, Cirstea O, Grin O. Risk factors for pneumonia in small children: a systematic review and meta-analysis of case control studies. Arch Balk Med Union. 2022;57(4):390-396.