title: A study of risk factors for pneumococcal disease among children in a rural area of west Africa.
abstract: 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.
authors.affiliation: Research Council Laboratories, Banjul, The Gambia.
authors.forename: T J
authors.initials: TJ
authors.lastname: O'Dempsey
authors.forename: T F
authors.initials: TF
authors.lastname: McArdle
authors.forename: J
authors.initials: J
authors.lastname: Morris
authors.forename: N
authors.initials: N
authors.lastname: Lloyd-Evans
authors.forename: I
authors.initials: I
authors.lastname: Baldeh
authors.forename: B E
authors.initials: BE
authors.lastname: Laurence
authors.forename: O
authors.initials: O
authors.lastname: Secka
authors.forename: B M
authors.initials: BM
authors.lastname: Greenwood
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D000704:Analysis of Variance; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000517:prevention & control; D009748:Nutrition Disorders / Q000150:complications; D016017:Odds Ratio; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D012423:Rural Health; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution