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Meta-analysis and systematic review of under-five pneumonia in Ethiopia

Bizualem Abebaw, Destaw Damtie*

Background: In developing countries like Ethiopia, pneumonia is the leading cause of morbidity and mortality of under-five children. Ethiopia accounts for more than 18% of under-five deaths each year. However, there is a lack of evidence on the prevalence and risk factors of pneumonia among the under-five. This systematic review and meta-analysis aimed to determine the pooled prevalence of pneumonia and its associated risk factor among under-five children in Ethiopia.

Methods: We used articles published in Pubmed/Medline, science direct, web of science Google scholar, Hinari and Cochrane library. The authors incorporated observational studies (cross-sectional, retrospective and prospective) revealing the prevalence and factors associated with under-five pneumonia. We used STATA software version 14 for meta-analysis. We used the Cochrane Q test statistics and the I2 test to analyze the heterogeneity of the study. The study used the random-effect model to determine the pooled prevalence of pneumonia and associated factors among under-five children in Ethiopia.

Results: The pooled magnitude of pneumonia among under-five children was 18.03% (95% CI: 14.63, 21.44) out of 21 studies in Ethiopia. Cooking food in the living room (OR: 5.91, 95% CI: -0.36, 12.18), carrying children on mothers’ back during cooking (OR: 4.22%; 95%CI: 1.98, 6.45), child history of Acute Respiratory Infection (ARI) (OR: 3.51, 95% CI: 1.58, 5.44), children living in the overcrowded family (>5) members (OR: 3.48% CI: 0.87, 6.09), use of wood as a fuel source (OR: 2.58%; CI: 0.92, 4.23), being unvaccinated (OR: 2.52, 95% CI: 0.92, 4.23), non-exclusive breastfeeding (OR: 2.23; 95% CI: 0.87, 3.59) using charcoal and dung as fuel sources (OR: 1.89%; 95%CI: -0.51, 4.28) and kitchen without window (OR: 1.68% CI: -1.19, 4.54) were the risk factors associated with under-five pneumonia.

Conclusion: There existed a relatively high incidence of pneumonia in Ethiopia. We recommend public awareness about the effects of cooking places, keeping children during cooking, ARI management, family size, fuel type, breastfeeding and windows in the kitchen on children’s health.