Imperial College London


Faculty of MedicineSchool of Public Health

Chair in Global Environmental Health



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BibTex format

author = {Howie, SR and Schellenberg, J and Chimah, O and Ideh, RC and Ebruke, BE and Oluwalana, C and Mackenzie, G and Jallow, M and Njie, M and Donkor, S and Dionisio, KL and Goldberg, G and Fornace, K and Bottomley, C and Hill, PC and Grant, CC and Corrah, T and Prentice, AM and Ezzati, M and Greenwood, BM and Smith, PG and Adegbola, RA and Mulholland, K},
doi = {10.5588/ijtld.15.0993},
journal = {International Journal of Tuberculosis and Lung Disease},
pages = {1405--1415},
title = {Childhood pneumonia and crowding, bed-sharing and nutrition: a case-control study from The Gambia},
url = {},
volume = {20},
year = {2016}

RIS format (EndNote, RefMan)

AB - SETTING: Greater Banjul and Upper River Regions, The Gambia. OBJECTIVE: To investigate tractable social, environmental and nutritional risk factors for childhood pneumonia. DESIGN: A case-control study examining the association of crowding, household air pollution (HAP) and nutritional factors with pneumonia was undertaken in children aged 2-59 months: 458 children with severe pneumonia, defined according to the modified WHO criteria, were compared with 322 children with non-severe pneumonia, and these groups were compared to 801 neighbourhood controls. Controls were matched by age, sex, area and season. RESULTS: Strong evidence was found of an association between bed-sharing with someone with a cough and severe pneumonia (adjusted OR [aOR] 5.1, 95%CI 3.2-8.2, P < 0.001) and non-severe pneumonia (aOR 7.3, 95%CI 4.1-13.1, P < 0.001), with 18% of severe cases estimated to be attributable to this risk factor. Malnutrition and pneumonia had clear evidence of association, which was strongest between severe malnutrition and severe pneumonia (aOR 8.7, 95%CI 4.2-17.8, P < 0.001). No association was found between pneumonia and individual carbon monoxide exposure as a measure of HAP. CONCLUSION: Bed-sharing with someone with a cough is an important risk factor for severe pneumonia, and potentially tractable to intervention, while malnutrition remains an important tractable determinant.
AU - Howie,SR
AU - Schellenberg,J
AU - Chimah,O
AU - Ideh,RC
AU - Ebruke,BE
AU - Oluwalana,C
AU - Mackenzie,G
AU - Jallow,M
AU - Njie,M
AU - Donkor,S
AU - Dionisio,KL
AU - Goldberg,G
AU - Fornace,K
AU - Bottomley,C
AU - Hill,PC
AU - Grant,CC
AU - Corrah,T
AU - Prentice,AM
AU - Ezzati,M
AU - Greenwood,BM
AU - Smith,PG
AU - Adegbola,RA
AU - Mulholland,K
DO - 10.5588/ijtld.15.0993
EP - 1415
PY - 2016///
SN - 1815-7920
SP - 1405
TI - Childhood pneumonia and crowding, bed-sharing and nutrition: a case-control study from The Gambia
T2 - International Journal of Tuberculosis and Lung Disease
UR -
UR -
VL - 20
ER -