Determinants, prevalence, spatial variation of pneumonia and control strategies among children aged under five years in Kericho County, Kenya

Abstract

Although the government of Kenya is putting efforts to reduce the mortality in children under five years old from pneumonia and related diseases, the prevalence of pneumonia in Kenya remains higher. For example, the incidence of pneumonia grew from 8 in 2008 to 9 in 2014, and 14 in 2020 per live birth. The prevalence of pneumonia in Kenya stands at 16, which is higher than the regional prevalence of 14 found in Africa. The main aim of this research was to evaluate the detenninants and prevalence of pneumonia, its spatial distribution, and household response strategies. The research was based on empirical and theoretical literature review. It was guided by germ theory and protective motivation theory. The study utilized descriptive research design involving questionnaires and interviews. The sample frame comprised 391 respondents that arrived using purposive sampling. Data was analyzed using descriptive statistics such as frequencies, percentages, and Chi-square. The results revealed that pneumonia among children under five years of age had a high prevalence of about 36% across various critical indicators. These indicators were cough, respiratory distress, and chest complications. Risk determinants of pneumonia prevalence included hereditary factors, wet cleaning practices, place of residency, and frequency of exposure to congested settings (p- value less than 0.005). Spatial analysis showed a marked spatial variation in pneumonia distribution. Ainamoi Ward with 54%; 469.3 km2 was highest and Kipchebor Ward with 32%; 51 1.8 km2 was lowest prevalence. Kipchimchim Ward recorded the lowest incidence at 14%, covering a total area of 164.2 km2. Household response strategies were frequently mentioned: wearing warm clothes (31%), eating a balanced diet (11%), improving air circulation in the home (9%), avoiding places where people gather in large groups (11%). The research demonstrated high prevalence and household response methods, as well as other important findings about pneumonia, the leading cause of death among children under the age of five. These outcomes are consistent with 2030 Agenda of Sustainable Development (SDG) which aims to ensure the well-being of children at all age groups globally. The research calls for a concerted effort to overcome pneumonia and highlights the importance of strengthening healthcare infrastructure, tackling underlying risk factors, such as hygiene, improving indoor air quality, and increasing vaccination. Priority areas include the development of tailored approaches to address the specific vulnerabilities of different populations, including improved immunization programs, early detection and treatment through training of community health workers and caregivers, and the implementation of integrated community case management centers and effective referral processes.