The effect of distance on observed mortality, childhood pneumonia and vaccine efficacy in rural Gambia.

Abstract:

:We investigated whether straight-line distance from residential compounds to healthcare facilities influenced mortality, the incidence of pneumonia and vaccine efficacy against pneumonia in rural Gambia. Clinical surveillance for pneumonia was conducted on 6938 children living in the catchment areas of the two largest healthcare facilities. Deaths were monitored by three-monthly home visits. Children living >5 km from the two largest healthcare facilities had a 2·78 [95% confidence interval (CI) 1·74-4·43] times higher risk of all-cause mortality compared to children living within 2 km of these facilities. The observed rate of clinical and radiological pneumonia was lower in children living >5 km from these facilities compared to those living within 2 km [rate ratios 0·65 (95% CI 0·57-0·73) and 0·74 (95% CI 0·55-0·98), respectively]. There was no association between distance and estimated pneumococcal vaccine efficacy. Geographical access to healthcare services is an important determinant of survival and pneumonia in children in rural Gambia.

journal_name

Epidemiol Infect

authors

Zaman SM,Cox J,Enwere GC,Bottomley C,Greenwood BM,Cutts FT

doi

10.1017/S0950268814000314

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

2491-500

issue

12

eissn

0950-2688

issn

1469-4409

pii

S0950268814000314

journal_volume

142

pub_type

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