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 Infectjournal_title
Epidemiology and infectionauthors
Zaman SM,Cox J,Enwere GC,Bottomley C,Greenwood BM,Cutts FTdoi
10.1017/S0950268814000314subject
Has Abstractpub_date
2014-12-01 00:00:00pages
2491-500issue
12eissn
0950-2688issn
1469-4409pii
S0950268814000314journal_volume
142pub_type
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