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Pneumonia
MICS3 Data Analysis and Report Writing
Background
• Pneumonia kills more children than any other illness – more than HIV/AIDS, malaria and measles combined. More than 2 million children die from pneumonia each year, accounting for 19% of under five deaths worldwide
• Pneumonia accounts for a significant proportion of the disease burden attributed to acute respiratory infections
• Pneumonia is a severe form of acute lower respiratory infection that specifically affects the lungs
International Goals & Targets
Reducing by one-third the deaths due to acute respiratory infections
List of Indicators
• Prevalence of suspected pneumonia
• Careseeking for suspected pneumonia
• Antibiotic treatment for suspected pneumonia
• Knowledge of danger signs
Definition of Indicator
% children aged 0-59 monthswith suspected pneumonia
Numerator: Number of children aged 0-59 months with suspected pneumonia in the 2 weeks prior to the survey (cough and fast or difficult breathing, excluding blocked nose)
Denominator: Total number of children aged 0-59 months surveyed
Prevalence of Suspected Pneumonia
Definition of Indicator
% children aged 0-59 monthswith suspected pneumonia taken to an
appropriate health care provider
Numerator: Number of children aged 0-59 months with suspected pneumonia in the 2 weeks prior to the survey who were taken to an appropriate health care provider
Denominator: Total number of children aged 0-59 months with suspected pneumonia in the 2 weeks prior to the survey
Careseeking for Suspected Pneumonia
Methodological Issues
• Suspected pneumonia is identified by its clinical symptoms, and include children that had a cough and fast or difficult breathing in the 2 weeks prior to the survey
• Excludes cases where symptoms are due to a blocked nose
• Reliability of prevalence estimates as measured through household surveys is limited
Methodological Issues
Appropriate health care provider includes:– government hospital, health center or health post – village health worker– public or private mobile outreach clinic– private hospital/clinic or private physician
Pharmacists, traditional practitioners and shopkeepers are not considered to be an appropriate health care provider
The percentage taken to an appropriate health care provider will not add to 100 since some children may have been taken to more than one provider
Methodological Issues
• For trend analysis of careseeking behavior care should be taken regarding comparability of categories included as “appropriate” health care providers
Tabulation Plan (Careseeking)
Regional Data
Careseeking for Pneumonia
66 62 5950 47
35
54
0
20
40
60
80
100
% u
nd
er
fiv
es
wit
h s
us
pe
cte
d p
ne
um
on
ia
tak
en
to
an
ap
pro
pri
ate
he
alt
h c
are
pro
vid
er
Careseeking Data (CEE/CIS)
Careseeking for Pneumonia
50
26
36
41
48
48
51
51
57
78
80
83
97
99
0 10 20 30 40 50 60 70 80 90 100
CEE/CIS
Armenia
Azerbaijan
Turkey
Kazakhstan
Kyrgyzstan
Tajikistan
Turkmenistan
Uzbekistan
Moldova, Rep of
Bosnia/Herzegovina
Albania
Serbia/Montenegro
Georgia
% children under five with suspected pneumonia taken to appropriate health care provider
Careseeking Data (ROSA)
67 66
28 26 22 20
59
0
20
40
60
80
100
% u
nd
er
fiv
es
wit
h s
us
pe
cte
d p
ne
um
on
iata
ke
n t
o h
ea
lth
ca
re p
rov
ide
r
Careseeking for Pneumonia
26
39
46
51
51
52
57
58
58
62
63
64
66
72
74
78
0 20 40 60 80 100
Haiti
Jamaica
Brazil
Colombia
Paraguay
Bolivia
Nicaragua
Peru
Suriname
El Salvador
DR
Guatemala
Belize
Venezuela
Trinidad/Tobago
Guyana
% under fives with suspected pneumonia taken to appropriate health care provider
Careseeking Data (TACRO)
Careseeking for
Pneumonia
66
38
43
47
52
57
65
66
70
74
76
78
93
0 20 40 60 80 100
Middle East/North Africa
Morocco
Tunisia
Yemen
Algeria
Sudan
OPT
Syria
Egypt
Lebanon
Iraq
Jordan
Iran
% under fives with suspected pneumonia taken to appropriate health provider
Careseeking Data (MENA)
Careseeking for Pneumonia
62
24
36
37
55
61
66
71
75
78
93
0 20 40 60 80 100
East Asia/Pacific (excl. China)
Timor-Leste
Lao PDR
Cambodia
Philippines
Indonesia
Myanmar
Viet Nam
PNG
Mongolia
Korea, Dem Rep
% under fives with suspected pneumonia taken to appropriate health care provider
Careseeking Data (EAPRO)
Careseeking for
Pneumonia
47
1416
2027
4044
4849494950
5355
5860
676869
75
0 20 40 60 80 100
East/Southern Africa
BotswanaEthiopia
RwandaMalawi
BurundiEritrea
MadagascarComoros
KenyaLesotho
Zimbabwe
NamibiaMozambique
AngolaSwaziland
UgandaTanzania
ZambiaSouth Africa
% children under five with suspected pneumonia taken to appropriate health care provider
Careseeking Data (ESARO)
Careseeking for
Pneumonia
35
222727
30323333
35363636
384041
444748
5064
7075
0 20 40 60 80 100
West/CentralAfrica
Chad
Niger
Senegal
Togo
CAR
Guinea
Nigeria
Benin
Burkina Faso
Congo, DR
Mali
Côte d'Ivoire
Cameroon
Mauritania
Ghana
Sao Tome/Principe
Gabon
Sierra Leone
Guinea-Bissau
Liberia
Gambia
% children under five with suspected pneumonia taken to appropriate health care provider
Careseeking Data (WCARO)
Careseeking for
Pneumonia
Definition of Indicator
% children aged 0-59 monthswith suspected pneumonia
receiving antibiotics
Numerator: Number of children aged 0-59 months with suspected pneumonia in the 2 weeks prior to the survey receiving antibiotics
Denominator: Total number of children aged 0-59 months with suspected pneumonia in the 2 weeks prior to the survey
Antibiotic Treatment for Pneumonia
Methodological Issues
Antibiotic use for suspected pneumonia does not include the following information:
– type of antibiotic used – proper dosage – timing of treatment
Tabulation Plan (Antibiotics)
Antibiotics Data
1224
77
912131314
1618202222222323242425
292930
3344
0 20 40 60 80 100
Burundi
Liberia
Mali
Rwanda
Morocco
Yemen
Niger
Burkina Faso
Brazil
Cameroon
Zambia
Pakistan
Senegal
Madagascar
Tanzania
Turkey
Kenya
Namibia
Nigeria
Malawi
Ghana
Egypt
DR
Paraguay
Colombia
India
Philippines
% under fives with suspected pneumonia receiving antibiotics
Data based on 27 DHS and
MICS surveys, early 1990s
Definition of Indicator
% caregivers who know that fast or difficult breathing
is a sign to seek care immediately
Numerator: Number of caregivers who know that difficult or fast breathing in a child aged 0-59 months is a sign to seek care immediately
Denominator: Total number of caregivers surveyed
Knowledge of Danger Signs
Tabulation Plan (‘Danger Signs’)
