Abstract
Background: Childhood Community acquired pneumonia has remained the top killer
disease of Children below the age of five years globally. This research evaluated the prevalence, risk
aspects of CAP and adherence by the health care providers to the national guidelines in its
management at the Kakamega county Referral Hospital. Methodology: A hospital based cross
sectional study and quantitative approach of data collection was used. Kappa Statistic was used to
determine level of agreement between clinicians and observer diagnosing severe pneumonia among
33 cases taken from the 287 who took part in the survey. Descriptive statistics, bivariate logistic and
statistical analysis software (SAS) were applied in analysis of data obtained. An odds ratio at 95%
confidence interval was calculated to establish the correlation inherent among the dependent and
independent variables. A ‘p’ value not exceeding 0.05 was deemed statistically substantial at 95%
confidence interval. Results: The outcome revealed that the prevalence of CAP was 72.8%
(182/250) in vaccinated and 81.1% (30/37) in non–vaccinated children at Kakamega county Referral
hospital. In bivariate analysis maternal level of education none/primary (p=0.02), rating of child’s
health as good in last three months (p=0.001), type of fuel used in cooking (p=0.04) were associated
with CAP. Adherence to national standards in management of CAP by 33 health care participants
was low (p=0.0001) and Kappa agreement on diagnosis of severe pneumonia by 2 raters was
(57.6%) at the Kakamega county referral hospital. Conclusion: The Mean performance was
significantly lower than the overall expected score indicating poor performance and adherence to
national guidelines. The occurrence of CAP in children below five years was high.
Recommendations: detected determinants be controlled and avoided by way of community
mobilization on health advantages of maternal education, exclusive breast feeding for first six
months, improvement of nutrition and improved cooking methods.
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