Factors Associated with Pneumonia Diagnosis among Children Aged 1–60 Months at Hospital, Palembang: A Cross-Sectional Study Using 2024 Medical Records
https://doi.org/10.33860/bpk.v54i2.4432
Keywords:
Childhood pneumonia, under-five children, immunization, medical records, pneumonia diagnosisAbstract
Background: National surveillance provides an overview of the overall burden of childhood pneumonia but offers limited insight into factors associated with pneumonia among children treated at individual healthcare facilities. Dr. Mohammad Hoesin General Hospital is a tertiary referral hospital in South Sumatra and therefore provides clinically relevant, although not population-representative, hospital-based evidence to complement national and provincial surveillance. This study aimed to examine factors associated with pneumonia diagnosis among children aged 1–60 months treated at Dr. Mohammad Hoesin General Hospital, Palembang, using 2024 medical record data.
Methods: This analytical cross-sectional study included 123 children aged 1–60 months, using medical records from 2024, comprising 91 with pneumonia and 32 without. Descriptive statistics were used to summarize participant characteristics. Bivariate analyses were performed using Pearson's chi-square test or Fisher's exact test, as appropriate. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using binary logistic regression.
Results: Among the 123 children included in this hospital-based sample, 91 (74.0%) were classified as having pneumonia. Incomplete immunization was associated with higher odds of pneumonia (crude OR=7.82; 95% CI: 2.42–25.22; Fisher's exact p<0.001). Age ≤12 months, male sex, malnutrition, and absence of exclusive breastfeeding showed positive but statistically non-significant crude associations, with wide confidence intervals.
Conclusion: Incomplete immunization was associated with higher odds of pneumonia in the bivariate analysis of this hospital-based sample. Because the estimate was unadjusted and the study was cross-sectional, hospital-based, and based on secondary records, adjusted studies with broader environmental and socioeconomic variables are required to confirm an independent association.
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Abate, B. B., Tusa, B. S., Sendekie, A. K., Araya, F. G., Bizuayehu, M. A., Walle, G. T., Kitaw, T. A., Tilahun, B. D., Alamaw, A. W., Zemariam, A. B., Kassaw, A., Kassie, A. M., Yilak, G., Bizuneh, F. K., & Dachew, B. (2025). Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis. International Breastfeeding Journal, 20, 18. https://doi.org/10.1186/s13006-025-00712-w
Abegaz, M. Y., Seid, A., Awol, S. M., & Hassen, S. L. (2023). Determinants of incomplete child vaccination among mothers of children aged 12–23 months in Worebabo district, Ethiopia: Unmatched case-control study. PLOS Global Public Health, 3(8), e0002088. https://doi.org/10.1371/journal.pgph.0002088
Afriani, B., & Oktavia, L. (2021). Faktor Risiko Kejadian Pneumonia pada Bayi. Babul Ilmi Jurnal Ilmiah Multi Science Kesehatan, 13(2). https://doi.org/10.36729/bi.v13i2.895
Amalia, L. (2020). Determinan Pneumonia Pada Anak Balita di Puskesmas Pataruman III Kota Banjar Tahun 2018. Jurnal Medika Hutama, 1(1), 8. http://jurnalmedikahutama.com/index.php/JMH/article/view/16
Caniago, O., Utami, T. A., & Surianto, F. (2022). Faktor yang Mempengaruhi Kejadian ISPA pada Balita. JOMIS (Journal of Midwifery Science), 6(2), 175–184. https://doi.org/10.36341/jomis.v6i2.2199
Chen, L., Miao, C., Chen, Y., Han, X., Lin, Z., Ye, H., Wang, C., Zhang, H., Li, J., Tang, Q., Dong, Y., Bai, M., Zhu, Y., & Liu, G. (2021). Age-specific risk factors of severe pneumonia among pediatric patients hospitalized with community-acquired pneumonia. Italian Journal of Pediatrics, 47(1), 100. https://doi.org/10.1186/s13052-021-01042-3
Dadanova, G., Kubatova, A., Horth, R., Nabirova, D., Ishenapisova, G., & Otorbaeva, D. (2025). P-625. Missed opportunities for vaccination among healthcare-seeking children–Kyrgyzstan, 2023. Open Forum Infectious Diseases, 12(Supplement_1). https://doi.org/10.1093/ofid/ofae631.823
Dai, Q., Dong, Y., Wu, J., & Peng, Q. (2025). Efficacy, immunogenicity, and safety of pneumococcal conjugate vaccine in children: a systematic review and meta-analysis. Frontiers in Pediatrics, 13. https://doi.org/10.3389/fped.2025.1652946
Daley, M. F., Glanz, J. M., Newcomer, S. R., Jackson, M. L., Groom, H. C., Lugg, M. M., McLean, H. Q., Klein, N. P., Weintraub, E. S., & McNeil, M. M. (2017). Assessing misclassification of vaccination status: Implications for studies of the safety of the childhood immunization schedule. Vaccine, 35(15), 1873–1878. https://doi.org/10.1016/j.vaccine.2017.02.058
Fatimah, Massi, M. N., Febriani, A. D. B., Hatta, M., Karuniawati, A., Rauf, S., Wahyuni, S., Hamid, F., Alasiry, E., Patellongi, I., Permatasari, T. A. E., & Farsida. (2022). The role of exclusive breastfeeding on sIgA and lactoferrin levels in toddlers suffering from Acute Respiratory Infection: A cross-sectional study. Annals of Medicine & Surgery, 77(103644). https://doi.org/10.1016/j.amsu.2022.103644
Jones, C. E., Danovaro-Holliday, M. C., Mwinnyaa, G., Gacic-Dobo, M., Francis, L., Grevendonk, J., Nedelec, Y., Wallace, A., Sodha, S. V., & Sugerman, C. (2024). Routine Vaccination Coverage — Worldwide, 2023. MMWR. Morbidity and Mortality Weekly Report, 73(43), 978–984. https://doi.org/10.15585/mmwr.mm7343a4
Karlinah, N. (2024). Hubungan Asi Eksklusif Terhadap Penyakit Infeksi Pada Balita Di Desa Karya Indah. Jurnal Ilmiah Kesehatan Mandira Cendikia, 3(7), 18–24. https://journal.mandiracendikia.com/index.php/JIK-MC/article/view/1209
Kemenkes RI. (2024). Profil Kesehatan Indonesia. https://www.kemkes.go.id/id/profil-kesehatan-indonesia.
Nulong, N., Chutipattana, N., Nguyen, L. T. K., Tran, A. D., Nguyen, U. T. T., & Le, C. N. (2025). Determinants of Parental Adherence to Childhood Immunization Among Children Under Five in Marginalized Asian Populations. International Journal of Environmental Research and Public Health, 22(11). https://doi.org/10.3390/ijerph22111692
Shahid, A. S. M. S. Bin, Rahman, A. E., Shahunja, K. M., Afroze, F., Sarmin, M., Nuzhat, S., Alam, T., Chowdhury, F., Sultana, M. S., Ackhter, M. M., Parvin, I., Saha, H., Islam, S. Bin, Shahrin, L., Ahmed, T., & Chisti, M. J. (2023). Vaccination following the expanded programme on immunization schedule could help to reduce deaths in children under five hospitalized for pneumonia and severe pneumonia in a developing country. Frontiers in Pediatrics, 11. https://doi.org/10.3389/fped.2023.1054335
Sidabutar, E., Ansariadi, Wahiduddin, Bustan, N., Stang, & Birawida, A. B. (2024). Analysis of risk factor for pneumonia in children less than five years in Makassar. Journal of Education and Health Promotion, 13, 16. https://doi.org/10.4103/jehp.jehp_727_23
Sriatmi, A., Martini, M., Jati, S. P., Budiyono, B., Handayani, N., Kusumawati, A., & Armunanto, A. (2024). Parent’s Knowledge and Attitude as Key Determinants of Completeness Childhood Immunization in Central Java, Indonesia. Jurnal Kesehatan Masyarakat, 20(1), 89–100. https://doi.org/10.15294/kemas.v20i1.47633
Sutriana, V. N., Sitaresmi, M. N., & Wahab, A. (2021). Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia. Clinical and Experimental Pediatrics, 64(11), 588–595. https://doi.org/10.3345/cep.2020.00339
Tangdilian, R., Azis, R., & Ningsih, N. A. (2025). Analysis of Risk Factors for Acute Respiratory Infections (ARI) in Children Under Five. Jurnal Keperawatan Profesional (KEPO), 6(1), 1–10. https://doi.org/10.36590/kepo.v6i1.1028
UNICEF. (2025). Pneumonia in Children Statistics. UNICEF. https://data.unicef.org/topic/child-health/pneumonia/
Wahyuni, E., Yorita, E., & Anissa, K. (2019). Status Gizi Berpengaruh Terhadap Kejadian Pneumonia pada Balita. Jurnal Media Kesehatan, 12(1), 30–39. https://doi.org/10.33088/jmk.v12i1.380
Wilkes, C., Bava, M., Graham, H. R., & Duke, T. (2023). What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review. Journal of Global Health, 13, 05003. https://doi.org/10.7189/jogh.13.05003
Worku, B. T., Wordofa, E. A., Senbeto, G., Zinab, B., Kebede, E. B., Abamecha, F., Debela, G. T., Birhanu, N., Siraneh, Y., & Tamiru, D. (2024). Age-appropriate vaccination and associated factors among children aged 12-35 months in Ethiopia: A multi-level analysis. PloS One, 19(10), e0305801. https://doi.org/10.1371/journal.pone.0305801
World Health Organization. (2022). Pneumonia in children. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/pneumonia?utm_source=chatgpt.com
Zhu, P., Wu, D., Wang, Y., Liu, X., E. Rodewald, L., Li, Y., Zheng, H., Cao, L., Song, Y., Song, L., Zhao, X., Yao, J., Wang, F., Li, M., Zhang, Q., Yan, T., & Yin, Z. (2023). Effectiveness of DTaP Against Pertussis in ≤2-Year-Old Children — Linyi Prefecture, Shandong Province, China, 2017–2019. China CDC Weekly, 5(17), 374–378. https://doi.org/10.46234/ccdcw2023.071
