Abstract

Objective: To characterize pneumonia features and identify factors associated with severe pneumonia in children aged 2-60 months at Kontum Provincial General Hospital, Vietnam.

Methods: This cross-sectional study included 370 mother-child pairs with pneumonia diagnoses from July 2023 to May 2024. Data on demographics, clinical characteristics, laboratory findings, and pre-hospitalization care were collected. Pneumonia diagnosis and severity classification followed Vietnamese Ministry of Health 2014 criteria. Multivariate logistic regression identified factors independently associated with severe pneumonia.

Results: Among the cohort (mean age 13.16±11.68 months), 55.7% were male and 75.4% belonged to ethnic minorities. The prevalence of severe pneumonia was 18.4%. Laboratory findings showed mean leukocyte count of 14,633.78±6,402.87 cells/mm³, neutrophil percentage of 52.42±33.00%, and CRP levels of 18.50±36.71 mg/L. Radiographic pulmonary lesions were present in 93.2% of cases. Multivariate analysis identified three independent risk factors for severe pneumonia: younger age (OR=0.965, 95%CI:0.935-0.996, p=0.029), first-born status (OR=1.846, 95%CI:1.047-3.254, p=0.034), and absence of pre-hospitalization medical care (OR=2.027, 95%CI:1.054-3.898, p=0.034). While 77.3% of children experienced symptoms for ≥3 days before hospitalization, only 42.4% had complete age-appropriate immunizations.

Conclusion: The prevalence of severe pneumonia in this predominantly ethnic minority population reflects Vietnam's ongoing epidemiological transition. Younger age, first-born status, and lack of pre-hospitalization care significantly increase severe pneumonia risk. These findings highlight the importance of enhanced community-based health education for first-time parents, strengthened primary healthcare capacity, and improved immunization coverage to reduce pneumonia severity in this vulnerable population.