Prevalence of Pneumonia and Its Associated Factors Among Children Under Five Years in Eastern Uganda: A Cross-Sectional Hospital-Based Study

Background: Pneumonia remains the leading cause of morbidity and mortality in children under five, accounting for 740,180 deaths globally and 14% of all under-five deaths. In Uganda, it is the second leading cause of mortality in this age group. Despite several studies on pneumonia risk factors, findings have been inconsistent. This study aimed to determine the prevalence and associated factors of pneumonia in children under five in Eastern Uganda. Methods: A hospital-based descriptive and analytical cross-sectional study was conducted among 385 children aged 2 to 59 months admitted to the pediatric ward. Pneumonia diagnosis followed the 2014 WHO guidelines and the Integrated Management of Newborn and Childhood Illness (IMNCI) classification. Data on socio-demographic, socioeconomic, child-related, and facility-related factors were collected using semi-structured questionnaires. Descriptive statistics determined prevalence, while logistic regression analysis using SPSS version 27 assessed factors associated with pneumonia. Results: The study found that the prevalence of pneumonia among children under five was 25.2% (95% CI: 19.1– 31.2%). The factors which were found to be associated with pneumonia include; use of grass as roofing material for the house (AOR: 4.658, P-value=0.016), child being malnourished (AOR: 15.749, P-value< 0.001), child not exclusively breastfed (AOR: 3.588, P-value= 0.044), child not having received vitamin A supplementation (AOR: 12.624, P-value=0.021), and staying beyond 5 km from the nearest health facility (AOR: 6.160, P-value= 0.011). Conclusion: This study found a high prevalence of pneumonia among children under five in Eastern Uganda, significantly exceeding the global target of 2.5%. The factors which were found to be associated with pneumonia included, being from household using grass as roofing material, malnutrition, nonexclusively breastfed, lack of vitamin A supplementation, staying a distance of more than 5 km from nearest health facility. These findings underpin a need for integrated community and policy-level interventions that improve child nutrition, promote optimal infant feeding practices, enhance preventive care, and strengthen access to healthcare services, while addressing underlying socioeconomic and environmental determinants.