Burden and Risk Factors of Childhood Pneumonia in Adamawa State, North East Nigeria: A Hospital-Based Analytical Study

Pneumonia remains the single leading infectious cause of childhood mortality globally, disproportionately affecting children in the sub-Saharan African context where risk factor burden is high and treatment access is limited. This hospital-based case-control study determines the burden and modifiable risk factors of childhood pneumonia among children aged 2 to 59 months at the Federal Teaching Hospital Gombe and Specialist Hospital Yola, serving Adamawa State, North East Nigeria. Cases were defined as children with radiologically or clinically confirmed pneumonia; 220 cases were matched with 440 controls by age and sex. Conditional logistic regression was used to estimate adjusted odds ratios. Household indoor air pollution from biomass fuel combustion was the strongest independent risk factor (adjusted OR 4.6, 95% CI 2.8-7.5). Other significant predictors included incomplete vaccination (adjusted OR 3.2), household crowding of more than five persons per sleeping room (adjusted OR 2.9), low birth weight (adjusted OR 3.6), and malnutrition (adjusted OR 4.1). Vitamin A deficiency, assessed by dietary intake proxy, was associated with a twofold increased pneumonia odds. Maternal exclusive breastfeeding for six months was protective (adjusted OR 0.41). The study provides the first case-control quantification of pneumonia risk factors from Adamawa State and recommends clean cooking fuel transitions, expanded pentavalent and pneumococcal vaccination coverage, and nutritional supplementation programmes. Keywords: childhood pneumonia, risk factors, case-control, Adamawa State, North East Nigeria.