Volume 101, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Pneumonia, as defined by WHO, is a syndromic diagnosis characterized by presence of cough or difficult breathing. Presentation to health-care provider depends on timely identification of signs and symptoms by caretakers. We explored patterns of health-care utilization among caretakers of a randomly selected sample of 1,152 children aged 2–59 months, residing in low-income settlements of Karachi, Pakistan. Information on household demographics, occurrence of pneumonia-specific symptoms, care seeking, air quality, and knowledge regarding preventive measures for pneumonia was collected. Predictors of care seeking were estimated using weighted logistic regression. Prevalence of pneumonia with cough and rapid or difficulty in breathing was found to be 40.8% and 37.1% in infants (2–11 months) and children (12–59 months), respectively. Ninety-five percentage of caretakers sought care, 68.5% privately. Odds ratios (ORs) for independent predictors of care-seeking were as follows: younger age of child (infants compared with children), 3.60 (95% CI = 2.65–4.87); caretaker with primary education compared with none, 3.40 (2.46–4.70); vaccine awareness, 1.65 (1.45–1.87); and breastfeeding awareness, 1.32 (1.13–1.53). Presence of symptoms such as fever OR, 1.51 (1.30–1.76); tachypnea, 1.57 (1.35–1.83); chest indrawing, 2.56 (2.05–3.18); persistent vomiting, 1.69 (1.37–2.09); and recurrent illness, 2.57 (2.23–2.97) were also predictive. There is high health-care utilization for pneumonia with the skewed presentation toward private services. Strategies should be focused on making pneumonia care standardized, efficient and affordable, especially in the private sector.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  • Received : 10 Aug 2018
  • Accepted : 08 Jul 2019
  • Published online : 03 Sep 2019

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