Individual and Environmental Factors Associated with Penumonia in Children under Five in Magetan, East Java, Indonesia

Yola Alqorien Mustikarani1)Setyo Sri Rahardjo2)Isna Qadridjati2)


1)Masters Program in Public Health, Universitas Sebelas Maret

2)Faculty of Medicine, Universitas Sebelas Maret



BackgroundPneumonia represents an important threat to children’s health in both deve­lo­ped and developing countries. Pneumonia is the leading killer of children under five worldwide. Pneumonia case in Magetan, East Java in 2017 was 1,833. This study aimed to examine the in­di­vidual and environmental factors associated with pneumonia in children under five in Magetan, East Java.

Subjects and MethodA case control study was conducted in Magetan, East Java, from Oc­to­ber to December 2018. A sample of 225 children under five was selected by fixed disease sam­pling. The dependent variable was pneumonia. The independent va­ria­bles were nutritional sta­tus, vitamin A intake, maternal stress, maternal edu­cation, family income, smoking beha­viour, cooking fuel, house physical environment, and the presence of infants in the kitchen. The data were collected by questionnaire and ana­lyzed by a multiple logistic regression.

Results: Pneumonia in children under five increased with maternal stress (b= 1.91; 95% CI= 0.75 to 3.06; p= 0.001), parental smoking behavior (b= 1.39; 95% CI= 0.46 to 2.32; p= 0.003), and infant presence in the kitchen (b= 1.37; 95% CI= 0.38 to 2.35; p= 0.007), and smoke from cooking fuel (b= 1.51; 95% CI= 0.46 to 2.55; p=0.005). Pneu­mo­nia in children under five dec­rea­sed with good nutritional status (b= -1.74; 95% CI= -2.70 to -0.78; p<0.001), vitamin A intake (b= -1.14; 95% CI= -2.04 to -0.24; p= 0.013), high maternal education (b= -1.41; 95% CI= -2.45 to -0.37; p=0.008), high family income (b= -0.91; 95% CI= -1.80 to -0.02; p=0.045), and good house physical en­vi­ron­ment (b=-1.86; 95% CI= -3.20 to -0.52; p=0.007).

Conclusion: Pneumonia in children under five increases with maternal stress, paren­tal smo­king behaviour, and infant presence in the kitchen, and smoke from coo­king fuel. It decreases with good nutritional status, vitamin A intake, high maternal edu­ca­tion, high family income, and good house physical environment.

Keywordspneumonia, biopsychosocial, environmental, determinant, children under five

Correspondence: Yola Alqorien Mustikarani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: yol­ Mobile: +6285856122288


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