Pneumonia in Ghana: prevalence, mortality and antimicrobial resistance-a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: Prevalence varied significantly by region (4.83% to 32.31%)

• Primary Outcome: Pooled prevalence of pneumonia in Ghana: 22.01%

• Nnt Or Sensitivity: Mortality rate: 3.07%; Children <5 years prevalence: 17.79%

• Confidence Interval: Not reported in abstract

Clinical Application

Findings inform global pneumonia surveillance and antimicrobial stewardship programs but require local adaptation Relevant for understanding global antimicrobial resistance patterns and informing travel medicine advice. Limited relevance to PBS or TGA decisions but may inform RACGP guidelines on international health Limited direct applicability to Australian populations due to different epidemiological context, healthcare infrastructure, and environmental factors

Abstract

Pneumonia is a major cause of morbidity and mortality in Ghana, especially among children <5 y of age and the elderly. However, comprehensive data on its prevalence and distribution remain limited. This systematic review addresses this gap by analysing the prevalence, regional variations, risk factors, antimicrobial resistance and mortality rates of pneumonia in Ghana. We searched PubMed, ScienceDirect, Web of Science and African Journals Online databases, including 21 studies with a total of 124 582 participants. A random-effects meta-analysis estimated pooled prevalence and subgroup differences based on age, region and participant type. Heterogeneity was assessed using the I2 test and meta-regression, with sensitivity analysis also conducted. Study quality was evaluated using standardized Joana Briggs Institute checklists for prevalence studies. The pooled prevalence of pneumonia in Ghana was 22.01%, with significant regional variations. The highest prevalence was observed in a study conducted in the Greater Accra and Northern regions (32.31%), while the lowest was in the Upper West (4.83%). The prevalence in children <5 y of age was 17.79%. Hospitalized patients had a higher prevalence (22.14%) than community children (21.49%). Streptococcus pneumoniae was the most common pathogen, with high resistance (>70%) to co-trimoxazole, gentamicin and tetracycline. Key risk factors included indoor air pollution and seasonal changes. The mortality rate for pneumonia was found to be 3.07%. This systematic review highlighted significant regional disparities, pathogen resistance patterns and environmental risk factors that shape the burden of pneumonia in Ghana, providing critical evidence for targeted public health strategies. The findings highlight avenues for future research, including environmental drivers of transmission, focusing on underreported regions and surveillance of antibiotic resistance of pathogens isolated from pneumonia patients.

References

1. 1.Kungu, F., Awere-Duodu, A., & Donkor, E. S. (2026). Pneumonia in Ghana: prevalence, mortality and antimicrobial resistance-a systematic review and meta-analysis. International Health. https://doi.org/10.1093/inthealth/ihaf077