Objective: Objective was to evaluate the sociodemographic and perinatal factors determining severity of acute lower respiratory tract infection (ALRTI) among children below five years. Materials and Methods: Cross sectional study conducted at HSK hospital & Research centre, Bagalkot, from March-2014 to August-2015. 200 ALRI cases aged 2 months to 5 years as per WHO criteria for pneumonia were evaluated for sociodemographic and perinatal factors determining severity of pneumonia. Results: In our study out of 200 cases admitted with ALRTI 3 had Pneumonia, 155 had Severe Pneumonia and 42 had Very Severe Pneumonia according to WHO ARI programme. There were 116(58%) male in the study. More than half were infants 107(53.5%), 57(28.5%) were of birth order 3 or more and 88(44%) were living in overcrowded houses. 36(18%) were home delivery, 32(16%) were preterms and 43(21.5%) had low birth weight (LBW). In our study 41(20.5%) cases received pre lacteal feeds, 138(69%) cases were exclusively breast fed and 53 (26.5%) were incompletely immunized. Statistical significance was found between EBF, gestation at delivery and pneumonia severity. Conclusion: Certain factors like young age, male sex, overcrowding, high birth order, low SES, prematurity, lack of EBF, Incomplete immunization, are associated with increased incidence of pneumonia. Measures like improving the living conditions and educating about need for family planning, birth spacing and adequate antenatal care to prevent preterm, LBW, overcrowding and malnutrition can decrease the ALRTI incidence. Promotion of EBF, immunization coverage and adequate perinatal care can reduce the disease burden.

Keywords: WHO; ALRTI; Pneumonia; EBF.