Background: Community acquired pneumonia (CAP) is a major public health problem and a principal cause of morbidity and mortality in children under 5 years of age worldwide. The 13-valent pneumococcal conjugate vaccine is the major intervention strategy used in the prevention of new infections. Though the vaccines have been in use since 2011in Cameroon, lower respiratory tract infections remain major causes of morbidity and mortality. Methods: A community-based case-control study involving 346 children <5 years was conducted between March and June 2018. A data extraction tool was used to identify children <5 years with an episode of pneumonia from consultation registers of two tertiary public hospitals in Fako Division and interviewed in their households. Data were analyzed using Statistical Package for Social Sciences version 20.0. Bivariate and multivariate logistic regression models were carried out to identify factors associated with pneumonia. Significance was obtained through adjusted odds ratio with its 95% confidence interval and a p<0.05. Results: A total of 346 children participated in the study comprising of 164 controls and 182 cases with mean age of 21 (SD 15) months. 50.57% of participants were males. Factors associated with pneumonia were: overcrowding; a0R 3.001, p-value <0.001, contact with someone with cough; aOR 2.970, p-value <0.001, passive cigarette smoking; aOR 2.560, p-value < 0.003 and age of the child (<24months) ;aOR 1.153, p-value 0.042. Conclusion: Pneumonia is a common infection in children <5 years of age. Overcrowding, passive cigarette smoking, contact with someone with cough symptoms, age of child <24 months, are associated with pneumonia in Fako Division.

Keywords: Community Acquired Pneumonia, Lower Respiratory Tract Infections, overcrowding, children, age of child, passive smoking.