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Crowding as a risk factor of meningococcal disease in Danish preschool children: a nationwide population-based
Susanna Deutch1, Rodrigo Labouriau, Henrik C Schønheyeder
1Research Unit Q, Department of Infectious Diseases, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark. susannadeutch@dadlnet.dk
Abstract:
Meningococcal disease (MD) remains an important health problem. Crowding has been suggested to be a risk factor for MD in children, but the evidence is relatively sparse. We performed a nationwide nested case-control study comprising 1222 children with MD and 24,549 population controls. We identified MD cases younger than 6 y in the Danish National Hospital Discharge Registry from 1980 to 1999, and obtained information on household density as a measure of crowding, per capita income and other potential confounders through The Danish Civil Registration System and social registries. The risk of MD associated with household density was estimated by conditional logistic regression for children less than 1 y of age (infants) and children aged 1 to 5 y, respectively. The risk of MD increased with increasing household density. In both age groups, the crude OR was 1.8 (95% confidence interval [CI]: 1.4-2.3) at a density of less than 20 m2 per person compared with the reference of more than 50 m2 per person. The adjusted OR for MD was 1.5 (95% CI: 1.1-1.9) for infants, and 1.5 (95% CI: 1.1-2.0) for children older than 1 y. Household density appears to be a risk factor of MD in preschool children.
Insights
Crowded living conditions increase the risk of meningococcal disease (MD) in young children. This study confirms household density as a significant risk factor for MD in infants and preschoolers.
Area of Science:
- Epidemiology
- Public Health
- Pediatrics
Background:
- Meningococcal disease (MD) poses a significant public health challenge.
- Evidence linking household crowding to MD risk in children is limited.
- Understanding risk factors is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate the association between household density and the risk of meningococcal disease in children.
- To quantify the risk of MD related to crowding in different pediatric age groups.
Main Methods:
- A nationwide nested case-control study was conducted in Denmark.
- Included 1222 children diagnosed with MD and 24,549 population controls (1980-1999).
- Household density was assessed using data from Danish Civil Registration System and social registries.
Main Results:
- Increased household density was significantly associated with a higher risk of MD.
- The adjusted odds ratio (OR) for MD was 1.5 (95% CI: 1.1-1.9) for infants and 1.5 (95% CI: 1.1-2.0) for children aged 1-5 years, comparing lower to higher density.
- A crude OR of 1.8 (95% CI: 1.4-2.3) was observed for densities below 20 m2 per person.
Conclusions:
- Household density is a confirmed risk factor for meningococcal disease in preschool-aged children.
- Findings highlight the importance of living conditions in the transmission of MD.
- Public health interventions should consider household crowding as a modifiable risk factor.
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