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Published on: February 23, 2014
Risk factors for community-acquired pneumonia in pre-school-aged children
Cameron C Grant1, Diane Emery, Tania Milne
1Department of Paediatrics: Child and Youth Health, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand. cc.grant@auckland.ac.nz
Insights
Poor housing conditions and nutritional status are key risk factors for childhood pneumonia in New Zealand. Interventions should focus on improving living environments and nutrition to reduce disease burden.
Area of Science:
- Pediatric Respiratory Medicine
- Environmental Health
- Epidemiology
Background:
- Community-acquired pneumonia (CAP) is a significant cause of childhood morbidity.
- Identifying modifiable risk factors is crucial for effective public health interventions.
Purpose of the Study:
- To determine risk factors associated with the development of CAP in children.
- To identify risk factors for hospitalisation due to CAP in children.
Main Methods:
- A case-control study was conducted in urban Auckland, New Zealand (2002-2004) involving children under 5 years old.
- Pneumonia cases (hospitalised and emergency department) were compared to a community control group.
- Adjusted odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess risk.
Main Results:
- Risk factors for pneumonia included lower weight-for-height, reduced outdoor time, prior chest infections, and bedroom mould.
- Risk factors for pneumonia hospitalisation included maternal pneumonia history, household crowding, cigarette smoke exposure, and bedroom mould.
Conclusions:
- Lower quality living environments, including mould and crowding, significantly increase pneumonia risk and hospitalisation.
- Poor nutritional status and exposure to cigarette smoke are also critical risk factors.
- Improving housing quality, reducing smoke exposure, and enhancing early childhood nutrition can decrease the burden of childhood pneumonia.
Aim:
To identify risk factors for children developing and being hospitalised with community-acquired pneumonia.
Methods:
Children <5 years old residing in urban Auckland, New Zealand were enrolled from 2002 to 2004. To assess the risk of developing pneumonia, children hospitalised with pneumonia (n= 289) plus children with pneumonia discharged from the Emergency Department (n= 139) were compared with a random community sample of children without pneumonia (n= 351). To assess risk of hospitalisation, children hospitalised with pneumonia were compared with the children discharged from the Emergency Department. Adjusted odds ratio (OR) with 95% confidence intervals (CIs) were used to estimate the risk of pneumonia and hospitalisation with pneumonia.
Results:
After adjustment for season, age and ethnicity there was an increased risk of pneumonia associated with lower weight for height (OR 1.28, 95% CI 1.10-1.51), spending less time outside (1.96, 1.11-3.47), previous chest infections (2.31, 1.55-3.43) and mould in the child's bedroom (1.93, 1.24-3.02). There was an increased risk of pneumonia hospitalisation associated with maternal history of pneumonia (4.03, 1.25-16.18), living in a more crowded household (2.87, 1.33-6.41) and one with cigarette smokers (1.99, 1.05-3.81), and mould in the child's bedroom (2.39, 1.25-4.72).
Conclusions:
Lower quality living environments increase the risk of pneumonia and hospitalisation with pneumonia in New Zealand. Poorer nutritional status may also increase the risk of pneumonia. Improving housing quality, decreased cigarette smoke exposure and early childhood nutrition may reduce pneumonia disease burden in New Zealand.
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