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Published on: August 7, 2017
Population-based study of the association between asthma and pneumococcal disease in children
Kimberly M Shea1, Timothy L Lash2, Sussie Antonsen3
1Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA ; Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
Insights
Asthma significantly increases the risk of pneumococcal disease (PD) in children. Children with comorbidities are more vulnerable to PD when they also have asthma.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Respiratory Medicine
Background:
- Asthma is a known risk factor for pneumococcal disease (PD).
- Limited research exists on this association specifically in pediatric populations.
- Understanding this link is crucial for childhood public health strategies.
Purpose of the Study:
- To evaluate the association between asthma and the risk of childhood pneumococcal disease.
- To investigate the interaction between asthma, comorbidity, and PD risk in children.
Main Methods:
- Nation-wide population-based cohort study in Denmark (1994-2007).
- Inclusion of all singleton live births before pneumococcal conjugate vaccine introduction.
- Utilized Danish medical registries and assessed biologic interaction between comorbidity and asthma.
Main Results:
- 2,253 cases of childhood PD observed in 888,655 children.
- Asthma adjusted incidence rate ratio for childhood PD was 2.2 (95% CI: 2.0, 2.5).
- Higher PD risk observed in children aged 24 to <60 months with asthma (IRR 4.1).
- Interaction between asthma and comorbidity accounted for 55-73% of PD cases in older children.
Conclusions:
- Asthma is confirmed as a significant risk factor for pneumococcal disease in children.
- Children with comorbidities exhibit heightened sensitivity to asthma's impact on PD risk.
- Findings underscore the importance of considering asthma and comorbidity in pediatric PD prevention.
Background:
Although asthma has recently been established as a risk factor for pneumococcal disease (PD), few studies have specifically evaluated this association in children.
Methods:
We conducted a nation-wide population-based cohort study of the effect of asthma on childhood PD among all singleton live births in Denmark from 1994 to 2007, before the introduction of the 7-valent pneumococcal conjugate vaccine. All data were abstracted from Danish medical registries. Because underlying comorbidity substantially increases the PD risk in children, standard methods were used to assess the evidence of biologic interaction between comorbidity and asthma on the risk of PD.
Results:
There were 2,253 cases of childhood PD among 888,655 children born in Denmark from 1994 to 2007. The adjusted incidence rate ratio of the effect of asthma on childhood PD was 2.2 (95% confidence interval [CI]: 2.0, 2.5). Age-stratified incidence rate ratios were 2.1 (95% CI: 1.8, 2.9) in children 6 months to <24 months, 4.1 (95% CI: 3.3, 5.1) in children 24 months to <60 months, and 2.3 (95% CI: 1.6, 3.2) in children ≥60 months. Evaluation of the biologic interaction between asthma and comorbidity in older children revealed that 55% (24 months to <60 months) to 73% (≥60 months) of cases among asthma-exposed children can be accounted for by the interaction between asthma and comorbidity.
Conclusion:
These results confirm that asthma is an important risk factor for PD in children and suggest that children with underlying comorbidities are more sensitive to the effect of asthma on PD than children without comorbidities.
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