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Risk Factors Associated With Bronchiolitis in Puerto Rican Children
Andrea Rivera-Sepúlveda, Enid García-Rivera, Mario Castro1
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO.
Insights
Bronchiolitis in Puerto Rican children is linked to atopy-related factors, not just traditional risks. Early identification of these factors can help prevent severe disease and potentially asthma development.
Area of Science:
- Pediatrics
- Epidemiology
- Environmental Health
Background:
- Bronchiolitis is a common respiratory infection in infants and young children.
- Understanding risk factors specific to certain populations, like Puerto Rican children, is crucial for targeted prevention and management strategies.
Purpose of the Study:
- To determine the frequency, severity, and risk factors for bronchiolitis in children under 24 months in Puerto Rico.
- To investigate the association between environmental factors, atopy, and bronchiolitis episodes.
Main Methods:
- A cross-sectional study was conducted in 4 emergency departments in Puerto Rico's metropolitan area from June 2014 to May 2015.
- Data collected included patient history, bronchiolitis severity, and environmental factors like weather and aeroallergens.
- 600 children under 24 months with a clinical diagnosis of bronchiolitis were included.
Main Results:
- Older age, male sex, history of asthma, allergic rhinitis, and caretaker's smoke exposure were significant predictors of bronchiolitis.
- Bronchiolitis episodes correlated with higher severity scores, more atopic factors, and increased hospitalizations.
- Over 50% of patients had prior bronchiolitis, with 40% of those hospitalized.
Conclusions:
- Atopy-related factors significantly influence the frequency and severity of bronchiolitis in Puerto Rican children.
- Puerto Rican children may develop atopy-related risk factors for severe bronchiolitis earlier in life.
- Modifiable atopy-related factors present an opportunity for intervention to prevent severe bronchiolitis and potentially reduce future asthma development.
Objective:
The objective of this study was to identify frequency, severity, and risk factors associated with bronchiolitis in Puerto Rican children.
Methods:
A cross-sectional was study performed at 4 emergency departments of Puerto Rico's metropolitan area, between June 2014 and May 2015. We included children younger than 24 months, with a clinical diagnosis of bronchiolitis, who were born and living in Puerto Rico at the time of recruitment. A physician-administered questionnaire inquiring about the patient's medical, family, and social history and a bronchiolitis severity assessment were performed. Daily weather conditions were monitored, and aeroallergens were collected with an air sample and precision weather station within the metropolitan area to evaluate environmental factors.
Results:
We included 600 patients for 12 months. More than 50% of the recruited patients had a previous episode of bronchiolitis, of which 40% had been hospitalized. Older age (odds ratio [OR], 18.3; 95% confidence interval [CI], 9.2-36.5), male sex (OR, 1.6; 95% CI, 1.1-2.4), history of asthma (OR, 8.9; 95% CI, 3.6-22), allergic rhinitis (OR, 3.6; 95% CI, 1.8-7.4), and smoke exposure by a caretaker (OR, 2.3; 95% CI, 1.2-4.4) were predictors of bronchiolitis episodes. Bronchiolitis episodes were associated with higher severity score (P = 0.040), increased number of atopic factors (P < 0.001), and higher number of hospitalizations (P < 0.001).
Conclusions:
This study identifies Puerto Rican children who may present a severe clinical course of disease without traditional risk factors. Atopy-related factors are associated with frequency and severity of bronchiolitis. Puerto Rican children present risk factors related to atopy earlier in life, some of which may be modified to prevent the subsequent development of asthma.
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