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Risk factors for pneumonia among children in a Brazilian metropolitan area
C G Victora1, S C Fuchs, J A Flores
1Mestrado em Epidemiologia, Universidade Federal de Pelotas, Brasil.
Insights
Infant pneumonia risk factors include poor education, household crowding, young maternal age, day care, low birth weight, and lack of breastfeeding. Addressing these can prevent childhood deaths.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Pneumonia is a leading cause of mortality in children under five globally.
- Identifying specific risk factors in infants is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate risk factors associated with radiologically confirmed pneumonia in infants under two years of age.
- To inform public health interventions aimed at reducing infant pneumonia incidence.
Main Methods:
- A hospital-based, case-control study was conducted in an urban area of southern Brazil.
- Five hundred ten infants diagnosed with pneumonia were compared to age-matched neighborhood controls.
- Conditional regression modeling was employed to identify independent risk factors, controlling for confounding variables.
Main Results:
- Significant risk factors identified include low paternal education, household crowding, young maternal age, and day-care center attendance.
- Low birth weight, inadequate weight-for-age, lack of breastfeeding, and a history of previous pneumonia or wheezing were also associated with increased risk.
- Day-care center attendance emerged as a major risk factor, with an adjusted odds ratio of 11.75.
Conclusions:
- Preventive measures should address identified risk factors such as socioeconomic status, environmental exposures, and infant feeding practices.
- Targeting day-care attendance, improving nutrition, and promoting breastfeeding can significantly reduce infant pneumonia burden.
- These findings support the development of public health policies to decrease pneumonia-related child mortality.
Objective:
To investigate risk factors for pneumonia for infants < 2 years of age.
Design:
Hospital-based, case-control study with neighborhood control subjects.
Setting:
Urban area in southern Brazil.
Subjects:
Five hundred ten infants with radiologically confirmed pneumonia who were admitted to a pediatric hospital. One age-matched neighborhood control subject was selected for each case.
Results:
Multiple conditional regression modeling was used to control for confounding, taking into account the hierarchical relationships between risk factors. The incidence of radiologically confirmed pneumonia was associated with low paternal education, the number of persons in the household, young maternal age, attendance at day-care centers, low birth weight and weight-for-age, lack of breast-feeding and of non-milk supplements, and a history of previous pneumonia or wheezing. Day-care center attendance showed the highest risk, with an adjusted odds ratio of 11.75.
Conclusions:
In addition to continued efforts toward appropriate case management, actions directed against the above risk factors may help prevent the major cause of deaths of children younger than 5 years.