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Acute respiratory illnesses in the first 18 months of life
I M López Bravo1, H Sepúlveda, I Valdés
1Medical Faculty, University of Chile, School of Public Health, Santiago, Chile.
Insights
Acute respiratory illnesses (ARI) are common in infants, with lower respiratory tract infections linked to factors like maternal schooling and housing. Hospitalization rates for ARI decreased with age in this Chilean study.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Acute respiratory illnesses (ARI) pose a significant health burden in early childhood.
- Understanding risk factors for ARI is crucial for developing effective prevention strategies.
Purpose of the Study:
- To assess the causes and frequency of ARI in the first 18 months of life in Chilean infants.
- To identify risk factors associated with upper and lower ARI, obstructive bronchitis, and pneumonia.
Main Methods:
- A cohort of 437 healthy newborns in Santiago, Chile, was followed for 18 months.
- Data on illnesses, including ARI, were collected through clinic visits, emergency services, private physicians, and maternal interviews.
- Statistical analysis was used to identify associations between ARI episodes and various risk factors.
Main Results:
- ARI accounted for 67% of all illnesses, with a rate of 33 episodes per 100 child-months.
- Incidences of ARI decreased significantly with age.
- Maternal smoking was associated with upper ARI; lower ARI was linked to maternal schooling, housing, family history of allergy, siblings, birth season, breastfeeding duration, and socioeconomic status.
- Obstructive bronchitis and pneumonia showed significant associations with multiple risk factors.
Conclusions:
- Lower respiratory tract infections in infants are associated with socioeconomic and environmental factors.
- Early identification of risk factors can guide interventions to reduce ARI burden and improve child health outcomes.
- Hospitalization rates for lower ARI decreased with increasing age.
Abstract:
To help assess the causes and frequency of acute respiratory illnesses (ARI) during the first 18 months of life in Chile, a cohort of 437 children born in good health between May 1991 and April 1992 was followed at an urban health clinic in northern Santiago. Information was obtained from medical checkups performed at the clinic, from emergency health care services, from private physicians, and from interviews with each child's mother when the child was enrolled in the study and when it was 6, 12, and 18 months old. Followup was completed for 379 (87%) of the children. ARI accounted for 67% of all 3762 episodes of illness recorded for these children in the 18-month study period, 1384 (55%) of the ARI episodes affecting the upper respiratory tract and the remaining 1144 (45%) affecting the lower. The overall rate of ARI observed was 33 episodes per 100 child-months of observation. The incidences of upper, lower, and total ARI episodes decreased significantly in the third six months of life. A statistically significant association was found between upper ARI (> or = 2 episodes) and maternal smoking (> or = 5 cigarettes per day), but no significant associations were found with any of the other risk factors studied. However, lower ARI (> or 2 episodes) was significantly associated with maternal schooling (< 8 years), a family history of atopic allergy, and substandard housing conditions; and lower ARI (> or = 4 episodes) was significantly associated with these factors and also with the existence of one or more siblings, birth in a cold season, limited breast-feeding (< 4 months), and low socioeconomic status. Significant associations were found between obstructive bronchitis episodes and most of the risk factors studied (gender, siblings, season of birth, duration of breast-feeding, maternal schooling, smoking, use of polluting fuels in the home, and a family history of atopic allergy); similarly, significant associations were found between the occurrence of pneumonia and many risk factors (including siblings, season of birth, duration of breast-feeding, maternal schooling, smoking, and socioeconomic level). Overall, 42 of the study children were hospitalized during the study period for lower tract ARI, and two children died of pneumonia at home during their first 6 months of life. The rate of hospitalization fell significantly with increasing age.