tetano
Editor, Senior Moderator
BMC Pediatr. 2016 Sep 22;16(1):157.
[h=1]Risk factors for community-acquired pneumonia in children under five years of age in the post-pneumococcal conjugate vaccine era in Brazil: a case control study.[/h] Fonseca Lima EJ[SUP]1,[/SUP][SUP]2[/SUP], Mello MJ[SUP]3,[/SUP][SUP]4[/SUP], Albuquerque MF[SUP]5[/SUP], Lopes MI[SUP]6[/SUP], Serra GH[SUP]4[/SUP], Lima DE[SUP]7[/SUP], Correia JB[SUP]3,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Pneumonia plays an important role in children's morbidity and mortality. In Brazil, epidemiological and social changes occurred concomitantly with the universal introduction of the 10-valent pneumococcal conjugate vaccine. This study identified risk factors for pneumonia following the implementation of a pneumococcal vaccination program.
[h=4]METHODS:[/h] A hospital-based, case-control study involving incident cases of pneumonia in children aged 1-59 months was conducted between October 2010 and September 2013 at a tertiary hospital in northeastern Brazil. The diagnosis of pneumonia was based on the World Health Organization (WHO) criteria. The control group consisted of children admitted to the day-hospital ward for elective surgery. Children with comorbidities were excluded. The risk factors for pneumonia that were investigated were among those classified by the WHO as definite, likely and possible. A multivariate analysis was performed including variables that were significant at p ≤ 0.25 in the bivariate analysis.
[h=4]RESULTS:[/h] The study evaluated 407 children in the case group and 407 children in the control group. Household crowding (OR = 2.15; 95 % CI, 1,46-3,18) and not having been vaccinated against the influenza virus (OR = 3.59; 95 % CI, 2,62-4.91) were the only factors found to increase the likelihood of pneumonia. Male gender constituted a protective factor (OR = 0.53; 95 % CI, 0,39-0,72).
[h=4]CONCLUSION:[/h] Changes on risk factors for pneumonia were most likely associated with the expansion of the vaccination program and social improvements; however, these improvements were insufficient to overcome inequalities, given that household crowding remained a significant risk factor. The protection provided by the influenza vaccine must be evaluated new etiological studies. Furthermore, additional risk factors should be investigated.
[h=4]KEYWORDS:[/h] Children; Influenza vaccines; Pneumococcal vaccines; Pneumonia; Risk factors
PMID: 27659204 DOI: 10.1186/s12887-016-0695-6
[PubMed - as supplied by publisher]
[h=1]Risk factors for community-acquired pneumonia in children under five years of age in the post-pneumococcal conjugate vaccine era in Brazil: a case control study.[/h] Fonseca Lima EJ[SUP]1,[/SUP][SUP]2[/SUP], Mello MJ[SUP]3,[/SUP][SUP]4[/SUP], Albuquerque MF[SUP]5[/SUP], Lopes MI[SUP]6[/SUP], Serra GH[SUP]4[/SUP], Lima DE[SUP]7[/SUP], Correia JB[SUP]3,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Pneumonia plays an important role in children's morbidity and mortality. In Brazil, epidemiological and social changes occurred concomitantly with the universal introduction of the 10-valent pneumococcal conjugate vaccine. This study identified risk factors for pneumonia following the implementation of a pneumococcal vaccination program.
[h=4]METHODS:[/h] A hospital-based, case-control study involving incident cases of pneumonia in children aged 1-59 months was conducted between October 2010 and September 2013 at a tertiary hospital in northeastern Brazil. The diagnosis of pneumonia was based on the World Health Organization (WHO) criteria. The control group consisted of children admitted to the day-hospital ward for elective surgery. Children with comorbidities were excluded. The risk factors for pneumonia that were investigated were among those classified by the WHO as definite, likely and possible. A multivariate analysis was performed including variables that were significant at p ≤ 0.25 in the bivariate analysis.
[h=4]RESULTS:[/h] The study evaluated 407 children in the case group and 407 children in the control group. Household crowding (OR = 2.15; 95 % CI, 1,46-3,18) and not having been vaccinated against the influenza virus (OR = 3.59; 95 % CI, 2,62-4.91) were the only factors found to increase the likelihood of pneumonia. Male gender constituted a protective factor (OR = 0.53; 95 % CI, 0,39-0,72).
[h=4]CONCLUSION:[/h] Changes on risk factors for pneumonia were most likely associated with the expansion of the vaccination program and social improvements; however, these improvements were insufficient to overcome inequalities, given that household crowding remained a significant risk factor. The protection provided by the influenza vaccine must be evaluated new etiological studies. Furthermore, additional risk factors should be investigated.
[h=4]KEYWORDS:[/h] Children; Influenza vaccines; Pneumococcal vaccines; Pneumonia; Risk factors
PMID: 27659204 DOI: 10.1186/s12887-016-0695-6
[PubMed - as supplied by publisher]