PEDIATRICS Vol. 93 No. 6 June 1994, pp. 977-985
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Risk Factors for Pneumonia Among Children in a Brazilian Metropolitan Area

Cesar G. Victora MD, PhD1, Sandra C. Fuchs MD, PhD1, José Antonio C. Flores MD2, Walter Fonseca MD, PhD3, and Betty Kirkwood MS4

1 Mestrado em Epidemiologia, Universidade Federal de Pelotas, CP 464 - 96100 Pelotas, RS, Brasil
2 Hospital Santo Antôonio, Porto Alegre, RS, Brasil
3 Mestrado em Epidemiologia, Universidade Federal de Pelotas, cP 464 - 96100 Pelotas, RS, Brasil, London School of Hygiene and Tropical Medicine, United Kingdom
4 London School of Hygiene and Tropical Medicine, United Kingdom

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.

Submitted on August 24, 1993
Accepted on October 21, 1993




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