Pneumonia and poverty: a prospective population-based study among children in Brazil

BMC Infectious Diseases

Research Article

Ana Lucia Andrade¹  Lícia KAM Thörn²  Simonne S Nouer³  Luiza H Ribeiro⁴  Ruth Minamisava⁵ 

[1] Department of Community Health, Institute of Tropical Pathology and Public Health, Federal University of Goias, Brazil;Department of Epidemiology, Secretariat of Health of the Municipality of Goiânia, Brazil;Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA;Samaritano Hospital of Goiânia, Goiânia, Brazil;School of Nursing, Federal University of Goiás, Brazil;

关键词: Pneumonia;    Minimum Wage;    Census Tract;    Invasive Pneumococcal Disease;    Bacterial Pneumonia;   

DOI  :  10.1186/1471-2334-11-180

 received in 2011-02-10, accepted in 2011-06-22,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundChildren in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia.MethodsA prospective population-based study on pneumonia was carried out as part of the Latin America Epidemiological Assessment of Pneumococcus (LEAP study). Chest x-rays were obtained for children one to 35 months old with suspected pneumonia presenting to emergency care centers and hospital emergency rooms in Goiania, Brazil. Chest radiographs were evaluated according to WHO guidelines. Clustering of radiologically-confirmed pneumonia were evaluated using a Poisson-based spatial scan statistic. Associations between census socioeconomic indicators and pneumonia incidence rates were analyzed using generalized linear models.ResultsFrom May, 2007 to May, 2009, chest radiographs were obtained from 11 521 children with clinical pneumonia; 3955 episodes were classified as radiologically-confirmed. Incidence rates were significantly higher in very low income areas (4825.2 per 105) compared to high income areas (1637.3 per 105). Spatial analysis identified clustering of confirmed pneumonia in Western (RR 1.78; p = 0.001) and Southeast (RR 1.46; p = 0.001) regions of the city, and clustering of hospitalized pneumonia in the Western region (RR 1.69; p = 0.001). Lower income households and illiteracy were associated with pneumonia incidence.ConclusionsIn infants the risk of developing pneumonia is inversely associated with the head of household income and with the woman educational level. Areas with deprived socioeconomic conditions had higher incidence of pneumonia and should be targeted for high vaccination coverage.

【 授权许可】

Unknown   
© Thörn et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.