Incidence and Risk Factors of Childhood Pneumonia-Like Episodes in Biliran Island, Philippines--A Community-Based Study.
Incidence and Risk Factors of Childhood Pneumonia-Like Episodes in Biliran Island, Philippines--A Community-Based Study.
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DOI：
10.1371/journal.pone.0125009
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Oshitani H
中科院分区：
文献类型：
--
作者：
Kosai H;Tamaki R;Saito M;Tohma K;Alday PP;Tan AG;Inobaya MT;Suzuki A;Kamigaki T;Lupisan S;Tallo V;Oshitani H
肺炎是包括菲律宾在内的发展中国家婴幼儿死亡的主要原因。然而，社区层面的数据仍然有限。我们的研究旨在估计儿童肺炎的发病率和死亡率，并评估儿童肺炎的危险因素和求医行为。在菲律宾比里兰岛进行了一项家庭层面的访谈调查。护理人员使用半结构问卷进行了采访，以检查儿童在2011年6月至2012年5月期间是否有类似肺炎的症状。在总共访问的3327户家庭中，3302户(99.2%)同意参与，5249名5岁以下儿童纳入研究。肺炎样发作、严重肺炎样发作和肺炎相关死亡的发生率分别为105/1000人年、61人/1000人年和0.9/1000人年。根据COX比例风险模型，哮喘史[危险比(HR)：5.85，95%可信区间(CI)：4.83-7.08]、低社会经济地位(HR：1.11，95%CI：1.02-1.20)和前往医疗机构的路程较长(HR：1.32，95%CI：1.09-1.61)与肺炎样事件的发生显著相关。对于重症肺炎样发作，哮喘史(HR：8.39，95%CI：6.54~10.77)和低SES(HR：1.30，95%CI：1.17~1.45)是显著的危险因素。旅行时间长的儿童在经历严重肺炎样发作时，不太可能寻求医院护理(优势比：0.32，95%CI：0.19-0.54)。儿童肺炎样发作的发生率与哮喘史、SES和前往医疗机构的旅行时间有关。旅行时间也被认为是寻求健康行为的一个强有力的指标。改善获得医疗设施的机会对于早期和有效的管理非常重要。有必要进行进一步的研究，以了解哮喘和肺炎之间的因果关系。
Pneumonia is a leading cause of deaths in infants and young children in developing countries, including the Philippines. However, data at the community level remains limited. Our study aimed to estimate incidence and mortality rates and to evaluate risk factors and health-seeking behavior for childhood pneumonia. A household level interview survey was conducted in Biliran Island, the Philippines. Caregivers were interviewed using a semi-structured questionnaire to check if children had symptoms suggesting pneumonia-like episodes from June 2011 to May 2012. Of 3,327 households visited in total, 3,302 (99.2%) agreed to participate, and 5,249 children less than 5 years of age were included in the study. Incidence rates of pneumonia-like episodes, severe pneumonia-like episodes, and pneumonia-associated mortality were 105, 61, and 0.9 per 1,000 person-years, respectively. History of asthma [hazard ratio (HR): 5.85, 95% confidence interval (CI): 4.83–7.08], low socioeconomic status (SES) (HR: 1.11, 95% CI: 1.02–1.20), and long travel time to the healthcare facility estimated by cost distance analysis (HR: 1.32, 95% CI: 1.09–1.61) were significantly associated with the occurrence of pneumonia-like episodes by the Cox proportional hazards model. For severe pneumonia-like episodes, a history of asthma (HR: 8.39, 95% CI: 6.54–10.77) and low SES (HR: 1.30, 95% CI: 1.17–1.45) were significant risk factors. Children who had a long travel time to the hospital were less likely to seek hospital care (Odds ratio: 0.32, 95% CI: 0.19–0.54) when they experienced severe pneumonia-like episodes. Incidence of pediatric pneumonia-like episodes was associated with a history of asthma, SES, and the travel time to healthcare facilities. Travel time was also identified as a strong indicator for health-seeking behavior. Improved access to healthcare facilities is important for early and effective management. Further studies are warranted to understand the causal relationship between asthma and pneumonia.
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影响因子：
2.9
作者：
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通讯作者：
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DOI：
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DOI：
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发表时间：
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期刊：
Bulletin of the World Health Organization: International Journal of Public Health
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