Mortality Associated With Acute Respiratory Infections Among Children at Home.
Mortality Associated With Acute Respiratory Infections Among Children at Home.
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DOI：
10.1093/infdis/jiy517
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发表时间：
2019-01-09
期刊：
影响因子：
--
通讯作者：
Polack FP
中科院分区：
文献类型：
--
作者：
Caballero MT;Bianchi AM;Nuño A;Ferretti AJP;Polack LM;Remondino I;Rodriguez MG;Orizzonte L;Vallone F;Bergel E;Polack FP
在发展中国家，许多5岁以下儿童的死亡发生在家中。急性呼吸道感染（ARIs）被认为在这些死亡中起重要作用。与致命事件相关的危险因素和病原体仍不清楚。在阿根廷布宜诺斯艾利斯开展了一项针对低收入家庭5岁以下儿童的病例对照研究，以确定家中死于急性呼吸道感染的儿童的危险因素和病毒病原体。共有278个5岁以下儿童的家庭（其中104个已死亡，174个为健康对照）参与了这项研究。87.5%的ari相关死亡发生在小于12个月的婴儿中。估计因急性呼吸道感染引起的婴儿死亡率为5.02 /1000活产。因急性呼吸道感染在家中死亡与以下因素相关：居住在拥挤的家中（优势比[OR]， 3.73； 95%可信区间[CI]， 1.41-9.88）、母亲为青少年（OR, 4.89; 95% CI, 1.37-17.38）、家中缺乏自来水（OR, 4.39; 95% CI, 1.11-17.38）、未按年龄接种疫苗（OR, 3.39; 95% CI, 1.20-9.62）、入住新生儿重症监护室（OR, 7.17; 95% CI, 2.21-23.27）以及急性呼吸道感染发作期间未就诊急诊（OR, 72.32; 95% CI, 4.82-1085.6）。婴儿因呼吸道合胞病毒感染而在家死亡的比率为每100个活产死亡0.26人，而因流感而在家死亡的比率为每1000个活产死亡0.07人。社会脆弱性是ARI造成的家庭死亡的根本原因。由于呼吸道合胞病毒和流感病毒感染的死亡率在家中婴儿中很高，与住院儿童的死亡率相似。社会经济脆弱社区的特定儿童亚群在家中死于急性呼吸道感染的风险更高。这是第一个提供婴儿呼吸道合胞病毒和甲型流感病毒感染的家庭死亡率的研究。
Numerous deaths in children aged <5 years in the developing world occur at home. Acute respiratory infections (ARIs) are thought to play an important role in these deaths. Risk factors and pathogens linked to fatal episodes remain unclear. A case-control study among low-income children aged <5 years was performed in Buenos Aires, Argentina, to define risk factors and viral pathogens among those who died of ARI at home. A total of 278 families of children aged <5 years (of whom 104 died and 174 were healthy controls) participated in the study. A total of 87.5% of ARI-associated deaths occurred among infants aged <12 months. The estimated mortality rate due to ARI among infants was 5.02 deaths/1000 live births. Dying at home from ARI was associated with living in a crowded home (odds ratio [OR], 3.73; 95% confidence interval [CI], 1.41–9.88), having an adolescent mother (OR, 4.89; 95% CI, 1.37–17.38), lacking running water in the home (OR, 4.39; 95% CI, 1.11–17.38), incomplete vaccinations for age (OR, 3.39; 95% CI, 1.20–9.62), admission to a neonatal intensive care unit (OR, 7.17; 95% CI, 2.21–23.27), and no emergency department visit during the ARI episode (OR, 72.32; 95% CI, 4.82–1085.6). The at-home death rate due to respiratory syncytial virus infection among infants was 0.26 deaths/100 live births and that due to influenza was 0.07 deaths/1000 live births. Social vulnerabilities underlie at-home mortality due to ARI. Mortality rates due to RSV and influenza virus infection are high among infants at home and are similar to those reported for hospitalized children. Specific subgroups of children in socioeconomically vulnerable communities are at higher risk for dying at home from acute respiratory tract infection. This is the first study to provide at-home mortality rates due to respiratory syncytial virus and influenza A virus infection among infants.
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影响因子：
168.9
作者：
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通讯作者：
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影响因子：
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DOI：
10.1590/s1518-8787.2017051006391
发表时间：
2017-01-01
期刊：
Revista de Saúde Pública
影响因子：
--
作者：
Leal, Maria do Carmo;Bittencourt, Sonia Duarte de Azevedo;Souza Jr, Paulo Roberto Borges de
通讯作者：
Souza Jr, Paulo Roberto Borges de