Journal Article

Nutritional Status and Diarrheal Illness as Independent Risk Factors for Alveolar Pneumonia

Christian L. Coles, Drora Fraser, Noga Givon-Lavi, David Greenberg, Raphael Gorodischer, Jacob Bar-Ziv and Ron Dagan

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 10, pages 999-1007
Published in print November 2005 | ISSN: 0002-9262
Published online October 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi312
Nutritional Status and Diarrheal Illness as Independent Risk Factors for Alveolar Pneumonia

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Community-acquired alveolar pneumonia (CAAP) is typically associated with bacterial infections and is especially prevalent in vulnerable populations worldwide. The authors studied nutritional status and diarrheal history as risk factors for CAAP in Bedouin children <5 years of age living in Israel. In this prospective case-control study (2001–2002), 334 children with radiographically confirmed CAAP were compared with 529 controls without pneumonia with regard to nutritional status and diarrhea history. Controls were frequency matched to cases on age and enrollment month. Logistic regression models were used to evaluate associations of CAAP with nutritional status and recent diarrhea experience. Anemia (adjusted odds ratio (AOR) = 3.32, 95% confidence interval (CI): 2.24, 4.94; p < 0.001), low birth weight (AOR = 2.16, 95% CI: 1.32, 3.54; p = 0.002), stunting (AOR = 2.22, 95% CI: 1.31, 3.78; p = 0.004), serum retinol concentration (AOR = 1.03 per μg/dl, 95% CI: 1.02, 1.05; p < 0.001), and having ≥1 diarrhea episodes within 31 days prior to enrollment (AOR = 2.30, 95% CI: 1.26, 4.19; p = 0.007) were identified as risk factors for CAAP. Results suggest that improving antenatal care and the nutritional status of infants may reduce the risk of CAAP in Bedouin children. Furthermore, they suggest that vaccines developed to prevent diarrhea may also lower the risk of CAAP.

Keywords: anemia; diarrhea; micronutrients; nutritional status; pneumonia; risk factors; AOR, adjusted odds ratio; CAAP, community-acquired alveolar pneumonia; CI, confidence interval

Journal Article.  5935 words. 

Subjects: Public Health and Epidemiology

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