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

Lícia K.A.M. Thörn, Ruth Minamisava, Simonne Nouer, Luiza H. Ribeiro, Ana L. Andrade

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Children in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia.Methods: A 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.Results: From 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.Conclusions: In 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.

Original languageEnglish (US)
Article number180
JournalBMC Infectious Diseases
Volume11
DOIs
StatePublished - Jun 22 2011

Fingerprint

Poverty
Brazil
Pneumonia
Population
Cluster Analysis
Thorax
Incidence
Spatial Analysis
Latin America
Emergency Medical Services
Censuses
Streptococcus pneumoniae
Developing Countries
Hospital Emergency Service
Linear Models
Vaccination
X-Rays
Guidelines

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

Cite this

Pneumonia and poverty : A prospective population-based study among children in Brazil. / Thörn, Lícia K.A.M.; Minamisava, Ruth; Nouer, Simonne; Ribeiro, Luiza H.; Andrade, Ana L.

In: BMC Infectious Diseases, Vol. 11, 180, 22.06.2011.

Research output: Contribution to journalArticle

Thörn, Lícia K.A.M. ; Minamisava, Ruth ; Nouer, Simonne ; Ribeiro, Luiza H. ; Andrade, Ana L. / Pneumonia and poverty : A prospective population-based study among children in Brazil. In: BMC Infectious Diseases. 2011 ; Vol. 11.
@article{4c52f913e68f42f9a93ba4aff9b8d779,
title = "Pneumonia and poverty: A prospective population-based study among children in Brazil",
abstract = "Background: Children in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia.Methods: A 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.Results: From 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.Conclusions: In 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.",
author = "Th{\"o}rn, {L{\'i}cia K.A.M.} and Ruth Minamisava and Simonne Nouer and Ribeiro, {Luiza H.} and Andrade, {Ana L.}",
year = "2011",
month = "6",
day = "22",
doi = "10.1186/1471-2334-11-180",
language = "English (US)",
volume = "11",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Pneumonia and poverty

T2 - A prospective population-based study among children in Brazil

AU - Thörn, Lícia K.A.M.

AU - Minamisava, Ruth

AU - Nouer, Simonne

AU - Ribeiro, Luiza H.

AU - Andrade, Ana L.

PY - 2011/6/22

Y1 - 2011/6/22

N2 - Background: Children in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia.Methods: A 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.Results: From 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.Conclusions: In 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.

AB - Background: Children in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia.Methods: A 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.Results: From 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.Conclusions: In 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.

UR - http://www.scopus.com/inward/record.url?scp=79959339653&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959339653&partnerID=8YFLogxK

U2 - 10.1186/1471-2334-11-180

DO - 10.1186/1471-2334-11-180

M3 - Article

C2 - 21696610

AN - SCOPUS:79959339653

VL - 11

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

M1 - 180

ER -