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Int J Epidemiol. 1993 Dec;22(6):1174-82.

Risk factors for mortality from acute lower respiratory tract infections in young Gambian children.

Author information

1
Medical Research Council Laboratories, Banjul, The Gambia.

Abstract

A case-control study has been undertaken in a rural area of The Gambia to evaluate risk factors for death from acute lower respiratory tract infections (ALRI) in young children. On the basis of a post-mortem interview 129 children aged < 2 years were thought to have died from ALRI. These cases were each matched according to age, sex, ethnic group, time and place of death with a child who had died from a cause other than an ALRI and with two live control children. Cases and controls were well matched. Comparison of cases and live controls suggested that exposure to smoke during cooking, parental smoking and exclusive, prolonged breastfeeding were associated with an increased risk of death from ALRI whilst sharing a bed with siblings, use of antenatal and welfare clinics and immunization were associated with a reduced risk of death from ALRI. No associations were found between mortality from ALRI and maternal education and literacy, socioeconomic status or with the age of the mother. Comparison of children who died from causes other than ALRI with the live controls showed a similar pattern of associations and no significant differences were found in any of the risk factors studied between children whose deaths were attributed to ALRI and those whose death was attributed to another cause. Association of death with exposure to smoke during cooking was the strongest risk factor identified. This risk might be altered by reducing smoke exposure during cooking.

PIP:

Acute lower respiratory tract infections (ALRI) are an important cause of mortality among children under 5 years old in many developing countries. While interventions aim to manage the occurrence of ALRI and the associated mortality through early diagnosis and treatment, efforts must also be taken to prevent the baseline infections. Birthweight, breastfeeding, overcrowding, and exposure to smoke are thought to influence young children's susceptibility to ALRI. The authors present results from a case-control study in a rural area of the Gambia where ALRI was found to be the most significant cause of death among individuals under 2 years old. The study was conducted to evaluate risk factors for mortality from these infections in young children. Post-mortem data on 129 under-2-year-olds thought to have died from ALRI were employed. Data for these cases were matched according to age, sex, ethnic group, and time and place of death with children who had died from other causes as well as with 2 groups of live control children. Results from the comparison between groups suggest that exposure to smoke during cooking, parental smoking, and exclusive, prolonged breast feeding were associated with an increased risk of death from ALRI. Sharing a bed with siblings, use of antenatal and welfare clinics, and immunization had an effect in the opposite direction. No associations were found between ALRI mortality and maternal education and literacy, socioeconomic status, or with mother's age. Comparing data on children who died from causes other than ALRI with the live controls yielded a similar pattern of associations and no significant differences were found in any of the risk factors studied between children whose deaths were attributed to ALRI and those whose death was attributed to another cause. Mortality was most strongly associated with exposure to smoke during cooking. The authors therefore note the need to reduce young children's exposure to such smoke in the interest of reducing the incidence and prevalence of ALRI.

PMID:
8144302
DOI:
10.1093/ije/22.6.1174
[Indexed for MEDLINE]

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