title: Nutritional status and diarrheal illness as independent risk factors for alveolar pneumonia.
abstract: 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 microg/dl, 95% CI: 1.02, 1.05; p < 0.001), and having > or =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.
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel. ccoles@jhsph.edu
authors.forename: Christian L
authors.initials: CL
authors.lastname: Coles
authors.forename: Drora
authors.initials: D
authors.lastname: Fraser
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
authors.forename: Raphael
authors.initials: R
authors.lastname: Gorodischer
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar-Ziv
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
mesh_terms: D000740:Anemia / Q000453:epidemiology; D018912:Arabs / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology; D015897:Comorbidity; D003967:Diarrhea / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D009752:Nutritional Status; D011014:Pneumonia / Q000097:blood / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014801:Vitamin A / Q000097:blood
chemical_list: D014801:Vitamin A