title: Risk factors for community-acquired pneumonia in pre-school-aged children.
abstract: OBJECTIVE
  To identify risk factors for children developing and being hospitalised with community-acquired pneumonia.
  
  
  METHODS
  Children <5 years old residing in urban Auckland, New Zealand were enrolled from 2002 to 2004. To assess the risk of developing pneumonia, children hospitalised with pneumonia (n= 289) plus children with pneumonia discharged from the Emergency Department (n= 139) were compared with a random community sample of children without pneumonia (n= 351). To assess risk of hospitalisation, children hospitalised with pneumonia were compared with the children discharged from the Emergency Department. Adjusted odds ratio (OR) with 95% confidence intervals (CIs) were used to estimate the risk of pneumonia and hospitalisation with pneumonia.
  
  
  RESULTS
  After adjustment for season, age and ethnicity there was an increased risk of pneumonia associated with lower weight for height (OR 1.28, 95% CI 1.10-1.51), spending less time outside (1.96, 1.11-3.47), previous chest infections (2.31, 1.55-3.43) and mould in the child's bedroom (1.93, 1.24-3.02). There was an increased risk of pneumonia hospitalisation associated with maternal history of pneumonia (4.03, 1.25-16.18), living in a more crowded household (2.87, 1.33-6.41) and one with cigarette smokers (1.99, 1.05-3.81), and mould in the child's bedroom (2.39, 1.25-4.72).
  
  
  CONCLUSIONS
  Lower quality living environments increase the risk of pneumonia and hospitalisation with pneumonia in New Zealand. Poorer nutritional status may also increase the risk of pneumonia. Improving housing quality, decreased cigarette smoke exposure and early childhood nutrition may reduce pneumonia disease burden in New Zealand.
authors.affiliation: Department of Paediatrics: Child and Youth Health, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand. cc.grant@auckland.ac.nz
authors.forename: Cameron C
authors.initials: CC
authors.lastname: Grant
authors.forename: Diane
authors.initials: D
authors.lastname: Emery
authors.forename: Tania
authors.initials: T
authors.lastname: Milne
authors.forename: Gregor
authors.initials: G
authors.lastname: Coster
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Forrest
authors.forename: Clare R
authors.initials: CR
authors.lastname: Wall
authors.forename: Robert
authors.initials: R
authors.lastname: Scragg
authors.forename: Richard
authors.initials: R
authors.lastname: Aickin
authors.forename: Sue
authors.initials: S
authors.lastname: Crengle
authors.forename: Alison
authors.initials: A
authors.lastname: Leversha
authors.forename: Colin
authors.initials: C
authors.lastname: Tukuitonga
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Robinson
mesh_terms: D016022:Case-Control Studies; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000209:etiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006798:Housing; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009520:New Zealand; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data; D011014:Pneumonia / Q000209:etiology*; D012307:Risk Factors