Koch Anders, Mølbak Kåre, Homøe Preben, Sørensen Per, Hjuler Thomas, Olesen Mette Ehmer, Pejl June, Pedersen Freddy Karup, Olsen Ove Rosing, Melbye Mads
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
Am J Epidemiol. 2003 Aug 15;158(4):374-84. doi: 10.1093/aje/kwg143.
Acute respiratory infections cause considerable morbidity among Inuit children, but there is very little information on the risk factors for these infections in this population. To identify such factors, the authors performed a prospective community-based study of acute respiratory infections in an open cohort of 288 children aged 0-2 years in the town of Sisimiut, Greenland. Between July 1996 and August 1998, children were monitored weekly, and episodes of upper and lower respiratory tract infections were registered. Risk factor analyses were carried out using a multivariate Poisson regression model adjusted for age. Risk factors for upper respiratory tract infections included attending a child-care center (relative risk = 1.7 compared with home care) and sharing a bedroom with adults (relative risk = 2.5 for one adult and 3.1 for two adults). Risk factors for lower respiratory tract infections included being a boy (relative risk = 1.5), attending a child-care center (relative risk = 3.3), exposure to passive smoking (relative risk = 2.1), and sharing a bedroom with children aged 0-5 years (relative risk = 2.0 for two other children). Breastfeeding tended to be protective for lower respiratory tract infections. The population-attributable risk of lower respiratory tract infections associated with passive smoking and child-care centers was 47% and 48%, respectively. The incidence of acute respiratory infections among Inuit children may be reduced substantially through public health measures.
急性呼吸道感染在因纽特儿童中导致相当高的发病率，但关于该人群中这些感染的危险因素的信息却非常少。为了确定这些因素，作者对格陵兰西西缪特镇288名0至2岁儿童的开放队列进行了一项基于社区的急性呼吸道感染前瞻性研究。1996年7月至1998年8月期间，每周对儿童进行监测，并记录上呼吸道和下呼吸道感染的发作情况。使用针对年龄进行调整的多变量泊松回归模型进行危险因素分析。上呼吸道感染的危险因素包括入托（与在家照料相比，相对风险 = 1.7）以及与成年人共用一间卧室（与一名成年人共用时相对风险 = 2.5，与两名成年人共用时相对风险 = 3.1）。下呼吸道感染的危险因素包括为男孩（相对风险 = 1.5）、入托（相对风险 = 3.3）、接触被动吸烟（相对风险 = 2.1）以及与0至5岁儿童共用一间卧室（与另外两名儿童共用时相对风险 = 2.0）。母乳喂养对下呼吸道感染往往具有保护作用。与被动吸烟和托幼中心相关的下呼吸道感染的人群归因风险分别为47%和48%。通过公共卫生措施，因纽特儿童急性呼吸道感染的发病率可能会大幅降低。
