Banerji Anna, Greenberg David, White Laura Forsberg, Macdonald W Alexander, Saxton Audrey, Thomas Eva, Sage Douglas, Mamdani Muhammad, Lanctôt Krista L, Mahony James B, Dingle Mia, Roberts Ann
Department of Pediatrics and Dalla Lana School of Public Health, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Pediatr Infect Dis J. 2009 Aug;28(8):697-701. doi: 10.1097/INF.0b013e31819f1f89.
To examine risk factors for lower respiratory tract infections (LRTI) hospital admission in the Canadian Arctic.
This was a case-control study during a 14-month period among children less than 2 years of age. Cases were admitted to the Baffin Regional Hospital in Iqaluit, Nunavut with LRTI. Controls were age matched and came from Iqaluit and 2 communities. Odds ratios (ORs) of hospital admission for LRTI were estimated through multivariate conditional logistic regression modeling for following risk factors: smoking in pregnancy, Inuit race, prematurity, adoption status, breast-feeding, overcrowding, and residing outside of Iqaluit. Viruses in nasophayngeal aspirates were sought at the time of each hospital admission.
There were 101 age-matched cases and controls. The following risk factors were significantly associated with an increased risk of admission for LRTI (adjusted OR): smoking in pregnancy (OR = 4.0; 95% CI: 1.1-14.6), residence outside of Iqaluit (OR = 2.7; 95% CI: 1.0 -7.2), full Inuit race (OR = 3.8; 95% CI: 1.1-12.8), and overcrowding (OR = 2.5, 95% CI: 1.1- 6.1). Non-breast-fed children had a 3.6-fold risk of being admitted for LRTI (95% CI: 1.2-11.5) and non-breast-fed adopted children had a 4.4-fold increased risk (95% CI: 1.1-17.6) when compared with breast-fed, nonadopted children. Prematurity was not associated with an increased risk of admission. Viruses were identified in 88 (72.7%) of admissions, with respiratory syncytial virus being identified in the majority of admissions, 62 (51.2%). Multiple viruses were isolated in 19 (15.7%) admissions.
Smoking during pregnancy, place of residence, Inuit race, lack of breast-feeding, and overcrowding were all independently associated with increased risk of hospital admission for LRTI among Inuit children less than 2 years of age. Future research on the role of adoption and genetics on the health of Inuit children are required.
研究加拿大北极地区下呼吸道感染（LRTI）住院的危险因素。
这是一项针对2岁以下儿童的为期14个月的病例对照研究。病例为因LRTI入住努纳武特地区伊魁特市巴芬地区医院的患儿。对照与病例年龄匹配，来自伊魁特市及另外两个社区。通过多变量条件逻辑回归模型，对以下危险因素估计LRTI住院的比值比（OR）：孕期吸烟、因纽特人种族、早产、收养状况、母乳喂养、居住拥挤及居住在伊魁特市以外。每次患儿住院时，采集鼻咽抽吸物检测病毒。
共有101对年龄匹配的病例和对照。以下危险因素与LRTI住院风险增加显著相关（校正OR）：孕期吸烟（OR = 4.0；95%CI：1.1 - 14.6）、居住在伊魁特市以外（OR = 2.7；95%CI：1.0 - 7.2）、纯因纽特人种族（OR = 3.8；95%CI：1.1 - 12.8）及居住拥挤（OR = 2.5，95%CI：1.1 - 6.1）。与母乳喂养、非收养儿童相比，非母乳喂养儿童LRTI住院风险高3.6倍（95%CI：1.2 - 11.5），非母乳喂养的收养儿童风险高4.4倍（95%CI：1.1 - 17.6）。早产与住院风险增加无关。88例（72.7%）住院患儿检测到病毒，多数（62例，51.2%）检测到呼吸道合胞病毒。19例（15.7%）住院患儿分离出多种病毒。
孕期吸烟、居住地点、因纽特人种族、母乳喂养缺乏及居住拥挤均与2岁以下因纽特儿童LRTI住院风险增加独立相关。未来需要研究收养和遗传学在因纽特儿童健康中的作用。
