Water Sanitation and Hygiene Research Group, Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Int J Epidemiol. 2013 Feb;42(1):194-200. doi: 10.1093/ije/dys233. Epub 2013 Feb 1.
We assessed the association between the duration of diarrhoea and the risk ofpneumonia incidence among children <5 years of age.
We analysed data from a cluster randomized controlled trial in Karachi, Pakistan, which assessed the effect of promoting hand washing with soap (antibacterial and plain) on child health. Field workers visited households with children <5 years of age weekly and asked primary caregivers if their child had diarrhoea, cough or difficulty breathing in the preceding week. We used the WHO clinical case definitions for diarrhoea and pneumonia.We used adjusted time-to-event analyses with cumulative diarrhoea prevalence over the previous 2 and 4 weeks as exposure and pneumonia as outcome. We calculated the attributable risk of pneumonia due to recent diarrhoea across the intervention groups.
873 households with children <5 years were visited. Children had an increased risk of pneumonia for every additional day of diarrhoea in the 2 weeks (1.06, 95% CI: 1.03-1.09) and 4 weeks (1.04, 95% CI: 1.03-1.06) prior to the week of pneumonia onset. The attributable risk of pneumonia cases due to recent exposure to diarrhoea was 6%. A lower associated pneumonia risk following diarrhoea was found in the control group: (3%) compared with soap groups (6% in antibacterial soap, 9% in plain soap).
Children <5 years of age are at an increased risk of pneumonia following recent diarrhoeal illness. Public health programmes that prevent diarrhoea may also reduce the burden of respiratory illnesses.
我们评估了腹泻持续时间与<5 岁儿童肺炎发病率之间的关系。
我们分析了巴基斯坦卡拉奇进行的一项群组随机对照试验的数据，该试验评估了促进使用肥皂（抗菌皂和普通皂）洗手对儿童健康的影响。现场工作人员每周访问<5 岁儿童的家庭，并询问主要照顾者，他们的孩子在前一周是否有腹泻、咳嗽或呼吸困难。我们使用世界卫生组织腹泻和肺炎的临床病例定义。我们使用调整后的时间事件分析，以过去 2 周和 4 周内累积的腹泻患病率作为暴露因素，以肺炎作为结果。我们计算了由于干预组最近发生腹泻而导致肺炎的归因风险。
共访问了 873 户有<5 岁儿童的家庭。与前一周相比，在发生肺炎前的 2 周（1.06，95%CI：1.03-1.09）和 4 周（1.04，95%CI：1.03-1.06）内，腹泻天数每增加一天，儿童患肺炎的风险就会增加。由于近期接触腹泻而导致肺炎的归因风险为 6%。与肥皂组相比（抗菌皂组为 6%，普通皂组为 9%），对照组腹泻后肺炎的相关风险较低：（3%）。
<5 岁儿童在近期发生腹泻后，患肺炎的风险增加。预防腹泻的公共卫生计划也可能减轻呼吸道疾病的负担。
