Anderson L J, Parker R A, Strikas R A, Farrar J A, Gangarosa E J, Keyserling H L, Sikes R K
Division of Viral Diseases, Centers for Disease Control, Atlanta, GA 30333.
Pediatrics. 1988 Sep;82(3):300-8.
To identify risk factors associated with hospitalization for acute lower respiratory tract illness, 102 children less than 2 years of age admitted to four Atlanta metropolitan area hospitals between December 1984 and June 1985 with the diagnosis of lower respiratory tract illness were studied. The most common causative agent associated with illness was respiratory syncytial virus, followed by other respiratory viruses, Haemophilus influenzae, and Streptococcus pneumoniae. The 102 case-patients were compared with 199 age- and sex-matched controls. A parent or guardian for each patient and control was interviewed by telephone regarding demographic data, care outside the home, breast-feeding, previous medical history, allergies, and smoking and illness in household members. Five factors were associated with lower respiratory tract illness in both a univariate analysis and a multiple logistic regression model (P less than .05). These factors were the number of people sleeping in the same room with the child, a lack of immunization the month before the patient was hospitalized, prematurity, a history of allergy, and regular attendance in a day-care center (more than six children in attendance). Care received outside of the home in a day-care home (less than or equal to six children in attendance) was not associated with lower respiratory tract illness. The suggestion made by our study and other studies was that for children less than 2 years of age, care outside of the home is an important risk factor for acquiring lower respiratory tract illness, as well as other infectious diseases, and that this risk can be reduced by using a day-care home instead of a day-care center.
为确定与急性下呼吸道疾病住院相关的危险因素，对1984年12月至1985年6月间因下呼吸道疾病诊断而入住亚特兰大市区四家医院的102名2岁以下儿童进行了研究。与疾病相关的最常见病原体是呼吸道合胞病毒，其次是其他呼吸道病毒、流感嗜血杆菌和肺炎链球菌。将这102例病例患者与199名年龄和性别匹配的对照进行比较。通过电话采访每位患者和对照的父母或监护人，询问人口统计学数据、家庭外护理、母乳喂养、既往病史、过敏情况以及家庭成员的吸烟和患病情况。在单因素分析和多因素逻辑回归模型中，有五个因素与下呼吸道疾病相关（P<0.05）。这些因素是与孩子同室睡觉的人数、患者住院前一个月未进行免疫接种、早产、过敏史以及定期在日托中心（有六个以上儿童）接受护理。在家庭日托所（有六个或更少儿童）接受的家庭外护理与下呼吸道疾病无关。我们的研究和其他研究表明，对于2岁以下的儿童，家庭外护理是患下呼吸道疾病以及其他传染病的重要危险因素，并且通过使用家庭日托所而非日托中心可以降低这种风险。
