O'Dempsey T J, McArdle T F, Morris J, Lloyd-Evans N, Baldeh I, Laurence B E, Secka O, Greenwood B M
Research Council Laboratories, Banjul, The Gambia.
Int J Epidemiol. 1996 Aug;25(4):885-93. doi: 10.1093/ije/25.4.885.
Pneumoccal infection is one of the leading causes of pneumonia, meningitis and septicaemia in developing countries. We have investigated possible risk factors for pneumococcal disease among children living in a rural area of The Gambia.
A prospective case-control study was conducted in which children with pneumococcal infection were identified from among children attending out-patient and under-fives clinics and matched according to age with healthy children selected randomly from the local community. A questionnaire was used to investigate possible nutritional, medical, socioeconomic and environmental risk factors for pneumococcal disease.
An increased risk of pneumococcal disease was associated with poor weight gain, a history of serious illness in the previous 6 months, exposure to cigarette smoke or being carried on mother's back while cooking. The risk of pneumococcal disease was reduced among children whose mothers had a personal source of income.
The incidence of pneumococcal disease could be reduced by improving nutrition and taking steps to identify and rehabilitate those children whose weight is faltering or falling. Encouraging mothers to develop greater financial independence may also be beneficial. Reduced exposure to smoke should be promoted by improving ventilation in kitchens, introducing more efficient and less polluting stoves, keeping children away from smoky environments and discouraging parental smoking.
在发展中国家，肺炎球菌感染是导致肺炎、脑膜炎和败血症的主要原因之一。我们对冈比亚农村地区儿童肺炎球菌疾病的可能危险因素进行了调查。
开展了一项前瞻性病例对照研究，从门诊和五岁以下儿童诊所的儿童中识别出肺炎球菌感染患儿，并根据年龄与从当地社区随机挑选的健康儿童进行匹配。使用问卷调查肺炎球菌疾病可能的营养、医疗、社会经济和环境危险因素。
肺炎球菌疾病风险增加与体重增加不佳、过去6个月内有严重疾病史、接触香烟烟雾或在母亲做饭时被背在背上有关。母亲有个人收入来源的儿童患肺炎球菌疾病的风险降低。
通过改善营养以及采取措施识别和康复体重增长缓慢或下降的儿童，可以降低肺炎球菌疾病发病率。鼓励母亲实现更大程度的经济独立也可能有益。应通过改善厨房通风、引入更高效且污染更少的炉灶、让儿童远离烟雾环境以及劝阻父母吸烟来减少接触烟雾。
