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Risk factors for pneumonia among children in a Brazilian metropolitan area.

OBJECTIVE
To investigate risk factors for pneumonia for infants < 2 years of age.


DESIGN
Hospital-based, case-control study with neighborhood control subjects.


SETTING
Urban area in southern Brazil.


SUBJECTS
Five hundred ten infants with radiologically confirmed pneumonia who were admitted to a pediatric hospital. One age-matched neighborhood control subject was selected for each case.


RESULTS
Multiple conditional regression modeling was used to control for confounding, taking into account the hierarchical relationships between risk factors. The incidence of radiologically confirmed pneumonia was associated with low paternal education, the number of persons in the household, young maternal age, attendance at day-care centers, low birth weight and weight-for-age, lack of breast-feeding and of non-milk supplements, and a history of previous pneumonia or wheezing. Day-care center attendance showed the highest risk, with an adjusted odds ratio of 11.75.


CONCLUSIONS
In addition to continued efforts toward appropriate case management, actions directed against the above risk factors may help prevent the major cause of deaths of children younger than 5 years.