Risk factors affect the incidence of childhood pneumonia in modern urban apartment?
Childhood pneumonia is the leading causes of death among children in China and worldwide. Using coal or wood as cooking fuel in rural area was considered as major cause of Pneumonia. However, the incidence of childhood pneumonia is still high in urban modern cities. Which home risk factors affect the incidence of childhood pneumonia in modern urban apartment? Professor Hua QIAN and his group from School of Energy and Environment, Southeast University set out to research this problem. A recent study found that the risk factors in indoor environment typical of modern apartments in China related to pneumonia among children. Their work, entitled “Home risk factors for childhood pneumonia in Nanjing, China”, was published in CHINESE SCIENCE Bulletin.2013.
The study is part of the China, Child, Home, and Health (CCHH) project, which is investigating associations between home indoor environmental factors and children’s health. This is a population-based cross-sectional study. The survey was performed and completed from December 2010 to March 2011 in Nanjing. Twenty-three kindergartens were randomly selected in the 11 districts. No kindergartens were selected in the 2 counties. Total 6461 questionnaires were distributed and 4014 properly filled-out questionnaires were returned, giving a response rate of 65.7%. The response rate was 61.8%, 68.4% and 82.0% for kindergartens in urban, suburban, and industrial areas respectively.
Statistical analysis was conducted using SPSS for Windows. Binary logistic models were used to test associations between home environmental exposure, building characteristics, life style and the risk of pneumonia infections. For those factors that reached significance in binary analysis, a multivariate logistic model was applied to calculate adjusted odds ratios for pneumonia infections. Step forward elimination techniques were used in the multivariate logistic regression model.
This study investigated the association between childhood pneumonia and indoor environment factors in modern homes. The pneumonia incidence is found to be high in Nanjing. Lack of ventilation, gas as cooking fuel, dampness, new furniture, “modern” floor and wall covering materials showed significant associations with the incidence of pneumonia. Other factors such as family allergy, child care by non-parents, other respiratory diseases were also reported to be associated with pneumonia. In summary, modern life style and home environment play an important role in developing pneumonia infections among children in Nanjing.
Pneumonia can occur at any age, although it is more common in younger children. Pneumonia accounts for 13% of all infectious illnesses in infants younger than 2 years.
Newborns with pneumonia commonly present with poor feeding and irritability, as well as tachypnea, retractions, grunting, and hypoxemia. Infections with group B Streptococcus, Listeria monocytogenes, or gram-negative rods (eg, Escherichia coli, Klebsiella pneumoniae) are common causes of bacterial pneumonia. Group B streptococci infections are most often transmitted to the fetus in utero. The most commonly isolated virus is respiratory syncytial virus (RSV).
Cough is the most common symptom of pneumonia in infants, along with tachypnea, retractions, and hypoxemia. These may be accompanied by congestion, fever, irritability, and decreased feeding. Streptococcus pneumoniae is by far the most common bacterial pathogen in infants aged 1-3 months.
Adolescents experience similar symptoms to younger children. They may have other constitutional symptoms, such as headache, pleuritic chest pain, and vague abdominal pain. Vomiting, diarrhea, pharyngitis, and otalgia/otitis are also common in this age group. Mycoplasma pneumoniae is the most frequent cause of pneumonia among older children and adolescents.
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This work was supported by the National Natural Science Foundation of China (51008063). This research will make contributions towards how to prevent pneumonia infection in children. In addition, it has important scientific references when the parents choose indoor decoration materials, living environment and so on.
See the article: ZHENG XiaoHong, QIAN Hua, ZHAO YiLi, SHEN HongPing, ZHAO Zhuohui, SUN YueXia& SUNDELL Jan. Home risk factors for childhood pneumonia in Nanjing, Science Bulletin, 2013. http://csb.scichina.com:8080/kxtb/CN/abstract/abstract510535.shtml
Pneumonia and other lower respiratory tract infections are the leading causes of death worldwide. Because pneumonia is common and is associated with significant morbidity and mortality, properly diagnosing pneumonia, correctly recognizing any complications or underlying conditions, and appropriately treating patients are important. Although in developed countries the diagnosis is usually made on the basis of radiographic findings, the World Health Organization (WHO) has defined pneumonia solely on the basis of clinical findings obtained by visual inspection and on timing of the respiratory rate. (See Clinical Presentation.)
Pneumonia may originate in the lung or may be a focal complication of a contiguous or systemic inflammatory process. Abnormalities of airway patency as well as alveolar ventilation and perfusion occur frequently due to various mechanisms. These derangements often significantly alter gas exchange and dependent cellular metabolism in the many tissues and organs that determine survival and contribute to quality of life. Recognition, prevention, and treatment of these problems are major factors in the care of children with pneumonia. (See Pathophysiology.)
One particular form of pneumonia present in the pediatric population, congenital pneumonia, presents within the first 24 hours after birth. For more information, see Congenital Pneumonia.
Other respiratory tract diseases such as croup (laryngotracheobronchitis), bronchiolitis, and bronchitis are beyond the scope of this article and are not discussed further.
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