TY - JOUR
T1 - Risk Factors for Pediatric Invasive Pneumococcal Disease in the Intermountain West, 1996-2002
AU - Haddad, Maryam B.
AU - Porucznik, Christina A.
AU - Joyce, Kerry E.
AU - De, Anindya K.
AU - Pavia, Andrew T.
AU - Rolfs, Robert T.
AU - Byington, Carrie L.
N1 - Funding Information:
Parents or guardians provided oral consent to participate in this investigation, which did not require direct involvement of any children. This investigation was approved by the institutional review boards of the University of Utah (for Primary Children's Medical Center), the Utah Department of Health, and the Centers for Disease Control and Prevention.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/2
Y1 - 2008/2
N2 - Purpose: In response to concerns that the epidemiology of pediatric invasive pneumococcal disease (IPD) in the Intermountain West (i.e., Utah, Idaho, Wyoming, Montana, and parts of Arizona and Nevada) was poorly understood and might differ from elsewhere in the United States, a case-control study was undertaken to determine factors associated with IPD during 1996-2002. Methods: A telephone questionnaire was administered to parents of children comprising 120 cases identified through hospital records and to parents of 156 age-matched controls located by random-digit dialing. The unit of analysis was each matched case-control set. Results: Underlying chronic illness was reported for 32 (27%) of the cases. For previously healthy children, breastfeeding had a protective benefit (adjusted odds ratio: 0.2; 95% confidence interval [CI], 0.1-0.6), while a history of tympanostomy tube surgery was a risk factor (adjusted odds ratio: 12.6; 95% CI, 1.5-107.3). Conclusions: The presence of an underlying chronic illness was the strongest risk factor for IPD. Except for a history of tympanostomy tube surgery, the factors associated with IPD in this investigation were similar to those reported from other geographic regions. Tympanostomy surgery might serve as a surrogate indicator for predisposition to recurrent otitis media or decreased ability to clear pneumococcal infection, raising risk for invasive disease. Pediatric clinicians should continue to encourage breastfeeding, and continued emphasis on pneumococcal vaccination should help prevent IPD.
AB - Purpose: In response to concerns that the epidemiology of pediatric invasive pneumococcal disease (IPD) in the Intermountain West (i.e., Utah, Idaho, Wyoming, Montana, and parts of Arizona and Nevada) was poorly understood and might differ from elsewhere in the United States, a case-control study was undertaken to determine factors associated with IPD during 1996-2002. Methods: A telephone questionnaire was administered to parents of children comprising 120 cases identified through hospital records and to parents of 156 age-matched controls located by random-digit dialing. The unit of analysis was each matched case-control set. Results: Underlying chronic illness was reported for 32 (27%) of the cases. For previously healthy children, breastfeeding had a protective benefit (adjusted odds ratio: 0.2; 95% confidence interval [CI], 0.1-0.6), while a history of tympanostomy tube surgery was a risk factor (adjusted odds ratio: 12.6; 95% CI, 1.5-107.3). Conclusions: The presence of an underlying chronic illness was the strongest risk factor for IPD. Except for a history of tympanostomy tube surgery, the factors associated with IPD in this investigation were similar to those reported from other geographic regions. Tympanostomy surgery might serve as a surrogate indicator for predisposition to recurrent otitis media or decreased ability to clear pneumococcal infection, raising risk for invasive disease. Pediatric clinicians should continue to encourage breastfeeding, and continued emphasis on pneumococcal vaccination should help prevent IPD.
KW - Children
KW - Immunization
KW - Streptococcus pneumoniae
KW - Utah
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U2 - 10.1016/j.annepidem.2007.09.006
DO - 10.1016/j.annepidem.2007.09.006
M3 - Article
C2 - 18191761
AN - SCOPUS:37849047671
SN - 1047-2797
VL - 18
SP - 139
EP - 146
JO - Annals of Epidemiology
JF - Annals of Epidemiology
IS - 2
ER -