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Volume 19, Number 2—February 2013

Research

Severe Lower Respiratory Tract Infection in Early Infancy and Pneumonia Hospitalizations among Children, Kenya

Patrick Kiio MunywokiComments to Author , Eric O. Ohuma, Mwanajuma Ngama, Evasius Bauni, J. Anthony G. Scott, and D. James Nokes
Author affiliations: Author affiliations: KEMRI-Wellcome Trust Research Programme Centre for Geographic Medicine Research–Coast, Kilifi, Kenya (P.K. Munywoki, E.O. Ohuma, M. Ngama, E. Bauni, J.A.G. Scott, D.J. Nokes); University of Oxford, Oxford, UK (E.O. Ohuma, J.A.G. Scott); University of Warwick, Coventry, UK (D.J. Nokes)

Main Article

Table 2

Results of multivariable Poisson regression analyses for hospital readmission diagnoses and all-cause mortality among children initially hospitalized during infancy at Kilifi district hospital, coastal Kenya, April 16, 2002–May 31, 2010*

Risk factor IRR (95% CI)
Pneumonia† Pneumonia with wheeze‡ All readmissions Nonpneumonia All-cause mortality
All LRTI§
Non-LRTI Referent
Patient age <3 mo 2.83 (1.93–4.15) NS 1.57 (1.21–2.04) 0.84 (0.69–1.02) NS
Patient age >3 mo
1.39 (0.99–1.96)

1.04 (0.84–1.30)


LRTI
Non-LRTI Referent
RSV LRTI NS 5.37 (2.66–10.83) NS NS 0.42 (0.20–0.90)
Other LRTI

3.50 (1.77–6.94)


1.09 (0.70–1.69)
Patient age
<3 mo at first admission Referent
>3 mo at first admission
NS
1.31 (0.79–2.15)
NS
1.38 (1.11–1.71)
0.88 (0.57–1.35)
Access to hospital
Poor Referent
Good
0.80 (0.62–1.02)
0.58 (0.35–0.98)
0.75 (0.63–0.89)
0.74 (0.60–0.91)
1.76 (1.16–2.67)
Length of hospital stay, d
<7 d Referent
>7 d
1.31 (0.88–1.95)
NS
1.21 (0.94–1.56)
1.11 (0.85–1.46)
2.45 (1.52–3.93)
Admitted to HDU
No Referent
Yes
0.48 (0.27–0.85)
NS
0.64 (0.44–0.94)
0.82 (0.52–1.29)
NS
Age at follow-up, mo
0–11 Referent
12–23 0.56 (0.45–0.68) 0.54 (0.35–0.82) 0.67 (0.58–0.77) 0.80 (0.65–0.99) 0.29 (0.17–0.49)
24–36 0.20 (0.14–0.28) 0.28 (0.13–0.60) 0.33 (0.27–0.41) 0.50 (0.39–0.65) 0.11 (0.05–0.25)
48–59
0.05 (0.03–0.09)
0.01 (0.002–0.10)
0.13 (0.10–0.17)
0.23 (0.17–0.30)
0.12 (0.06–0.23)
Admission for non-LRTI
No Referent
Yes
1.92 (1.49–2.47)
1.44 (0.84–2.50)
NS
NS
2.03 (1.32–2.67)
Readmission
During Jan–Jun Referent
During Jul–Dec NS NS NS NS 0.60 (0.39–0.93)

*Risk factors refer to state at the time of first admission, except the last 3 variables (age group in months, occurrence of >1 non-LRTI admissions, and readmission time), which refer to calendar time during follow-up. IRR, incidence rate ratio; LRTI, lower respiratory tract infection; NS, not statistically significant and thus excluded from the final model for the specified outcome; RSV, respiratory syncytial virus; HDU, high dependency unit.
†Defined as history of cough or difficulty breathing and >1 of the following: fast breathing for age (>60 breaths/min if <2 months of age or >50 breaths/min if 2–11 months of age); lower chest wall indrawing; low oxygen saturation (<90%) by pulse oximetry; or inability to feed, prostration, or unconsciousness.
‡Pneumonia with concurrent wheeze.
§Combined group of children with RSV and other LRTI. IRRs (95% CIs) for readmission with pneumonia, pneumonia with wheeze, any readmission, nonpneumonia, and all-cause mortality comparing RSV LRTI vs. other LRTI group are 1.14 (0.85–1.53), 1.53 (0.92–2.54), 1.10 (0.89–1.37), 1.07 (0.82–1.39), and 0.39 (0.18–0.82), respectively.

Main Article

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