Prevalence of underlying risk factors among children with all-cause pneumonia in an urban setting
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BACKGROUND: After the introduction of PCV7 and PCV13, the number of cases of pneumonia in children caused by vaccine serotypes has decreased significantly. Children with comorbidities, however, are still at high risk for IPD. This study aims to compare children with comorbidities to healthy children in an urban setting to assess current risk factors and potential risk factors for pneumonia. METHODS: Existing clinical data of Boston Medical Center patients under 7 years of age were used to compare age, gender, race, comorbidities, and immune status of children with pneumonia to those of children without pneumonia. A representative random sample of 150 patients with pneumonia and 150 patients without pneumonia was selected. Medical record and chart information were reviewed in order to obtain clinical and demographic data. RESULTS: In our study cohort, 120 of 300 (40%) children whose charts were reviewed had at least one comorbidity. Among 150 children with pneumonia, 76 (50.7%) cases were found to have at least one underlying condition, whereas in children without pneumonia 44 (29.3%) of 150 cases had at least one underlying clinical condition (chi-square value 14.2; p-value <0.001). Children with comorbidities were 2.47 times more likely to have pneumonia compared to children without any chronic conditions (OR 2.47, 95% CI 1.54 - 3.98). The risk of having pneumonia among children who are not Hispanic/Latino/Spanish was approximately 40% less compared to children of Hispanic origin (OR 0.61; 95% CI 0.31 - 1.19; p-value 0.14). CONCLUSIONS: Our study shows that children with underlying conditions are at greater risk for pneumonia compared to healthy children without chronic conditions. Ethnicity is also associated with pneumonia cases, with Hispanic children at increased risk for pneumonia compared to non-Hispanic children.