Skip Navigation LinksHome > June 2014 - Volume 33 - Issue 6 > Child, Household, and Caregiver Characteristics Associated w...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000283
Original Studies

Child, Household, and Caregiver Characteristics Associated with Hospitalization for Influenza Among Children 6–59 Months of Age: An Emerging Infections Program Study

Dharan, Nila J. MD*; Sokolow, Leslie Z. MS, MPH*†; Cheng, Po-Yung PhD*; Gargiullo, Paul PhD*; Gershman, Ken MD, MPH; Lynfield, Ruth MD§; Morin, Craig MPH§; Thomas, Ann MD; Meek, James MPH; Farley, Monica M. MD**; Arnold, Kathryn E. MD††; Reingold, Arthur MD‡‡; Craig, Allen S. MD§§¶¶; Schaffner, William MD¶¶; Bennett, Nancy M. MD‖‖; Zansky, Shelley PhD***; Baumbach, Joan MD, MPH†††; Lathrop, Sarah DVM, PhD‡‡‡; Kamimoto, Laurie MD, MPH*; Shay, David K. MD, MPH*

Open Access
Collapse Box

Abstract

Background:

Young children are at increased risk of severe outcomes from influenza illness, including hospitalization. We conducted a case-control study to identify risk factors for influenza-associated hospitalizations among children in US Emerging Infections Program sites.

Methods:

Cases were children 6–59 months of age hospitalized for laboratory-confirmed influenza infections during 2005–2008. Age- and zip-code-matched controls were enrolled. Data on child, caregiver and household characteristics were collected from parents and medical records. Conditional logistic regression was used to identify independent risk factors for hospitalization.

Results:

We enrolled 290 (64%) of 454 eligible cases and 1089 (49%) of 2204 eligible controls. Risk for influenza hospitalization increased with maternal age <26 years [odds ratio (OR): 1.8, 95% confidence interval (CI): 1.1–2.9]; household income below the poverty threshold (OR: 2.2, 95% CI: 1.4–3.6); smoking by >50% of household members (OR: 2.9, 95% CI: 1.4–6.6); lack of household influenza vaccination (OR: 1.8, 95% CI: 1.2–2.5) and presence of chronic illnesses, including hematologic/oncologic (OR: 11.8, 95% CI: 4.5–31.0), pulmonary (OR: 2.9, 95% CI: 1.9–4.4) and neurologic (OR: 3.8, 95% CI: 1.6–9.2) conditions. Full influenza immunization decreased the risk among children 6–23 months of age (OR: 0.5, 95% CI: 0.3–0.9) but not among those 24–59 months of age (OR: 1.5, 95% CI: 0.8–3.0; P value for difference = 0.01).

Conclusions:

Chronic illnesses, young maternal age, poverty, household smoking and lack of household influenza vaccination increased the risk of influenza hospitalization. These characteristics may help providers to identify young children who are at greatest risk for severe outcomes from influenza illness.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Copyright © 2014 by Lippincott Williams & Wilkins

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.