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Community-acquired Pneumonia With Pleural Effusion in Children and Municipal Human Development Index in Rio de Janeiro, Brazil

Land, Marcelo, PhD*; Maia, Paula, MsC*; de Fátima March, Maria, PhD*; Ferreira, Alvaro, PhD; Sant´Anna, Clemax, PhD*

The Pediatric Infectious Disease Journal: November 2018 - Volume 37 - Issue 11 - p 1093–1096
doi: 10.1097/INF.0000000000001980
Original Studies

Background: This study evaluated admissions with severe community-acquired pneumonia (CAP) with pleural effusion (PE) in a pediatric university hospital and the impact of the increased average municipal human development index (M-HDI) in the local incidence of the disease in the last decade.

Methods: This is a retrospective longitudinal study of patients (0–13 years old) with CAP. The municipal human development index (M-DHI) of the place of residence of patients was obtained. We calculate the crude odds ratios (ORs) of variables related to risk of developing PE. The variables that reached a significance level of 80% (P < 0.20) were selected for multivariate analysis. The logistic regression model was used for the selection of the parsimonious model, according to the likelihood ratio.

Results: The 465 patients’ ages ranged from 1 to 174 months. The median of age (months) in children with PE was 36.00; in children without the PE was 29.00 (P < 0.011); media of variation in M-HDI in the period in patients with PE was 0.767 ± 0.002 and in patients without PE was 0.778 ± 0.002 (P < 0.001). In the logistic regression model, the absence of comorbidity (OR = 2.909) and the HDI < 0.770 (OR = 3.015) were predictive factors associated with PE.

Conclusion: The progressive increase of the M-DHI during the study period, although to a slightly higher level, was correlated with the reduction in the number of admissions with CAP with PE.

From the *Department of Pediatrics, Faculty of Medicine of Federal University of Rio de Janeiro, Brazil

Pontifícia Universidade Católica do Rio de Janeiro, Brazil.

Accepted for publication December 2, 2017.

The Committee of Ethics in Research of IPPMG-UFRJ approved the study on May 17, 2011, under number 23/11 (Annex B), in compliance with the Guidelines and Rules on Research Involving Human Beings, according to the Brazilian Resolution CNS 466/2012.

CCS is supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (grant #305044/2012–5).

The authors have no funding or conflicts of interest to disclose.

Authors’ contributions: ML, CCS, MFPM and PM participated in the conception of the study, collected and analyzed data, wrote the article. ML, CCS, AF, MFPM designed the study, analyzed data and gave conceptual and critical advices.

Address for correspondence: Clemax Sant´Anna, PhD, Faculty of Medicine of Federal University of Rio de Janeiro, R. Bruno Lobo 50, Rio de Janeiro, RJ- 21-941-912. Brazil. E-mail:

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