Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.

Children with poor nutrition are at increased risk of pneumonia. In many tropical settings seasonal pneumonia epidemics occur during the rainy season, which is often a period of poor nutrition. We have investigated whether seasonal hunger may be a driver of seasonal pneumonia epidemics in children i...

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Autores principales:	Stuart Paynter, Robert S Ware, Marilla G Lucero, Veronica Tallo, Hanna Nohynek, Eric A F Simões, Philip Weinstein, Peter D Sly, Gail Williams, ARIVAC Consortium
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/346c5083bb1343e3af1d5fa8b08aa600
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spelling	oai:doaj.org-article:346c5083bb1343e3af1d5fa8b08aa6002021-11-18T07:39:26ZPoor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.1932-620310.1371/journal.pone.0067528https://doaj.org/article/346c5083bb1343e3af1d5fa8b08aa6002013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23840731/?tool=EBIhttps://doaj.org/toc/1932-6203Children with poor nutrition are at increased risk of pneumonia. In many tropical settings seasonal pneumonia epidemics occur during the rainy season, which is often a period of poor nutrition. We have investigated whether seasonal hunger may be a driver of seasonal pneumonia epidemics in children in the tropical setting of the Philippines. In individual level cohort analysis, infant size and growth were both associated with increased pneumonia admissions, consistent with findings from previous studies. A low weight for age z-score in early infancy was associated with an increased risk of pneumonia admission over the following 12 months (RR for infants in the lowest quartile of weight for age z-scores 1.28 [95% CI 1.08 to 1.51]). Poor growth in smaller than average infants was also associated with an increased risk of pneumonia (RR for those in the lowest quartile of growth in early infancy 1.31 [95%CI 1.02 to 1.68]). At a population level, we found that seasonal undernutrition preceded the seasonal increase in pneumonia and respiratory syncytial virus admissions by approximately 10 weeks (pairwise correlation at this lag was -0.41 [95%CI -0.53 to -0.27] for pneumonia admissions, and -0.63 [95%CI -0.72 to -0.51] for respiratory syncytial virus admissions). This lag appears biologically plausible. These results suggest that in addition to being an individual level risk factor for pneumonia, poor nutrition may act as a population level driver of seasonal pneumonia epidemics in the tropics. Further investigation of the seasonal level association, in particular the estimation of the expected lag between seasonal undernutrition and increased pneumonia incidence, is recommended.Stuart PaynterRobert S WareMarilla G LuceroVeronica TalloHanna NohynekEric A F SimõesPhilip WeinsteinPeter D SlyGail WilliamsARIVAC ConsortiumPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 6, p e67528 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stuart Paynter Robert S Ware Marilla G Lucero Veronica Tallo Hanna Nohynek Eric A F Simões Philip Weinstein Peter D Sly Gail Williams ARIVAC Consortium Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.
description	Children with poor nutrition are at increased risk of pneumonia. In many tropical settings seasonal pneumonia epidemics occur during the rainy season, which is often a period of poor nutrition. We have investigated whether seasonal hunger may be a driver of seasonal pneumonia epidemics in children in the tropical setting of the Philippines. In individual level cohort analysis, infant size and growth were both associated with increased pneumonia admissions, consistent with findings from previous studies. A low weight for age z-score in early infancy was associated with an increased risk of pneumonia admission over the following 12 months (RR for infants in the lowest quartile of weight for age z-scores 1.28 [95% CI 1.08 to 1.51]). Poor growth in smaller than average infants was also associated with an increased risk of pneumonia (RR for those in the lowest quartile of growth in early infancy 1.31 [95%CI 1.02 to 1.68]). At a population level, we found that seasonal undernutrition preceded the seasonal increase in pneumonia and respiratory syncytial virus admissions by approximately 10 weeks (pairwise correlation at this lag was -0.41 [95%CI -0.53 to -0.27] for pneumonia admissions, and -0.63 [95%CI -0.72 to -0.51] for respiratory syncytial virus admissions). This lag appears biologically plausible. These results suggest that in addition to being an individual level risk factor for pneumonia, poor nutrition may act as a population level driver of seasonal pneumonia epidemics in the tropics. Further investigation of the seasonal level association, in particular the estimation of the expected lag between seasonal undernutrition and increased pneumonia incidence, is recommended.
format	article
author	Stuart Paynter Robert S Ware Marilla G Lucero Veronica Tallo Hanna Nohynek Eric A F Simões Philip Weinstein Peter D Sly Gail Williams ARIVAC Consortium
author_facet	Stuart Paynter Robert S Ware Marilla G Lucero Veronica Tallo Hanna Nohynek Eric A F Simões Philip Weinstein Peter D Sly Gail Williams ARIVAC Consortium
author_sort	Stuart Paynter
title	Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.
title_short	Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.
title_full	Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.
title_fullStr	Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.
title_full_unstemmed	Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.
title_sort	poor growth and pneumonia seasonality in infants in the philippines: cohort and time series studies.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/346c5083bb1343e3af1d5fa8b08aa600
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Poor growth and pneumonia seasonality in infants in the Philippines: cohort and time series studies.

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