Risk factors for hospital admission due to acute lower respiratory tract infection in Guarani indigenous children in southern Brazil: a population‐based case‐control study

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To assess risk factors associated with hospital admission due to acute lower respiratory tract infection (<jats:styled-content style="fixed-case">ALRTI</jats:styled-content>) in indigenous Guarani children <5 years of age in southern Brazil.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Population‐based matched case–control study from May 2007 to June 2008 in 81 Guarani villages. Cases were defined as hospital admissions due to confirmed <jats:styled-content style="fixed-case">ALRTI</jats:styled-content>. Two controls free from acute respiratory infection, matched according to age, sex and place of residence, were selected for each case at the time of the case's hospitalisation. Both cases and controls were recruited by a surveillance routine established for the study.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The analysis was performed on 120 cases and 201 controls. The risk factors that remained significantly associated with hospitalisation due to <jats:styled-content style="fixed-case">ALRTI</jats:styled-content> in the hierarchical multivariate conditional logistic regression were: low stable monthly per capita household income (<<jats:styled-content style="fixed-case">US</jats:styled-content>$30.00 = <jats:styled-content style="fixed-case">OR</jats:styled-content>: 2.77, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.51–5.10; no income= <jats:styled-content style="fixed-case">OR</jats:styled-content>: 1.88, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.02–3.47); large number of persons in the household (6–9 =  <jats:styled-content style="fixed-case">OR</jats:styled-content>: 2.03, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.06–3.88; 10–16 =  <jats:styled-content style="fixed-case">OR</jats:styled-content>: 5.00, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.81–13.86); indoor exposure to fumes from burning firewood used for cooking (<jats:styled-content style="fixed-case">OR</jats:styled-content>: 3.08, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.39–6.84);low maternal age (<jats:styled-content style="fixed-case">OR</jats:styled-content>: 2.77, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.42–5.39); and low birthweight (<jats:styled-content style="fixed-case">OR</jats:styled-content>: 6.12, <jats:styled-content style="fixed-case">IC</jats:styled-content><jats:sub>95%</jats:sub>: 1.44–26.13).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Acute respiratory infections are a major cause of morbidity and mortality among Guarani children. Our study provides the first evidence about their determinants in indigenous peoples in Brazil that can help to better understand the epidemiology of respiratory infections in indigenous children.</jats:p></jats:sec>