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Table 1 Overview of studies of residential crowding and RSV disease by risk status a (N = 20)

From: Residential crowding and severe respiratory syncytial virus disease among infants and young children: A systematic literature review

     Crowding Variables  
Reference Study Type/Population Numberof Participants Age Criteria ≥1 Significant in Unadjusted Analysis ≥1 Significant in Adjusted Analysis Bias Assessment b
High-risk population, (n = 9)     
Broughton et al., 2005 c[15] Cohor, <32-week GA, UK N = 126 ≤1 year Not conducted Yes No apparent bias concerns
Bulkow et al., 2002[23] Case–control, Alaska natives, US Cases n = 204
Controls n = 338
<3 years Yes Yes No apparent bias concerns
Carbonell-Estrany et al., 2000[24] Cohort, ≤32-week GA, Spain N = 584 ≤1 year Yes Yes No apparent bias concerns
Carbonell-Estrany et al., 2001[25] Cohort, ≤32-week GA, Spain N = 999 ≤6 months in October Yes Yes No apparent bias concerns
Figueras-Aloy et al., 2004[26] Case–control, 33- to 35-week GA, Spain Cases n = 186
Controls n = 371
<1 year Yes Yes No apparent bias concerns
Figueras-Aloy et al., 2008[18] 2 Cohorts, 32- to 35-week GA, Spain Cohort 1 (cases), n = 202
Cohort 2 (controls), n = 5239
Discharged during or ≤6 months of age at start of RSV season Yes Not applicabled No apparent bias concerns
Kanra et al., 2005[27] Cohort, 64.3% preterm (<35-week GA), 20.8% CHF, Turkey N = 332 <6 months and preterm; <2 years with CLD No Not conducted No multivariate analysis
Law et al., 2004[19] Cohort, 33- to 35-week GA, Canada N = 1860 ≤7 months (or older to end of RSV season) Yes Yes No apparent bias concerns
Simoes et al., 1993[22] Case–control, Multiples vs. singletons, all ≤32-week GA with CLD; US Cases n = 34
Controls n = 34
Combined group analyzed
<2 years Yes NR Multivariate analysis NR
Mixed-risk population, (n = 11)     
Albargish and Hasony, 1999 c[16] Cross-sectional study, Iraq n = 500 with LRTI (37.6% RSV-positive); n = 57 controls <5 years No Not conducted No multivariate analysis
Flores et al., 2004 c[14] Cohort, Portugal N = 225 (137 RSV-positive, 88 RSV-negative) <3 years No Not conducted No multivariate analysis
Hayes et al., 1989[21] Case–control, American Samoa Cases n = 13
Controls n = 45
<2 years Yes Not conducted No multivariate analysis
Holberg et al., 1991 c[17] Cohort, US N = 1179 ≤1 year Yes Yes No apparent bias concerns
Lanari et al., 2002[28] Cohort, Italy N = 1232 <2 years Yes Not conducted No multivariate analysis
Nielsen et al., 2003[20] Case–control, Denmark Cases n = 1272
Controls n = 6075
<2 years Not conducted Yes No apparent bias concerns
Okiro et al., 2008 c[9] Cohort, Kenya N = 469 <2 weeks old, followed for 3 RSV seasons Yes Yes No apparent bias concerns
Reeve et al., 2006[29] Case–control, Australia Cases n = 271
Controls n = 542
<3 years Not conducted Yes No apparent bias concerns
Rossi et al., 2007[30] Case–control, Italy Cases n = 145
Controls n = 292
≤4 years Yes Yes No apparent bias concerns
von Linstow et al., 2008[31] Cohort, Denmark N = 217 ≤1 year Yes Yes No apparent bias concerns
Weber et al., 1999[32] Case–control, Gambia Cases n = 277
Controls n = 364
Not specified, median 9 months Yes Yes No apparent bias concerns
  1. CHF = congestive heart failure; CLD = chronic lung disease; GA = gestational age; LRTI = lower respiratory tract infection; NR = not reported; RSV = respiratory syncytial virus; UK = United Kingdom; US = United States.
  2. a Risk status of study population: High risk = high risk of severe RSV disease; includes children born prematurely (<35 weeks gestation), of certain ethnicities (i.e. Alaska Native; Inuit), or with chronic lung disease of prematurity or congenital heart disease. Mixed risk = children with individual differences in risk of severe RSV disease; includes studies of the general population even when a minority of the study population includes high-risk children.
  3. bBias was assessed for selective reporting (not presenting all outcomes related to residential crowding) and confounding (not adjusting for other factors that may affect the association of residential crowding and severe RSV disease).
  4. c Treatment of RSV disease was not limited to the hospital setting in this study. Patients were diagnosed in the physician’s office, the emergency department, an outpatient clinic, or in multiple settings including the hospital.
  5. d In the Figueras-Aloy study of 2008 [18], one crowding variable was negative in unadjusted analysis and a second crowding variable (having school-aged siblings) was significant in the unadjusted analysis but was not entered by itself into the multivariate model.