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

Colosia, Ann D; Masaquel, Anthony; Hall, Caroline Breese; Barrett, Amy M; Mahadevia, Parthiv J; Yogev, Ram

doi:10.1186/1471-2334-12-95

Table 2 Association of residential crowding and severe RSV disease among high-risk ^a children (N = 9)

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

Study	Crowding Variable	Unadjusted Outcome(95% CI)	Adjusted Outcome(95% CI)
Broughton et al., 2005 [15]	Number of school-aged siblings	Not conducted	aOR 1.45 (1.03–2.06), P = 0.035
Bulkow et al., 2002 [23]	≥5 rooms in the house	NS; OR NR	NA
	Shares bedroom with 4 others	NS; OR NR	NA
	≥7 others in household	OR 2.07 (NR), P = 0.003	NS, aOR NR
	≥2 others aged <2 years in household	OR 3.02 (NR), P = 0.011	NS, aOR NR
	Household crowding index^b ≥2	OR 1.71 (NR), P = 0.005	aOR 1.72 (NR), P = 0.024
	≥4 others aged <12 years in household	OR 1.91 (NR), P = 0.005	aOR 2.13 (NR), P = 0.011
	Shares bed with ≥1 other person	OR 1.74 (NR), P = 0.007	aOR 2.20 (NR), P = 0.036 ^c
Carbonell-Estrany et al., 2000 [24]	School-aged siblings (yes/no)	P = 0.07	aOR 1.86 (1.01–3.4), P < 0.048
Carbonell-Estrany et al., 2000 [24]	≥1 sibling vs. no siblings	P = 0.9	NA
Carbonell-Estrany et al., 2001 [25]	School-aged siblings (yes/no)	P = 0.01	aOR 1.64 (1.05–2.55), P = 0.027
Figueras-Aloy et al., 2004 [26]	≥4 inhabitants in the home excluding study subject and school-aged siblings	OR 1.79 (1.18–2.72), P = 0.015	aOR 1.91 (1.19–3.07), *P =* 0.0074
Figueras-Aloy et al., 2004 [26]	≥1 school-aged sibling	OR 2.40 (1.61–3.57), P < 0.00001	aOR 2.85 (1.88–4.33), P < 0.000001
Figueras-Aloy et al., 2008 [18]	≥4 inhabitants in the home excluding study subject and school-aged siblings	NS, OR 1.37 (0.85 – 2.20), P = 0.238	NA
Figueras-Aloy et al., 2008 [18]	≥1 school-aged sibling	OR 1.96 (1.47–2.60), P < 0.00001	NA^d
Kanra et al., 2005 [27]	Number of siblings	NS	Not conducted
Law et al., 2004 [19]	>5 people living in household including study subject	RR 2.41 (1.42–4.06), P = 0.001	NS, aOR 1.69 (0.93 – 3.10), P = 0.088
Law et al., 2004 [19]	>5 people in the household including study subject (analysis corrected for changes in risk factor status from baseline)	OR NR *, P* ≤ 0.002	aOR 1.79 (1.02–3.16), *P =* 0.044
	Preschool-aged siblings (yes/no)	NA	aOR 2.76 (1.51-5.03), P = 0.001
Simoes et al., 1993 [22]	>4 persons living in the home^e	RR 1.1 (0.3 – 3.9) ^c , P NR	aRR NR
	>1 person per 19 m² living area^e	RR 14.4 (1.9–109.6) ^c , ( P = 0.002)	aRR NR
	>1 child per 22 m² living area^e	RR 8.4 (2.4–29.8) ^c , ( P = 0.004)	aRR NR
	>4 persons living in the home^f	NS, RR 0.77 (0.2 – 2.4) ^d , P NR	aRR NR
	>1 person per 19 m² living area^f	NS, RR 1.09 (0.3 – 4.5) ^d , P NR	aRR NR
	>1 child per 22 m² living area^f	NS, RR 2.8 (0.8 – 10.0) ^d , P NR	aRR NR

aOR = adjusted odds ratio; aRR = adjusted relative risk; CI = confidence interval; NA = not applicable, variable not included in the model; NR = not reported; NS = not significant; OR = odds ratio; RR = relative risk; RSV = respiratory syncytial virus; UK = United Kingdom; US = United States.
Significant outcomes are presented in bold; nonsignificant outcomes are presented in italics.
^a High risk = high risk of severe RSV disease; includes studies of children born prematurely (<35 weeks gestation), of certain ethnicities (i.e. Alaska Natives; Inuits), or with chronic lung disease of prematurity or congenital heart disease.
^b Total number of persons divided by number of rooms excluding bathrooms, hallways, closets.
^c Multivariate outcome reported only for subgroup of children ≥6 months of age.
^d A joint variable, school-aged sibling(s) or day care attendance was included in the multivariate model.
^e Analysis based on subgroup of patients diagnosed with RSV pneumonia and hospitalized.
^f Analysis based on subgroup of patients diagnosed with RSV bronchiolitis; 64% were hospitalized.

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