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Table 3 Residential crowding and severe RSV disease in mixed-risk a study populations (N = 11)

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)
Albargish and Hasony, 1999 [16] Crowding index (not defined) NS across 6 levels of crowding, P > 0.05 Not conducted
Flores et al., 2004 [14] >5 persons per household NS, P NR Not conducted
Hayes et al., 1989 [21] Median number of children sleeping in the house RSV-positive, 4.0 (range 211)
Ill controlsb, 3.0 (range, 118); P= 0.005
Well controlsb, 3.0 (range, 1–9); NS, P NR
Not conducted
Holberg et al., 1991 [17] ≥2 sharing room with index child RR 4.7 (1.6-14.2), P= 0.001 aRR 4.0 (1.5–10.7), P= 0.002
1 person sharing room with index child NS, RR 1.6 (0.5 5.5), P NR NA
Lanari et al., 2002 [28] Birth order, 1–3; 4–5; ≥6 Difference in rates of RSV positivity among children hospitalized with bronchiolitis, P< 0.05 Not conducted
Nielsen et al.,2003 [20] First older sibling age difference Not conducted 0–2 years difference, aOR 1.76 (1.45-2.32)
2–4 years difference, aOR 1.64 (1.40-2.07)
>4 years difference, aOR 1.23 (1.01-1.56)
Presence of >1 older sibling Not conducted NS, aOR 1.10 (0.92 1.35), P NR
Presence of ≥1 younger sibling Not conducted NS, aOR 1.02 (0.53 1.98), P NR
Square meters per resident Not conducted <22, NS, aOR 1.10 (0.87-1.42) P NR
22–28, NS, aOR 1.14 (0.92-1.48) P NR
28–36, NS, aOR 1.02 (0.82-1.29) P NR
>36, Reference
Okiro et al., 2008 [9]c Number of children in family 1–5, reference
6–10, NS RR 1.32 (0.85–2.04) P > 0.05
≥11, RR 2.51 (1.32–4.76) P< 0.05
15, reference
6 10, NS, aRR 0.97 (0.57 1.66) P > 0.05
≥11, aRR 2.58 (1.03–6.50) P< 0.05
Number of siblings aged <6 years 1–2, RR 1.78 (1.06–2.98) P< 0.05
3–4, RR 2.00 (1.00–3.97) P< 0.05
≥5, NS, RR 2.39 (0.81 7.09) P > 0.05
1–2, aRR 2.00 (1.17–3.42) P< 0.05
3 4, NS, aRR 1.99 (0.81 4.91) P > 0.05
≥5, NS, aRR 1.74 (0.54 5.63) P > 0.05
Reeve et al., 2006 [29] Presence of older siblingd Not conducted aOR 1.6 (1.2–2.2), P= 0.005
Rossi et al., 2007 [30] Birth order ≥2 OR 1.98 (1.28–3.05), P= 0.002 aOR 1.92 (1.21–3.06), P= 0.0049
≥2 children in the family OR 1.83 (1.16–2.88), P= 0.009 NAe
von Linstow et al., 2008 [31] Presence of older siblings OR 3.79 (0.98–14.73), P = 0.054 aOR 4.49 (1.08–18.73), P= 0.04
Weber et al., 1999 [32] Number of people living in the house, ≥10 vs. < 10f OR 1.59 (1.14–2.2), P= 0.006 aOR 3.06 (1.92–4.89), P <0.001
Number of children living on the compound, ≥4 vs. < 4f OR 1.7 (1.09–2.66), P= 0.02 NS, aOR 1.52 (0.81 2.85), P = 0.19
Number of children 2 to <3 years of ageg 1 child, NS, OR 1.4 (0.83–2.3), P = 0.21
≥2 children, NS, 1.2 (0.63–2.5), P = 0.53
1 child, aOR 2.6 (1.2–5.6), P =0.014
≥2 children, NS, aOR 0.78 (0.29–2.1), P = 0.63
Number of children 3 to 5 years of ageg 1 child, NS, 1.4 (0.85–2.30), P = 0.193
≥2 children, OR 4.3 (2.4–7.8), P< 0.001
1 child, NS, aOR 1.9 (0.91 3.8), P = 0.087
≥2 children, aOR 9.1 (3.7–23), P< 0.001
Siblings alivef, ≥3 vs. < 3 OR 1.48 (1.05–2.09), P= 0.023 NS, aOR 1.17 (0.71 1.96) b , P = 0.53
  1. aOR = adjusted odds ratio; aRR = adjusted relative risk; CI = confidence interval; LRTI = lower respiratory tract infection; 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.
  2. Significant outcomes are presented in bold, and non-significant outcomes are presented in italics.
  3. a Mixed-risk population studies include children with individual differences in risk of severe RSV disease and studies of the general population even when a minority of the study population includes high-risk children.
  4. b In the Hayes et al. (1989) study, ill controls had lower respiratory tract illnesses that did not require hospitalization. The well controls had no lower respiratory tract illness and were not hospitalized.
  5. c Okiro et al. (2008) conducted an extensive examination of variables related to crowding. Results of unadjusted and adjusted outcomes are provided only for variables included in the adjusted analysis for the RSV–LRTI population. Variables from the unadjusted analysis were considered for inclusion in the adjusted analysis if the relevant statistical test had a P value of ≤0.25; for groups of collinear variables, only those with the strongest univariate association were included. Variables with statistically significant outcomes in the unadjusted model included number of family children, number of siblings aged <6 years, number of male siblings, number of siblings aged <6 years living in same house as index, number of siblings aged ≥6 years living in same house as index, number of siblings aged ≥6 years going to school. Variables with no statistically significant outcomes in the unadjusted model included number of adults sleeping in index’s room, number of siblings aged <6 years sleeping in same room as index, number of siblings aged ≥6 years sleeping in same room as index, number of siblings aged <6 years sleeping in the same bed as index, and number of siblings aged <6 years going to school.
  6. d Reported as “previous birth” or “previous pregnancy”.
  7. e Variable not entered into adjusted model because of strong autocorrelation with birth order variable.
  8. f Estimates based on 277 matched sets.
  9. g Estimates based on 172 matched sets using the extended questionnaire.