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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 2–11)

Ill controlsb, 3.0 (range, 1–18); 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

1–5, 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.
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BMC Infectious Diseases

ISSN: 1471-2334

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