American Journal of Epidemiology Vol. 136, No. 2: 221-235
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Risk Factors for Invasive Haemophilus influenzae Type b in Los Angeles County Children 18-60 Months of Age
1UCLA Center for Vaccine Research, Harbor-UCLA Medical Center, UCLA School of Medicine Torrance, CA
2Acute Communicable Disease Division, Los Angeles County Department of Health Services Los Angeles, CA
Reprint requests to Dr. C. M. Vadheim, UCLA Center for Vaccine Research, Harbor-UCLA Medical Center, Bldg. E-6, 1124 W. Carson St, Torrance, CA 90502
Potential factors that confer risk or protection for invasive Haemophilus influenzae type b disease were evaluated in Los Angeles County children 18–60 months of age by case-control methods. In this age group, 79 H. influenzae type b cases were identified by overlapping surveillance methods, and 221 random controls were selected by random digit dialing. Cases and controls were similar in sex, prior health, proportion attending day care, parental educational level, history of breast feeding, and proportion vaccinated with measles/mumps/rubella vaccine. The effect of H. influenzae type b vaccination was controlled in all analyses, and results of vaccine efficacy have been reported elsewhere. Cases were more likely to have a significant underlying medical condition, reside in a home with more than six residents, have a lower yearly household income, have two or more smokers in the home, and to be black. Using conditional logistic regression models, the following were significant independent risk factors after adjusting for age, month of diagnosis, H. influenzae type b vaccine status, and the other factors: 1) more than two smokers in the house (odds ratio (OR) = 6.00; 95% confidence interval (Cl) 1.49–24.06); 2) household size of more than six persons (OR for more than six vs. less than three persons = 3.71; 95% Cl 1.10–12.60); and 3) black maternal race (OR for black vs. Hispanic = 3.47; 95% Cl 1.41–8.53). We conclude that exposure to smoking in the home, living in households with more than six members, and the black race are each independently associated with an increased risk for H. influenzae type b disease in Los Angeles County children and, when combined, constitute a major reason for H. influenzae type b disease occurrence. Am J Epidemiol 1992;136:221–35.
ethnic groups; Haemophilus influenzae; immunization; population; risk factors; smoking
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