American Journal of Epidemiology Advance Access originally published online on August 9, 2007
American Journal of Epidemiology 2007 166(9):1080-1087; doi:10.1093/aje/kwm178
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ORIGINAL CONTRIBUTIONS |
Risk Factors for Invasive Pneumococcal Disease among Navajo Adults
1 Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
2 Respiratory Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
3 Current affiliation: Yale University School of Medicine, New Haven, CT
4 Current affiliation: University of North Carolina School of Public Health, Chapel Hill, NC
5 Current affiliation: Harvard Medical School, Boston, MA
Correspondence to Dr. James Watt, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 621 North Washington Street, Baltimore, MD 21205 (e-mail: jwatt{at}jhsph.edu).
Received for publication April 28, 2006. Accepted for publication May 11, 2007.
Invasive pneumococcal disease (IPD) is 3–5 times more common among Navajo adults than in the general US population. The authors conducted a case-control study to identify risk factors for IPD among Navajo adults. Navajos aged 
18 years with IPD were identified through prospective, population-based active laboratory surveillance (December 1999–February 2002). Controls matched to cases on age, gender, and neighborhood were selected. Risk factors were identified through structured interviews and medical record reviews. The authors conducted a matched analysis based on 118 cases and 353 controls. Risk factors included in the final multivariable analysis were chronic renal failure (odds ratio (OR) = 2.6, 95% confidence interval (CI): 0.9, 7.7), congestive heart failure (OR = 5.6, 95% CI: 2.2, 14.5), self-reported alcohol use or alcoholism (OR = 2.9, 95% CI: 1.5, 5.4), body mass index (weight (kg)/height (m)2) <5th (OR = 3.2, 95% CI: 1.0, 10.6) or >95th (OR = 2.8, 95% CI: 1.0, 8.0) percentile, and unemployment (OR = 2.6, 95% CI: 1.2, 5.5). The population attributable fractions were 10% for chronic renal failure, 18% for congestive heart failure, 30% for self-reported alcohol use or alcoholism, 6% for body mass index, and 20% for unemployment. Several modifiable risk factors for IPD in Navajos were identified. The high prevalence of renal failure, alcoholism, and unemployment among Navajo adults compared with the general US population may explain some of their increased risk of IPD.
alcoholism; heart failure, congestive; Indians, North American; kidney failure, chronic; risk factors; Streptococcus pneumoniae; unemployment
Abbreviations: BMI, body mass index; IPD, invasive pneumococcal disease
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B. Simell, M. Lahdenkari, A. Reunanen, H. Kayhty, and M. Vakevainen Effects of Ageing and Gender on Naturally Acquired Antibodies to Pneumococcal Capsular Polysaccharides and Virulence-Associated Proteins Clin. Vaccine Immunol., September 1, 2008; 15(9): 1391 - 1397. [Abstract] [Full Text] [PDF]
|
|