Role of parental smoking in severe bronchiolitis: a hospital based case-control study

Authors

  • Mohamad Ismael K. Department of Pediatrics, MES Medical College, Perinthalmanna, Kerala, India
  • Santhosh Jose Department of Pediatrics, MES Medical College, Perinthalmanna, Kerala, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20175507

Keywords:

Bronchiolitis, Infants, Parental smoking

Abstract

Background: Bronchiolitis is one of the commonest causes of hospitalization of infants and young children in India. Parental smoking is an important risk factor for both susceptibility and severity of bronchiolitis. Paternal smoking alone causes a 1.3-fold (95% CI = 1.2-1.4) increase in risk. The aim of this study was to find out the role of parental smoking in severe bronchiolitis.

Methods: This is a case control study conducted in the Department of Pediatrics from July 2013 to December 2015. Sixty-four patients admitted into the ward with severe bronchiolitis were enrolled as cases and sixty-four suitably matched apparently healthy children attending EPI centre and outpatient department presenting with non-respiratory illness were enrolled as controls. Every second case satisfying the inclusion and exclusion criteria was enrolled in the study.

Results: The mean age of the patients was 8.53 (SD±4.75) months. Forty-two (65%) patients were male and twenty-two (34.3%) patients were female. Male-to-female ratio was 1.9:1. Most of the cases (62.5%) came from low socioeconomic background. More than half of the cases (53.13%) were not exclusively breastfed babies. Mean length of hospital stay was SD (5.41±2.82) days. Thirty-nine (60%) cases and twenty-three (35%) controls were exposed to parental smoking. Result was highly significant (p = 0.005). Odds ratio was 2.8 (95% CI from 1.36 to 5.68).

Conclusion: Exposure to parental smoking causes a statistically significant (p = 0.005, odds ratio = 2.8) increase in the risk of developing severe bronchiolitis in the first year of life

References

Hasan MR, Hossain MA, Mahmud AM Kabir AR, Amin MA, Rahman MM. National guidelines asthma, bronchiolitis and COPD. Bangladesh Asthma Association. 2005.

Coates BM, Lauren L, Goodman CM, Goodman DM. Wheezing in infants: bronchiolitis. In: Kliegman RM, eds. Nelson textbook of pediatrics. 20th edition. Reed Elsevier India Private Limited. 2016.

Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H. Global estimate of the incidence of clinical pneumonia among children under five years of age. Bulle World Health Organization. 2004;82(12):895-903.

Carroll KN, Gebretsadik T, Griffin MR. Maternal asthma and maternal smoking are associated with increased risk of bronchiolitis during infancy. Pediatr. 2007;119(6):1104-12.

Kabir ARML, Mollah AH, Anwar KS, Rahman AKMF, Amin R, Rahman ME. Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh. Acta Paediatrica. 2009;98(10):1593-9.

Singh AM, Moore PE, Gern JE, Lemanske RF, Hartert TV. Bronchiolitis to asthma: a review and call for studies of gene-virus interactions in asthma causation. Am J Respiratory Critical Care Med. 2007;175(2):108-19.

National Strategic Plan of Action for Tobacco Control, 2007-2010, Ministry of Health and Family Welfare, Government of People’s Republic of Bangladesh, Dhaka, Bangladesh. 2007.

Jones LL, Hashim A, McKeever T, Cook DG, Britton J, Leonardi-Bee J. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis. Respiratory Res. 2011;12:5.

Chatzimichael A, Tsalkidis A, Cassimos D. The role of breastfeeding and passive smoking on the development of severe bronchiolitis in infants. Minerva Pediatrica. 2007;59(3):199-206.

Rida MF. Risk factors for Respiratory Syncytial Virus (RSV) bronchiolitis in children: a hospital based study. Iraq Postgraduate Med J. 2011;10(3):305-10

Bradley JP, Bacharier LB, Bonfiglio J. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatr. 2005;115(1):e7-14.

Bashar AHMK, Ali MM, Hoque M. Efficacy of nebulized L-adrenaline versus nebulized salbutamol in infants with acute bronchiolitis. Sylhet Med J. 2011;34(1):8-14.

Denicola LK. Bronchiolitis. Mediscope. 2008;19(2):157-65.

Semple MG, Taylor-Robinson DC, Lane S, Smyth RL. Household tobacco smoke and admission weight predict severe bronchiolitis in infants independent of deprivation: prospective cohort study. PLoS One. vol. 6, no. 7, Article ID e22425, 2011.

Law BJ, Langley JM, Allen U. The pediatric investigators collaborative network on infections in canada study of predictors of hospitalization for respiratory syncytial virus infection for infants born at 33 through 35 completed weeks of gestation. Pediatr Infect Dis J. 2004;23(9):806-14.

Sommer C, Resch B, Simoes EAF. Risk factors for severe respiratory syncytial virus lower respiratory tract infection. Open Microbiol J. 2011;5(S2):144-54.

Sritippayawan S, Prapphal N, Wong P, Tosukhowong P, Samransamruajkit R, Deerojanawong J. Environmental tobacco smoke exposure and respiratory syncytial virus infection in young children hospitalized with acute lower respiratory tract infection. J Med Assoc Thailand. 2006;89(12):2097-103.

Strachan DP, Cook DG. Parental smoking and lower respiratory illness in infancy and early childhood. Thorax. 1997;52(10):905-14.

Schvartsman C, Farhat SCL, Schvartsman S, Saldiva PHN. Parental smoking patterns and their association with wheezing in children. Clin. 2013;68(7):934-9.

Jurado D, Munoz C, de Dios JL, Munoz-Hoyos A, Is maternal smoking more determinant than paternal smoking on the respiratory symptoms of young children? Respiratory Med. 2005;99(9):1138-44.

Downloads

Published

2017-12-21

Issue

Section

Original Research Articles