The Etiology of Pneumonia in Zambian Children: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study.

Autor:	Mwananyanda L; From the Department of Global Health, Boston University School of Public Health, Boston, Massachusetts.; Right To Care-Zambia, Lusaka, Zambia., Thea DM; From the Department of Global Health, Boston University School of Public Health, Boston, Massachusetts., Chipeta J; Department of Paediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia.; Department of Paediatrics, University Teaching Hospital, Lusaka, Zambia., Kwenda G; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia., Mulindwa JM; Department of Paediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia., Mwenechanya M; Department of Paediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia., Prosperi C; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Higdon MM; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Haddix M; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Hammitt LL; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Feikin DR; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Murdoch DR; Department of Pathology and Biomedical Sciences, University of Otago, Christchurch, New Zealand.; Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand., O'Brien KL; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Deloria Knoll M; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Mwansa J; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia.; Department of Microbiology, Lusaka Apex Medical University, Lusaka, Zambia., Wa Somwe S; Department of Paediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia., Seidenberg P; From the Department of Global Health, Boston University School of Public Health, Boston, Massachusetts.; Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2021 Sep 01; Vol. 40 (9S), pp. S40-S49.
DOI:	10.1097/INF.0000000000002652
Abstrakt:	Background: Childhood pneumonia in developing countries is the foremost cause of morbidity and death. Fresh information on etiology is needed, considering the changing epidemiology of pneumonia in the setting of greater availability of effective vaccines, changing antibiotic use and improved access to care. We report here the Zambia site results of the Pneumonia Etiology Research for Child Health study on the etiology of pneumonia among HIV-uninfected children in Lusaka, Zambia. Methods: We conducted a case-control study of HIV-uninfected children age 1-59 months admitted with World Health Organization-defined severe or very severe pneumonia to a large tertiary care hospital in Lusaka. History, physical examination, chest radiographs (CXRs), blood cultures and nasopharyngeal/oropharyngeal swabs were obtained and tested by polymerase chain reaction and routine microbiology for the presence of 30 bacteria and viruses. From age and seasonally matched controls, we tested blood and nasopharyngeal/oropharyngeal samples. We used the Pneumonia Etiology Research for Child Health integrated analysis to determine the individual and population etiologic fraction for individual pathogens as the cause of pneumonia. Results: Among the 514 HIV-uninfected case children, 208 (40.5%) had abnormal CXRs (61 of 514 children were missing CXR), 8 (3.8%) of which had positive blood cultures. The overall mortality was 16.0% (82 deaths). The etiologic fraction was highest for respiratory syncytial virus [26.1%, 95% credible interval (CrI): 17.0-37.7], Mycobacterium tuberculosis (12.8%, 95% CrI: 4.3-25.3) and human metapneumovirus (12.8%, CrI: 6.1-21.8). Conclusions: Childhood pneumonia in Zambia among HIV-uninfected children is most frequently caused by respiratory syncytial virus, M. tuberculosis and human metapneumovirus, and the mortality remains high. Competing Interests: M.D.K. has received funding for consultancies from Merck, Pfizer, Novartis, and grant funding from Merck and Pfizer. M.M.H. has received grant funding from Pfizer. L.L.H. has received grant funding from GlaxoSmithKline, Pfizer, and Merck. K.L.O. has received grant funding from GlaxoSmithKline and Pfizer and participates on technical advisory boards for Merck, Sanofi-Pasteur, PATH, Affinivax, and ClearPath. C.P. has received grant funding from Merck. The funding mentioned here for these authors was unrelated to this study. The other authors have no conflicts of interest to disclose. (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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