Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania
| Autor: | Andrea Pietravalle, Chiara Bertolaso, Maria Incoronata Lemmo, Kajoro Mphayokulela, Renato Cutrera, Carolina Putotto, Elisa De Vitis, Joseph Kazaura, Maria Podagrosi, Marzia Duse, Marta Unolt, Francesco Nieddu, Chiara Azzari, Marzia Trivelli, Fabiana Ursitti, Chiara Mariani, Serena Caggiano, Paola Pansa, Nicola Ullmann, Michael Mkwambe |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics antibiotic therapy community-acquired pneumonia developing countries molecular diagnostic prevention vaccines child child preschool community-acquired Infections comorbidity female humans infant infant newborn length of stay male phenotype pneumonia bacterial prognosis risk factors severity of illness index Tanzania hospitals district catalysis molecular biology medicine.medical_treatment Antibiotics Comorbidity Severity of Illness Index lcsh:Chemistry 0302 clinical medicine Community-acquired pneumonia Risk Factors Oxygen therapy Antibiotic therapy Developing countries Molecular diagnostic Prevention Vaccines Child Child Preschool Community-Acquired Infections Female Humans Infant Infant Newborn Length of Stay Phenotype Pneumonia Bacterial Prognosis Hospitals District 030212 general & internal medicine lcsh:QH301-705.5 Spectroscopy Cause of death biology General Medicine Computer Science Applications medicine.medical_specialty medicine.drug_class 030231 tropical medicine Article Catalysis Inorganic Chemistry 03 medical and health sciences medicine Physical and Theoretical Chemistry Molecular Biology business.industry Organic Chemistry medicine.disease biology.organism_classification Pneumonia lcsh:Biology (General) lcsh:QD1-999 Etiology business |
| Zdroj: | International Journal of Molecular Sciences, Vol 18, Iss 3, p 623 (2017) International Journal of Molecular Sciences International Journal of Molecular Sciences; Volume 18; Issue 3; Pages: 623 |
| ISSN: | 1422-0067 |
| Popis: | Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died. Surprisingly, 54% of patients were admitted with a wrong diagnosis, which increased complications, the need for antibiotics and chest X-rays, and the length of hospitalization. Comorbidity, found in 32% of children, significantly increased severity, complications, deaths, need for chest X-rays, and oxygen therapy. Malnourished children (29%) required more antibiotics. Microbiologically, Streptococcus pneumonia (S. p.), Haemophilus influenza type b (Hib) and Staphylococcus aureus (S. a.) were the bacteria more frequently isolated. Seventy-five percent of patients had mono-infection. Etiology was not correlated with severity, complications, deaths, oxygen demand, or duration of hospitalization. Our study highlights that difficult diagnoses and comorbidities negatively affect clinical evolution. S. p. and Hib still play a large role; thus, implementation of current vaccine strategies is needed. DBS is a simple and efficient diagnostic method for bacterial identification in countries with scarce resources. |
| Databáze: | OpenAIRE |
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