Excess risk of subsequent infection in hospitalized children from a community cohort study in Cambodia and Madagascar
| Autor: | Lison Rambliere, Elsa Kermorvant-Duchemin, Agathe de Lauzanne, Jean-Marc Collard, Perlinot Herindrainy, Muriel Vray, Benoit Garin, Andrianirina Zafitsara Zo, Fanjalalaina Rasoanaivo, Jacob Rakotoarimanana Feno Manitra, Tanjona Bodonirina Raheliarivao, Jean-Baptiste Niokhhor Diouf, Véronique Ngo, Siyin Lach, Pring Long, Laurence Borand, Touch Sok, Armiya Youssouf Abdou, Michael Padget, Yoann Madec, Didier Guillemot, Elisabeth Delarocque-Astagneau, Bich-Tram Huynh |
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| Přispěvatelé: | Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials (EMAE), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur du Cambodge, Réseau International des Instituts Pasteur (RIIP), Institut Pasteur de Madagascar, Institut Pasteur de Dakar, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier de Soavinandriana (CENHOSOA), Centre Hospitalier Roi Baudouin, Ministry of Health [Hanoi], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), This work was supported by internal resources from University Paris-Sud. The research project BIRDY was implemented with the financial support of the Monegasque co-operation for development, the Total Foundation and MSDAVENIR., We are grateful to the BIRDY study group (Supplementary Text S2, available as Supplementary data at IJE online), all mothers and their newborns, physicians, laboratory staff, field investigators, community workers and collaborators for their participation in this project and David R.M. Smith for his proofreading in English. |
| Rok vydání: | 2021 |
| Předmět: |
Epidemiology
global health Infant General Medicine cohort infection diarrhoea post-hospital syndrome sepsis Cohort Studies Hospitalization Madagascar Humans [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Female low- and middle-income countries lower-respiratory infection Prospective Studies hospital Cambodia Child Children Child Hospitalized Respiratory Tract Infections care pathway |
| Zdroj: | International Journal of Epidemiology International Journal of Epidemiology, 2022, 51 (5), pp.1421-1431. ⟨10.1093/ije/dyac048⟩ |
| ISSN: | 1464-3685 0300-5771 |
| DOI: | 10.1093/ije/dyac048⟩ |
| Popis: | Background Children in low- and middle-income countries are particularly vulnerable in the months following an initial health event (IHE), with increased risk of mortality caused mostly by infectious diseases. Due to exposure to a wide range of environmental stressors, hospitalization in itself might increase child vulnerability at discharge. The goal of this study was to disentangle the role of hospitalization on the risk of subsequent infection. Methods Data from a prospective, longitudinal, international, multicenter mother-and-child cohort were analysed. The main outcome assessed was the risk of subsequent infection within 3 months of initial care at hospital or primary healthcare facilities. First, risk factors for being hospitalized for the IHE (Step 1) and for having a subsequent infection (Step 2) were identified. Then, inpatients were matched with outpatients using propensity scores, considering the risk factors identified in Step 1. Finally, adjusted on the risk factors identified in Step 2, Cox regression models were performed on the matched data set to estimate the effect of hospitalization at the IHE on the risk of subsequent infection. Results Among the 1312 children presenting an IHE, 210 (16%) had a subsequent infection, mainly lower-respiratory infections. Although hospitalization did not increase the risk of subsequent diarrhoea or unspecified sepsis, inpatients were 1.7 (95% Confidence Intervals [1.0–2.8]) times more likely to develop a subsequent lower-respiratory infection than comparable outpatients. Conclusion For the first time, our findings suggest that hospitalization might increase the risk of subsequent lower-respiratory infection adjusted on severity and symptoms at IHE. This highlights the need for robust longitudinal follow-up of at-risk children and the importance of investigating underlying mechanisms driving vulnerability to infection. |
| Databáze: | OpenAIRE |
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