Lethality by pneumonia and factors associated to death

Ferreira, Sidnei; Sant’Anna, Clemax Couto; March, Maria de Fátima Bazhuni Pombo; Santos, Marilene Augusta Rocha Crispino; Cunha, Antônio José Lêdo Alves da

doi:10.1016/j.jped.2013.05.008

Cited by 15 publications

(18 citation statements)

References 14 publications

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“…Similarly, risk factors associated with mortality, such as low weight for age, lack of access to safe drinking water, and presence of at least one co-morbid condition, were also consistent with previous studies [19, 20]. Not surprisingly, increased mortality of children <5 years was positively related to severity of pneumonia as seen in other studies [19, 21]. Interestingly, we found no significant association between pentavalent vaccination status and pneumonia mortality on multivariable modeling; however, pentavalent vaccination status was found to be protective for severe pneumonia.…”

Section: Discussionsupporting

confidence: 90%

Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction

Saha

Kim

et al. 2016

BMC Public Health

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BackgroundPneumonia is the leading infectious cause of morbidity and mortality in young children in Bangladesh. We present the epidemiology of pneumonia in Bangladeshi children <5 years before 10-valent pneumococcal conjugate vaccine introduction and investigate factors associated with disease severity and mortality.MethodsChildren aged 2–59 months admitted to three Bangladeshi hospitals with pneumonia (i.e., cough or difficulty breathing and age-specific tachypnea without danger signs) or severe pneumonia (i.e., cough or difficulty breathing and ≥1 danger signs) were included. Demographic, clinical, laboratory, and vaccine history data were collected. We assessed associations between characteristics and pneumonia severity and mortality using multivariable logistic regression.ResultsAmong 3639 Bangladeshi children with pneumonia, 61% had severe disease, and 2% died. Factors independently associated with severe pneumonia included ages 2–5 months (adjusted odds ratio [aOR] 1.60 [95% CI: 1.26–2.01]) and 6–11 months (aOR 1.31 [1.10–1.56]) relative to 12–59 months, low weight for age (aOR 1.22 [1.04–1.42]), unsafe drinking water source (aOR 2.00 [1.50–2.69]), higher paternal education (aOR 1.34 [1.15–1.57]), higher maternal education (aOR 0.74 [0.64–0.87]), and being fully vaccinated for age with pentavalent vaccination (aOR 0.64 [0.51–0.82]). Increased risk of pneumonia mortality was associated with age <12 months, low weight for age, unsafe drinking water source, lower paternal education, disease severity, and having ≥1 co-morbid condition.ConclusionsModifiable factors for severe pneumonia and mortality included low weight for age and access to safe drinking water. Improving vaccination status could decrease disease severity.

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Section: Discussionsupporting

confidence: 90%

Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction

Saha

Kim

et al. 2016

BMC Public Health

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“…Our ndings were similar to the results of a prospective cohort study carried out by Penelope et al, who identi ed the mortality of severe childhood pneumonia would increase when combined with anemia and gastrointestinal hemorrhage 7 . It was obvious that the presence of neonatal asphyxia in infants with severe pneumonia was related to a higher mortality, similarly to what was demonstrated in foregoing investigation 8,30 . Consequently, accurately diagnosing and treating actively are essential to reduce the severe pneumonia mortality.…”

Section: Discussionsupporting

confidence: 82%

“…Several independent risk factors associated with death identi ed in our multivariate analyses were also observed in previous studies. Very severe pneumonia, severe underweight and lower birth weight were eminent mortality predictors of severe pneumonia 3,8,26 . Thus, we should precisely distinguish the severity of pneumonia and weight categories for children at admission.…”

Section: Discussionmentioning

confidence: 95%

“…Pathogens were isolated and detected directly from the samples of sputum, blood, bronchoalveolar wash/aspirate and pleural effusion gathered during hospitalization 8 .…”

Section: Variables and De Nitionsmentioning

confidence: 99%

“…To the best of our knowledge, several investigations performed in Africa and South America had showed more attention to clinical characteristics and comorbidities, identifying sex, days with symptoms, lack of breast-feed, and concurrent underweight for age, very severe pneumonia, severe malnutrition, or HIV infection as risk factors for death from severe pneumonia in children 2,3,6,7 . Sidney F et al identi ed that inappropriate initial antibiotic therapy, including use of antibiotics except penicillin could increase the risk of death in children with community-acquired pneumonia (CAP) [8][9][10][11][12][13] . Nevertheless, there remains scarce information about antimicrobial practices for severe childhood pneumonia 14 .…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and Mortality Predictors for Severe Childhood Pneumonia in ICUs: A Real-World Study in China

Cao

Zuo³

et al. 2020

Preprint

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Background To identify the epidemiology and mortality predictors for severe childhood pneumonia and evaluate the influence of medications on clinical outcome in the real world.Methods We performed a retrospective observation study among children with severe pneumonia aged ≤ 5 years of age, separately comparing the detailed information between the in-hospital death cases and the survival cases in two different age groups. Multivariate regression model was used to figure out mortality predictors.Results 945 children were recruited, including 604 infants and 341 young children. Overall 88 deaths occurred (9.3%). There was low adherence to guidelines in antimicrobials and carbapenems were widely served as initial empiric regimens, but the efficacy was not superior to the guidelines recommended. In multivariate analyses, very severe pneumonia (OR: 3.55; 95% CI: 1.39–9.09), lower birth weight (OR: 3.92; 95% CI: 1.50-10.23), severe underweight (OR: 4.72; 95% CI: 1.92–11.62), mechanical ventilation (OR: 5.06; 95% CI: 1.97–12.95;OR: 14.43; 95% CI 3.31–62.96),comorbidity including anemia (OR: 5.61; 95% CI: 2.36–13.35), neonatal asphyxia (OR: 6.03; 95% CI: 1.57–23.12), gastrointestinal hemorrhage (OR: 3.73; 95% CI: 1.21–11.48) and sedative-hypnotics ( OR: 4.32; 95% CI: 1.76–10.61; OR: 4.13; 95% CI༚1.50-11.38) were independent risk factors for death, whereas a lower mortality was present in infants with probiotics (OR: 0.24; 95% CI: 0.10–0.54).Conclusions Severe pneumonia remains a primary cause of death in children under 5 years of age. Clinical characteristics, comorbidity and medications are evidently associated with death. Importantly, we should pay particular attention to the identification of the mortality predictors and establish prophylactic measures to reduce the mortality.

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A cost-effectiveness analysis of pneumococcal conjugate vaccines in infants and herd protection in older adults in Colombia

Ordóñez¹,

Ordóñez²

2023

Expert Review of Vaccines

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Lethality by pneumonia and factors associated to death

Cited by 15 publications

References 14 publications

Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction

Epidemiology and risk factors for pneumonia severity and mortality in Bangladeshi children <5 years of age before 10-valent pneumococcal conjugate vaccine introduction

Epidemiology and Mortality Predictors for Severe Childhood Pneumonia in ICUs: A Real-World Study in China

A cost-effectiveness analysis of pneumococcal conjugate vaccines in infants and herd protection in older adults in Colombia

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