Pneumonia mortality among children in Brazil: a success story

Axelsson, Inge; Silfverdal, Sven‐Arne

doi:10.2223/jped.2080

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…In Brazil, despite the overall reduction in pneumonia deaths in young children, a high mortality rate persists, with discrepancies between different regions. The rate found in the North corresponds to that found in the South eight years ago 2,3 . There has been an overall increase in the incidence of pneumonic complications, particularly the parapneumonic pleural effusion (PPE) 4 .…”

Section: Introductionsupporting

confidence: 78%

Parapneumonic pleural effusion: reality and strategies in an Amazon university hospital

Arêas

Júnior

et al. 2016

Rev. Col. Bras. Cir.

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Objective: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE), and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD) . Methods: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011. Results: we studied 46 patients, most children under three years of age (74%), with no gender predominance. A significant portion of the sample (28%) had inappropriate body mass index. We found short stature in five patients (11%), which tended, in general, to a worst postoperative outcome when compared with children of normal height (p=0.039). The average duration of symptoms till admission was 16.9 days. Empyema was a common diagnosis in the first surgery (47.8%), and its bearers had longer duration of chest tube drainage (p=0.015). Most children (80.4%) were operated only once. The mean length of hospital stay was 25.9 days. Thoracic drainage (water-sealed) was the most common procedure (85%), with conversion to OTD in 24% of the sample, thoracotomy being rare (4%). There were no deaths. Conclusion: the studied individuals often had advanced disease and nutritional disorders, affecting outcome. OTD remains a valid option for specific situations, and further studies are needed for confirmation.

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Section: Introductionsupporting

confidence: 78%

Parapneumonic pleural effusion: reality and strategies in an Amazon university hospital

Arêas

Júnior

et al. 2016

Rev. Col. Bras. Cir.

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“…Cerca de 2-3% das IRA evoluem para infecção do parênquima pulmonar, correspondendo às pneumonias. [1][2][3] Destas, 10-20% evoluirão para óbito, contabilizando 1,2 milhões de óbitos por ano no mundo. O Brasil concentrava grande parte dos casos de pneumonia em menores ou crianças com 5 anos no início da década de 2000.…”

Section: Introductionunclassified

“…O Brasil concentrava grande parte dos casos de pneumonia em menores ou crianças com 5 anos no início da década de 2000. [1][2][3] A elevada morbimortalidade das IRA vem sendo estudada desde a década de 1970, com investigações pioneiras de Bulla e Hitze em 1978 até o presente, pois, 40 anos depois, ainda é um desafio do ponto de vista da saúde pública. Ao longo desses anos, pacientes pediátricos, por sua vulnerabilidade às infecções, são o grupo prioritário para se beneficiar das condutas padronizadas que visem reduzir a mortalidade por uma das IRA mais temidas: a pneumonia.…”

Section: Introductionunclassified

“…A mortalidade por PAC foi responsável por cerca de 5% das mortes entre menores de 5 anos. 3,4 O principal agente etiológico das PAC em menores de 5 anos é o Streptococcus pneumoniae (pneumococo), de acordo com estudos nacionais e internacionais. 4 A vacinação conjugada antipneumocócica é utilizada desde o ano 2000 nos Estados Unidos, primeiro como vacina conjugada antipneumocócica 7 valente (PCV7), substituída em 2010 pela vacina pneumocócica 13 valente (PCV13).…”

Section: Introductionunclassified

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Pneumonia adquirida na comunidade em crianças e vacinação antipneumocócica 10 valente: atualização

March¹,

Galvao²

2018

Rev Ped SOPERJ

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Introdução: a incorporação da vacina antipneumocócica 10 valente no calendário vacinal brasileiro em 2010, no Programa Nacional de Imunizações, gerou a redução de doenças pneumocócicas, como meningites e pneumonia adquirida na comunidade, e da colonização de orofaringe e mucosa nasal pelo pneumococo (Streptococcus pneumoniae). Objetivo: realizar um estudo de revisão sobre etiologia, quadro clínico, complicações, conduta e medidas preventivas das pneumonias adquiridas na comunidade, e discutir a resistência do pneumococo aos antibióticos. Fontes de dados: livros, artigos e diretrizes considerados relevantes nos últimos 21 anos, indexados nos bancos de dados PubMed, Medline, Lilacs e SciELO, com os descritores 'pneumonia', 'criança' e 'vacinas pneumocócicas' nas línguas portuguesa, inglesa e espanhola. Síntese dos dados: todos os casos de pneumonia adquirida na comunidade grave necessitam de hospitalização e, em geral, uso de ampicilina ou penicilina cristalina como primeira escolha. A amoxicilina é indicada no tratamento ambulatorial na dose de 50 mg/kg/dia de 8 em 8 horas. Estudos nacionais identificaram que um ano após sua introdução na rede pública houve redução das hospitalizações de crianças por pneumonia adquirida na comunidade no Brasil. Conclusões: o tratamento das pneumonias adquiridas na comunidade ainda é um desafio e a instituição de um fluxograma de tratamento pode ser útil, priorizando a penicilina e seus derivados, ainda considerados drogas de escolha em todas as diretrizes nacionais e internacionais. O estabelecimento da vacina antipneumocócica 10 valente no calendário vacinal trouxe redução das internações por pneumonia adquirida na comunidade e deve ser incentivada pelo pediatra.

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Relationship Between Pulse Oximetry Results and Prognosis of Children With Pneumonia

Rahmati¹,

Sajedi²,

Safdarian³

et al. 2016

Acta Healthmedica

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Introduction:Pulse oximetry is shown to be a reliable indicator of severity of pneumonia in children, and its use is associated with decrease in mortality of pneumonia among children. Also it is a cost-effective tool in management of pneumonia. The general objective of this study is to determine the relationship between pulse oximetry results and prognosis of children with pneumonia. Methods: This cross-sectional study was carried out on children with respiratory symptoms aged 1 month to 5 years old referring to Bandar Abbas Pediatric Hospital, Iran between January and March 2016. Convenience sampling was used to select the study participants. According to the clinical signs and symptoms, as well as chest radiography, patients were allocated to one of the groups of Pneumonia or Non-Pneumonia. O2 saturation was measured at baseline, using pulse oximetry. The patients were assessed for condition at discharge, oxygendelivery device, and duration of hospitalization. Independent samples t-test, one-way analysis of variance (ANOVA) and Pearson Correlation were used for data analysis via IBM SPSS version 23.0 software. A p-value less than 0.05 was considered as significant. Results: In total, 299 patients with a mean age of 14.3 ± 9.83 years were studied in two groups of Pneumonia (n=149) and Control (n=150). Of the two groups, 178 (59.5%) were male and 121 (40.5%) were female. Baseline mean O2 saturation was 97.90 ± 4.60 percent in the pneumonia group and 99.95 ± 0.57 percent in the nonpneumonia group (p < 0.001). Among pneumonia patients, saturation of O2 was significantly lower in the group of patients who died, in comparison to children who were discharged by the physician or by parental consent. (83 ± 8.27 versus 98.17 ± 3.69 and 99.16 ± 2.56; p < 0.001). Results of this study showed that there was significant difference in the saturation of O2 according to oxygen-delivery devices in pneumonia patients (p < 0.001). Conclusion: Lower initial O2 saturation is observed in the pneumonia patients in comparison to the control group, in patients with death, in comparison to discharged patients by physician or parental consent. Also, the O2 saturation was significantly different according the oxygen-delivery devices (p < 0.001). Furthermore, lower O2 saturation was associated with longer duration of hospitalization. Therefore, pulse oximetry has good prognostic role in children with pneumonia. We recommend using pulse oximetry in evaluation of children with pneumonia especially in low resource setting.

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Pneumonia mortality among children in Brazil: a success story

Cited by 3 publications

References 5 publications

Parapneumonic pleural effusion: reality and strategies in an Amazon university hospital

Parapneumonic pleural effusion: reality and strategies in an Amazon university hospital

Pneumonia adquirida na comunidade em crianças e vacinação antipneumocócica 10 valente: atualização

Relationship Between Pulse Oximetry Results and Prognosis of Children With Pneumonia

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