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

Saha, Shampa; Mk, Hasan; Kim, Lindsay; Farrar, Jennifer L.; Hossain, Belal; Islam, Maksuda; Ahmed, Asm Nawshad Uddin; Amin, Muhammad Umar; Hanif, Mohammed; Hussain, Manzoor; Arifeen, Shams El; Whitney, Cynthia G.; Saha, Samir K.

doi:10.1186/s12889-016-3897-9

Cited by 36 publications

(36 citation statements)

References 21 publications

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“…The death rate among children admitted to hospital with pneumonia was low compared to other settings [19,34,35], but similar to mortality rates recorded in Vietnam [12,17]. Infants were overrepresented among children with an adverse outcome, but this is a consistent finding even in settings with high PCV-13 vaccination coverage [36].…”

Section: Discussionsupporting

confidence: 65%

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

et al. 2019

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Pneumonia is the most common reason for paediatric hospital admission in Vietnam. The potential value of using the World Health Organization (WHO) case management approach in Vietnam has not been documented.We performed a prospective descriptive study of all children (2–59 months) admitted with “pneumonia” (as assessed by the admitting clinician) to the Da Nang Hospital for Women and Children to characterise their disease profiles and assess risk factors for an adverse outcome. The disease profile was classified using WHO pneumonia criteria, with tachypnoea or chest indrawing as defining clinical signs. Adverse outcome was defined as death, intensive care unit admission, tertiary care transfer or hospital stay >10 days.Of 4206 admissions, 1758 (41.8%) were classified as “no pneumonia” using WHO criteria and only 252 (6.0%) met revised criteria for “severe pneumonia”. The inpatient death rate was low (0.4% of admissions) with most deaths (11 out of 16; 68.8%) occurring in the “severe pneumonia” group. An adverse outcome was recorded in 18.7% of all admissions and 60.7% of the “severe pneumonia” group. Children were hospitalised for a median of 7 days at an average cost of 253 USD per admission. Risk factors for adverse outcome included WHO-classified “severe pneumonia”, age <1 year, low birth weight, previous recent admission with an acute respiratory infection and recent tuberculosis exposure. Breastfeeding, day-care attendance and pre-admission antibiotic use were associated with reduced risk.Few hospital admissions met WHO criteria for “severe pneumonia”, suggesting potential unnecessary hospitalisation and use of intravenous antibiotics. Better characterisation of the underlying diagnosis requires careful consideration.

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Section: Discussionsupporting

confidence: 65%

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

et al. 2019

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Section: Discussionsupporting

confidence: 59%

Characterisation of children hospitalised with pneumonia in central Vietnam: A prospective study

Kim

Tran

Fitzgerald

et al. 2019

Paediatric Respiratory Epidemiology

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Pneumonia is the most common reason for paediatric hospital admission in Vietnam. Revised World Health Organization (WHO) criteria recently adjusted the definition of "severe pneumonia" to reduce unnecessary hospitalization, but its impact on case management practices in Vietnam has not been documented. We performed a prospective descriptive study of all children (2-59 months) admitted with 'pneumonia' to the Da Nang Hospital for Women and Children in central Vietnam, to characterise their disease profile and assess risk factors for adverse outcome. We found that few hospital admissions met WHO criteria for 'severe pneumonia', suggesting unnecessary hospitalisation for intravenous antibiotics in a large number of children. Although adoption of the WHO case management will reduce unnecessary admissions, careful interpretation of signs and symptoms is required to ensure optimal management. We believe that this manuscript will be of interest to your international readership given that the findings reflect existing practice in large parts of Asia, which is different to reports from sub-Saharan Africa.

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“…The overall death rate (0.8%) was very low compared to children with severe pneumonia in other settings . All deaths occurred at secondary and tertiary level hospitals reflect appropriate referral of the most severe cases.…”

Section: Discussionmentioning

confidence: 99%

Disease spectrum and management of children admitted with acute respiratory infection in Viet Nam

Nguyen

Truong

et al. 2017

Tropical Med Int Health

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

Cited by 36 publications

References 21 publications

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

Characterisation of children hospitalised with pneumonia in central Vietnam: A prospective study

Disease spectrum and management of children admitted with acute respiratory infection in Viet Nam

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