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

Nguyen, Thu-Anh; Nguyen, Dong; Truong, Thanh‐Huong; Tran, Minh-Dien; Graham, Stephen M.; Marais, Ben J.

doi:10.1111/tmi.12874

Cited by 20 publications

(37 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most children received a longer antibiotic course than recommended by national and international guidelines. This has also been observed in multiple retrospective studies in Vietnam15 21 and China. 13 In the study setting, children generally completed a full course of antibiotics (either oral or intravenous) before hospital discharge, since this is provided free of charge to all children <6 years of age.…”

Section: Discussionsupporting

confidence: 75%

“…Non-severe pneumonia can be managed as an outpatient with a 5-day course of oral antibiotics 10 12. Despite international recommendations and published evidence to support this approach, broad-spectrum antibiotics continue to be overprescribed,4 13 while unnecessary hospital admission and extended treatment durations impose a huge financial burden on families and healthcare systems 14–16…”

Section: Introductionmentioning

confidence: 99%

“…In Vietnam, pneumonia accounts for nearly a third of all paediatric admissions to hospital 15 17 18. Indications are that many of these ‘pneumonia’ admissions do not meet WHO criteria for pneumonia and that even less meet strict criteria for severe pneumonia,15 16 which generally guides the need for hospital admission and the use of intravenous antibiotics. Childhood pneumonia is a major contributor to antibiotic use and hospital admissions in other East Asian countries as well 17–19.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antibiotic use in children hospitalised with pneumonia in Central Vietnam

et al. 2020

View full text Add to dashboard Cite

Background and objectivesExcessive use of antibiotics has been noted in children with respiratory tract infections in Vietnam, but antibiotic use in hospitalised children is poorly documented. Antibiotic use and direct healthcare costs in children hospitalised with pneumonia in central Vietnam were assessed.MethodsA prospective descriptive study of children under 5 years old admitted with a primary admission diagnosis of ‘pneumonia’ to the Da Nang Hospital for Women and Children over 1 year.ResultsOf 2911 children hospitalised with pneumonia, 2735 (94.0%) were classified as ‘non-severe’ pneumonia by the admitting physician. In total, 2853 (98.0%) children received antibiotics. Intravenous antibiotics were given to 336 (12.3%) children with ‘non-severe’ and 157/176 (89.2%) children with ‘severe’ pneumonia; those with ‘non-severe’ pneumonia accounted for 68.2% (336/493) of intravenous antibiotics given. Only 19.3% (95/493) of children on intravenous antibiotics were stepped down to an oral antibiotic. Cefuroxime was the preferred oral agent, and ceftriaxone was the preferred injectable agent. Hospital admission for oral antibiotics in ‘non-severe’ pneumonia was a major cost driver, with an average direct cost of US$78.9 per patient, accounting for 54.0% of the total hospitalisation cost in the study cohort. In addition, 336 (12.3%) children with non-severe pneumonia received intravenous antibiotics without indication, accounting for a further 23.2% of hospitalisation costs.ConclusionLimiting unnecessary hospitalisation and considering early intravenous to oral step down antibiotic will reduce direct health system costs and morbidity in children with respiratory tract infections in Vietnam.

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antibiotic use in children hospitalised with pneumonia in Central Vietnam

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Vietnam is one of the 15 countries where the prevalence of child pneumonia is highest. Pneumonia is a leading cause of admission in Vietnamese pediatric hospitals [8] and represented 11.4-11.9% of total DALYs among Vietnamese children <5 years of age in 2014-2017 [9]. Also, pneumonia accounted for 11% of deaths in younger Vietnamese children in 2015, 10 times more than in developed countries [6].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Severe Pneumonia According to WHO 2005 Criteria Definition Among Children <5 Years of Age in Thai Binh, Vietnam: A Case–Control Study

Hoang¹,

Dao²,

Minodier³

et al. 2019

JEGH

View full text Add to dashboard Cite

Vietnam is one of the 15 countries where the prevalence of child pneumonia is highest. It is a major cause of admission in pediatric hospitals. However, little is known on the burden of severe pneumonia and their risk factors in children <5 years of age in Vietnam. A case-control study was conducted among children aged 2-59 months presenting with pneumonia at the Pediatric Provincial Hospital of Thai Binh. Cases were children with severe pneumonia while controls included those with non-severe pneumonia as defined by the World Health Organization (WHO) classification of 2005. Eighty-three cases and 83 controls were included. Sex ratio was 2.19. Children with severe pneumonia were significantly less likely to receive antibiotics preadmission compared to children with non-severe pneumonia [odds ratio (OR) = 0.16, 95% confidence interval (CI) = 0.06-0.42]. The main risk factors of severe pneumonia were a lack of immunization (OR = 4.77, 95% CI = 1.80-12.65), an exposure to cigarette smoke (OR = 3.87, 95% CI = 1.62-9.23), and having a mother with a low level of education. Children with severe pneumonia were 25 times more likely to present with associated measles with p < 0.0001 and five times more likely to present with diarrhea than children with non-severe pneumonia (p < 0.0001). Improving immunization coverage, educating parents about the risks of passive smoking and the recognition of respiratory distress signs, and facilitating early antibiotic access for infants with acute pulmonary disease should reduce the burden of such illnesses. To implement a national, multicenter study about pneumonia in children, more precise inclusion criteria should be chosen, including radiological and/or biological assessment.

show abstract

“…Acute respiratory infections (ARI) are the leading cause of child mortality in developing countries accounting for 1.3 million deaths annually [17]. Worldwide, tropics hold significant percentage of cases: India-14% [18], Nepal-28.4%, Thailand-18.2% and Vietnam-27.9% in 2017 [19]. The scenario is reasonably similar in Sri Lanka; in 2015, respiratory diseases (most common being acute upper and lower respiratory infections (ALRI, AURI), asthma, bronchiolitis, pneumonia and tonsillitis) were the third commonest cause of hospitalization at all ages [20].…”

Section: Introductionmentioning

confidence: 99%

Impact of microbial air quality in preschools on paediatric respiratory health

et al. 2019

View full text Add to dashboard Cite

Microbial air quality (MAQ) is unambiguously linked with one's health particularly in pulmonology. Children remain more vulnerable in acquiring airborne infections than adults. MAQ studies and management are being implemented in developed countries, yet such information and actions are scarce in developing countries. Herein, we aimed to determine the indoor and outdoor airborne microbial concentrations in a rural versus urban perspective and their association with paediatric respiratory health. Preschools, one representing an urbanized and the other, a rural area, from Kandy, Sri Lanka, were considered. Respiratory health of 146 children (age; 3-6 years) was examined, and questionnaire-based information was obtained from their parents. Air samples were taken using natural sedimentation, single-stage viable sampler and fine particulate sampler to calculate the total microbial and culturable counts. Inhalation dose rates were calculated as per standard reference values. Microorganisms were identified using 16SrRNA sequencing. Accordingly, 57.97% (n = 40) urban and 31.17% (n = 24) rural subjects suffered from at least one respiratory disease, upper respiratory tract infections, rhinitis, wheeze, etc. High total microbial counts (cells/m 3) were seen in urban preschool (indoor: 4.66 × 10 5 vs. 2.45 × 10 5 , outdoor: 4.29 × 10 4 vs. 2.74 × 10 4). Inhalation dose rates were high in urban preschool, both indoor and outdoor (2.00 × 10 4 and 1.05 × 10 4 cells/kg day). Irrespective of the site, indoor microbial counts were high and majority were opportunistic pathogens: Pseudomonas stutzeri, P. fluorescens, P. putida, Brevundimonas diminuta, Enterobacter cloacae, Bacillus pumilus, Acinetobacter calcoaceticus, B. cereus, Pseudoescherichia vulneris and Morganella morganii. Accordingly, observed dynamics can be a risk factor for the higher respiratory disease prevalence seen among urban preschoolers.

show abstract

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

Abstract: Acute respiratory infection is a major cause of paediatric hospitalisation in Viet Nam, characterised by prolonged hospitalisation for relatively mild disease. There is huge potential to reduce unnecessary hospital admission and cost.

Cited by 20 publications

References 24 publications

Antibiotic use in children hospitalised with pneumonia in Central Vietnam

Antibiotic use in children hospitalised with pneumonia in Central Vietnam

Risk Factors for Severe Pneumonia According to WHO 2005 Criteria Definition Among Children <5 Years of Age in Thai Binh, Vietnam: A Case–Control Study

Impact of microbial air quality in preschools on paediatric respiratory health

Contact Info

Product

Resources

About