Etiologic Agents and Outcome Determinants of Community-Acquired Pneumonia in Urban Children: A Hospital-Based Study

Johnson, Austin; Osinusi, K; Adérele, W. I.; Gbadero, Daniel; Olaleye, O.D.; Adeyemi-Doro, F. A. B.

doi:10.1016/s0027-9684(15)31269-4

Cited by 66 publications

(65 citation statements)

References 29 publications

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“…The results for children presenting at the hospital are similar to those of recent investigations showing that S. aureus was the most frequent cause of communityacquired bacteremia caused by Gram-positive organisms in infants and young children in Nigeria and Mozambique, respectively (17,34). Consistent with previous studies of areas of sub-Saharan Africa where malaria is endemic, which showed that NTS are the most common invasive bacteria associated with elevated pediatric morbidity and mortality (4,9,15,36), NTS were the most common isolates obtained from children with malaria presenting at SDH.…”

Section: Discussionsupporting

confidence: 85%

Bacteremia in Kenyan Children Presenting with Malaria

et al. 2011

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Since the etiologies and clinical outcomes of bacteremia in children with Plasmodium falciparum infections, particularly in areas of holoendemic malaria transmission, are largely unexplored, blood cultures and comprehensive clinical, laboratory, hematological, and nutritional parameters for malaria-infected children (aged 1 to 36 months, n ‫؍‬ 585 patients) were investigated at a rural hospital in western Kenya. After the exclusion of contaminant microorganisms, the prevalence of bacteremia was 11.7% in the cohort (n ‫؍‬ 506), with nontyphoidal Salmonella spp. being the most common isolates (42.4%). Bacteremia was found to occur in a significantly higher proportion of females than males and was associated with elevated blood glucose concentrations and lowered malaria parasite and hemoglobin (Hb) levels compared to those in abacteremic participants. In addition, the incidences of respiratory distress and severe malarial anemia (SMA; Hb level of <6.0g/dl) were nonsignificantly greater in children with bacteremia. Mortality was 8.5-fold higher in children with bacteremia. Multivariate logistic regression analyses revealed that bacteremia was significantly associated with reduced incidences of high-density parasitemia (HDP; >10,000/l) and increased incidences of malnutrition (i.e., underweight; weight-for-age Z score of <؊2 using the NCHS system). Since previous studies showed that bacteremia caused by Gram-negative organisms is associated with enhanced anemia and mortality, multivariate logistic regression was also performed separately for randomly age-and gender-matched children with bacteremia caused by Gram-negative organisms (n ‫؍‬ 37) and for children found to be abacteremic (n ‫؍‬ 74). These results revealed that the presence of bacteremia caused by Gram-negative organisms was significantly associated with reduced HDP, enhanced susceptibility to respiratory distress, SMA (Hb level of <6.0 g/dl), and being underweight (Z score, <؊2). Data presented here from a region of holoendemic P. falciparum transmission demonstrate that although bacteremia is associated with reduced malaria parasitemia, a number of unfavorable clinical outcomes, including malnutrition, respiratory distress, anemia, and mortality, are elevated in children with bacteremia, particularly in cases of Gram-negative origin.

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Section: Discussionsupporting

confidence: 85%

Bacteremia in Kenyan Children Presenting with Malaria

et al. 2011

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“…The overall prevalence of CAP in Africa is unknown, due to the lack of standardized protocols and reporting. A study in Uganda reported Klebsiella pneumoniae as the prevalent pathogen in neonates and S. pneumoniae was the most common etiological agent in those aged between 3 months and 5 years [43][44][45].…”

Section: Cap: Epidemiologymentioning

confidence: 99%

Pneumonia: A Challenging Health Concern with the Climate Change

Kayembe¹,

Kayembe²

2017

Contemporary Topics of Pneumonia

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Pneumonia is still a global health concern with high mortality rate, mainly among children under 5 years and adults over 65 years. In addition to pathogen virulence, immunoevasion capacity, and drug resistance ability, risk factors for the patient include aging, comorbidities, malnutrition, and all causes affecting the immune system. The extent to which environmental disorders affect the respiratory health is established for chronic diseases such as asthma, COPD, and cardiovascular diseases, but less is known about the underlying mechanisms of their impact on infectious diseases of the respiratory system. This chapter aims to recall the epidemiology, diagnosis, and treatment of pneumonia, with a focus on the impact of climate change and related risk factors on acute low tract respiratory infections.

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“…[121] Etiologic studies of pediatric hospitalizations for acute lower respiratory tract infections have identified influenza to be associated with 2-23% of admissions, with most large studies identifying influenza virus in 5-10% of hospitalized children in both developed and developing countries. [122][123][124][125][126][127][128][129][130][131][132][133][134][135][136][137][138][139][140] Rates of influenza-associated hospitalizations are primarily available from developed countries, where approximately 1-3 hospitalizations per 1000 child-years have been observed. [113,114,117,[141][142][143][144][145] Influenza-associated hospitalization rates are higher among children with cardiac and pulmonary conditions than among healthy children.…”

Section: Disease Burdenmentioning

confidence: 99%