Lower Respiratory Tract Infections in Children in a Well-vaccinated South African Birth Cohort: Spectrum of Disease and Risk Factors

Roux, David M le; Nicol, Mark P.; Myer, Landon; Vanker, Aneesa; Stadler, Jacob A M; Delft, Eckart von; Zar, Heather J.

doi:10.1093/cid/ciz017

Cited by 39 publications

(36 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies from South Africa have shown HEU infants have an increased risk of both bacterial infections including invasive pneumococcal disease [10] and viral infections such as respiratory syncytial virus (RSV) [11]. HIV exposure has also been found to be a key risk factor for pneumonia in infants [12,13].…”

Section: Introductionmentioning

confidence: 99%

Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort

Gray

Wedderburn

MacGinty

et al. 2020

Aids

View full text Add to dashboard Cite

Objective: To assess the impact of HIV and antiretroviral exposure without infection on lung growth and function over the first 2 years of life. Design: Prospective observational study of an African birth cohort, Drakenstein Child Health Study. Method: Infants enrolled antenatally had lung function measured at 6 weeks, 1 and 2 years. HIV-infected women received antiretroviral therapy (ART) as per local guidelines. The association between HIV and antiretroviral exposure with lung function was assessed using mixed effects modelling. Results: Of 1143 infants born, two HIV-infected infants were excluded from analysis; 909 (80%) infants had lung function collected at 6 weeks [190 (21%) were HIV-exposed uninfected (HEU)]; 782 (69%) at 1 year and 741 (65%) at 2 years. At 6 weeks HEU infants had larger tidal volume compared with HIV-unexposed infants (1.13 ml, confidence interval: 0.02-2.23, P ¼ 0.045). High maternal viral load was associated with a 17% lower expiratory flow over 2 years (0.17, confidence interval 0.00-0.34, P ¼ 0.046). First-line ART initiated during pregnancy was associated with lower infant tidal volume at 6 weeks compared with those who initiated ART before pregnancy (À2.7 ml, À5.31 to À0.10, P ¼ 0.042), and low maternal CD4 þ cell counts associated with lower infant tidal over 2 years (À11.1 ml, À18.58-3.58, P ¼ 0.004). Conclusion: HIV exposure is associated with altered lung function in early life, with a vulnerable HEU subgroup based on maternal disease severity, immunological compromise and ART exposure. These data highlight the importance of ongoing surveillance of respiratory health in HEU children.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort

Gray

Wedderburn

MacGinty

et al. 2020

Aids

View full text Add to dashboard Cite

show abstract

“…2 In line with the literature, the majority of the patients in our study were male and aged 1 year or younger. 10 Factors paving the way for LRTI such as the history of passive smoking, family history of asthmaatopy, at least one family member who had a respiratory tract infection in the last month, a sibling going to school or daycare, 11 and living in the city center 12 were detected. At least one viral agent was detected in 30 (42.9%) of our patients.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey

Kar

Akın

Sert

et al. 2020

J Pediatr Infect Dis

View full text Add to dashboard Cite

Objective Lower respiratory tract infections (LRTI) are one of the most important causes of morbidity and mortality in childhood. Hypoxemia, pulmonary hypertension (PH) due to pulmonary vasoconstriction, and heart failure due to various causes are the most important risk factors for mortality in LRTI. The aim of this study was to investigate characteristics of the patients with LRTI and the frequency of PH that developed secondary to LRTI. Materials and Methods The study included 70 patients who were diagnosed as having LRTI clinically and radiologically between January 2012 and March 2013 at Department of Pediatrics, Konya Training and Research Hospital. Age, sex, risk factors for LRTI, symptoms and physical examination findings, laboratory tests, and Doppler echocardiography findings of the patients were retrospectively reviewed. Results Of the patients, 44 (62.9%) were male and 26 (37.1%) were female. Thirty-seven (52.9%) patients were younger than 1 year, and the mean age was 2.5 ± 3.11 years. The most common symptoms of the patients were cough and fever. Rhonchus, retraction, and crackles were found to be the most common findings in physical examinations. Heart failure was found in 10% of patients and PH was detected in 8.6% through Doppler echocardiography. Development of heart failure and the presence of bilateral patch infiltration on posteroanterior chest X-rays were significantly more frequent in patients with PH. Some 42.9% of patients had at least one viral agent in their nasopharyngeal swabs. The most common viral agents were respiratory syncytial virus and rhinoviruses. Conclusion PH may develop during the course of LRTI in children. Given that the development of PH can cause life-threatening complications such as heart failure, affected patients should be kept under close follow-up. It should be remembered that PH is more likely to develop in patients with bilateral patch infiltration on chest X-ray.

show abstract

“…Hypoxaemia cut-offs in Puno, Peru (located 3825 m above sea level) were based on the 10th centile for oxygen saturation of healthy children, established during formative research [27]. The cut-off for hypoxaemia at altitudes <2500 m was selected based on data from Malawi showing an increased mortality from pneumonia in children below these oxygen saturations and from contemporary child pneumonia epidemiology studies that used similar thresholds [28][29][30][31]. Repeat episodes of severe pneumonia have to be…”

Section: Case Definition Of Severe Pneumoniamentioning

confidence: 99%

Design and conduct of facility-based surveillance for severe childhood pneumonia in the Household Air Pollution Intervention Network (HAPIN) trial

et al. 2020

View full text Add to dashboard Cite

Pneumonia is both a treatable and preventable disease but remains a leading cause of death in children worldwide. Household air pollution caused by burning biomass fuels for cooking has been identified as a potentially preventable risk factor for pneumonia in low- and middle-income countries. We are conducting a randomised controlled trial of a clean energy intervention in 3200 households with pregnant women living in Guatemala, India, Peru and Rwanda. Here, we describe the protocol to ascertain the incidence of severe pneumonia in infants born to participants during the first year of the study period using three independent algorithms: the presence of cough or difficulty breathing and hypoxaemia (≤92% in Guatemala, India and Rwanda and ≤86% in Peru); presence of cough or difficulty breathing along with at least one World Health Organization-defined general danger sign and consolidation on chest radiography or lung ultrasound; and pneumonia confirmed to be the cause of death by verbal autopsy. Prior to the study launch, we identified health facilities in the study areas where cases of severe pneumonia would be referred. After participant enrolment, we posted staff at each of these facilities to identify children enrolled in the trial seeking care for severe pneumonia. To ensure severe pneumonia cases are not missed, we are also conducting home visits to all households and providing education on pneumonia to the mother. Severe pneumonia reduction due to mitigation of household air pollution could be a key piece of evidence that sways policymakers to invest in liquefied petroleum gas distribution programmes.

show abstract

Lower Respiratory Tract Infections in Children in a Well-vaccinated South African Birth Cohort: Spectrum of Disease and Risk Factors

Cited by 39 publications

References 32 publications

Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort

Impact of HIV and antiretroviral drug exposure on lung growth and function over 2 years in an African Birth Cohort

Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey

Design and conduct of facility-based surveillance for severe childhood pneumonia in the Household Air Pollution Intervention Network (HAPIN) trial

Contact Info

Product

Resources

About