Severe Pneumonia in Mozambican Young Children: Clinical and Radiological Characteristics and Risk Factors

Sigaùque, Betuel; Roca, Anna; Bassat, Quique; Morais, Luís; Quintó, Llorenç; Berenguera, Anna; Machevo, Sónia; Bardají, Azucena; Corachán, M; Ribó, Josep; Menéndez, Clara; Schuchat, Anne; Flannery, Brendan; Soriano‐Gabarró, Montse; Alonso, Pedro L.

doi:10.1093/tropej/fmp030

Cited by 53 publications

(81 citation statements)

References 32 publications

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“…HIV has been established as a strong risk factor for pneumonia and IPD [2,29]. Recent data from the same hospital show a 26% prevalence of HIV infection among children under 2 years of age admitted to hospital between March 2005-2006 with severe pneumonia [30]. Taking into account that S. pneumoniae is the leading cause of severe pneumonia in children, we can assume that the prevalence of HIV infection among cases included in our study would be remarkable.…”

Section: Paediatric Respiratory Infections X Vallès Et Almentioning

confidence: 74%

Serotype-specific pneumococcal disease may be influenced by mannose-binding lectin deficiency

Vallès¹,

Roca²,

Lozano³

et al. 2010

European Respiratory Journal

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Previous studies of the association between the mannose-binding lectin pathway deficiencies and invasive pneumococcal disease are inconclusive. Invasiveness of Streptococcus pneumoniae is dependent on serotype. We aimed to determine the association between invasive pneumococcal disease and MBL2 and MASP2 genetic variants, regarding serotype distribution.A hospital-based case-control study was conducted in children admitted to hospital in rural Mozambique in June 2002-November 2003. The study included children admitted to hospital with invasive pneumococcal disease, in whom S. pneumoniae was isolated from blood and subsequently serotyped. Sequence-based typing analysis of amplicons covering the polymorphic regions of MASP2 (exon 3) and MBL2 (promoter and exon 1) was performed.An overall high frequency of MBL2 genotypes associated with low serum levels of MBL (43%) was found. Carriers of MBL-deficient genotypes were associated with invasive pneumococcal disease produced by low-invasive serotypes (OR 5.55, p50.01).Our data suggest that susceptibility to pneumococcal disease among MBL-deficient patients may be influenced by serotype invasiveness. Type-specific capsular serotype of S. pneumoniae would need to be taken into account in further genetic association studies of invasive pneumococcal disease.

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Section: Paediatric Respiratory Infections X Vallès Et Almentioning

confidence: 74%

Serotype-specific pneumococcal disease may be influenced by mannose-binding lectin deficiency

Vallès¹,

Roca²,

Lozano³

et al. 2010

European Respiratory Journal

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“…22 Severe pneumonia accounted for 16% of hospitalizations among children less than two years of age, and had an associated case-fatality rate (CFR) of 11%. 23 Verbal autopsy studies confirmed from the community perspective that these two conditions are the leading causes of death in children less than five years of age. …”

mentioning

confidence: 89%

“…Treatment of malaria or severe pneumonia was conducted according to national guidelines, and has been described. 23,26 Antibiotic therapy was reassessed according to culture results and sensitivity patterns. Children requiring specialized care were transferred to Maputo Central Hospital.…”

mentioning

confidence: 99%

Distinguishing Malaria from Severe Pneumonia among Hospitalized Children who Fulfilled Integrated Management of Childhood Illness Criteria for Both Diseases: A Hospital-Based Study in Mozambique

Bassat¹,

Machevo²,

O’Callaghan-Gordo³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. Malaria and severe pneumonia in hospitalized young children may show striking clinical similarities, making differential diagnosis challenging. We investigated ways to increase diagnostic accuracy in patients hospitalized with clinical symptoms compatible with malaria and severe pneumonia, in an area with high a prevalence of infection with human immunodeficiency virus. A total of 646 children admitted at the Manhiça District Hospital in Manhiça, Mozambique who met the World Health Organization clinical criteria for severe pneumonia and malaria were recruited for 12 months and thoroughly investigated to ascertain an accurate diagnosis. Although symptom overlap between malaria and severe pneumonia was frequent among hospitalized children, true disease overlap was uncommon. Clinical presentation and laboratory determinations were ineffective in reliably distinguishing between the two diseases. Infection with human immunodeficiency virus differentially influenced the epidemiology and clinical presentation of these two infectious diseases, further challenging their discrimination on clinical grounds, and having a greater impact on the current burden and prognosis of severe pneumonia. Malaria and pneumonia in the study area. At the time of the study, malaria in Manhiça accounted for one-third of all outpatient visits, 19 half of the pediatric admissions, and 19% of all in-hospital pediatric deaths. 22 A total of 11.1% of all malaria admissions and 41.1% of severe malaria cases had severe respiratory findings. 22 Severe pneumonia accounted for 16% of hospitalizations among children less than two years of age, and had an associated case-fatality rate (CFR) of 11%. 23 Verbal autopsy studies confirmed from the community perspective that these two conditions are the leading causes of death in children less than five years of age. 24Procedures for recruited children and sample collection. This study was part of a larger project designed to describe the epidemiology and clinical characteristics of children less than five years of age admitted with respiratory distress. However, this analysis includes only patients simultaneously fulfilling at admission IMCI-defined clinical criteria for malaria (fever or a history of fever in the preceding 24 hours) and severe pneumonia (cough and/or breathing difficulties, plus chest indrawing with or without increased respiratory rate according to age group). Children fulfilling inclusion criteria and whose parents had signed an informed consent form underwent a series of standardized procedures. Anteroposterior chest radiographs were obtained on admission or otherwise within the first 48 hours of hospitalization according to severity. Pulse oximetry (Nellcor, Boulder, CO) was used to determine oxygen saturation, and nasopharyngeal aspirates were performed for diagnosis of respiratory viruses by using NPAK ® Kits (MPRO, Farmington Hills, MI). Venous blood was obtained at admission for malaria diagnosis, blood culture, full blood cell count, and biochemical determinations.HIV-spe...

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“…Para avaliar os fatores associados à pneumonia severa entre crianças menores de dois anos internadas em Moçambique, na África, Sigaúque et al (2009) conduziram um estudo transversal que identificou a anemia (OR=10,13), a desnutrição (OR=2,42) e a co-infecção com HIV (OR=17,21) como fatores de risco para a morte pela doença. A desnutrição e a anemia severas, associadas com a pneumonia grave, também estariam associadas à infecção pelo HIV.…”

Section: Ira Em Crianças Menores De Cinco Anos De Idade Aunclassified

“…Os benefícios do aleitamento materno para as crianças têm sido relacionados às menores taxas de diarreia, infecções do trato respiratório, otite média e outras infecções, e menor mortalidade por essas doenças em crianças amamentadas quando comparadas às não amamentadas (LEÓN-CAVA et al, 2002 Por fim, sem a pretensão de esgotar as possibilidades de atenção à criança na APS, destaca-se a importância do acompanhamento, controle e manejo de condições crônicas capazes de predispor a criança a um quadro grave de pneumonia, como as doenças de base pulmonar, as doenças cardiovasculares, as neuropatias graves, as doenças metabólicas e as imunológicas (JACKSON et al, 2013;NASCIMENTO-CARVALHO et al, 2002;RAMACHANDRAN, et al, 2012;SIGAÚQUE et al, 2009).…”

Section: Identificou Que Ounclassified

Abordagem hierarquizada para a identificação de fatores associados à hospitalização por pneumonia, em menores de cinco anos de idade: estudo caso-controle

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Severe Pneumonia in Mozambican Young Children: Clinical and Radiological Characteristics and Risk Factors

Cited by 53 publications

References 32 publications

Serotype-specific pneumococcal disease may be influenced by mannose-binding lectin deficiency

Serotype-specific pneumococcal disease may be influenced by mannose-binding lectin deficiency

Distinguishing Malaria from Severe Pneumonia among Hospitalized Children who Fulfilled Integrated Management of Childhood Illness Criteria for Both Diseases: A Hospital-Based Study in Mozambique

Abordagem hierarquizada para a identificação de fatores associados à hospitalização por pneumonia, em menores de cinco anos de idade: estudo caso-controle

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