The Epidemiology and Aetiology of Infections in Children Admitted with Clinical Severe Pneumonia to a University Hospital in Rabat, Morocco

Jroundi, Imane; Mahraoui, Chafiq; Benmessaoud, Rachid; Moraleda, Cinta; Tligui, H.; Seffar, Myriam; Kettani, Selma Cherif; Benjelloun, Badr Sououd; Chaacho, Saad; Maaroufi, A; Hayes, Edward B.; Álvarez-Martínez, Míriam J.; Muñoz-Almagro, Carmen; Ruiz, Joaquı́m; Alonso, Pedro L.; Bassat, Quique

doi:10.1093/tropej/fmu010

Cited by 36 publications

(71 citation statements)

References 21 publications

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“…Thirty‐seven studies from 24 countries published between 2002 and 2014, with suitable case fatality data among children <5 years of age with community‐acquired, medically attended, confirmed RSV‐ARI were included in the mortality analysis. The case fatality estimates (reported per 1,000 children) were stratified according to age and region (Table ).…”

Section: Resultsmentioning

confidence: 99%

Respiratory syncytial virus hospitalization and mortality: Systematic review and meta‐analysis

Stein

Bont

Zar

et al. 2016

Pediatric Pulmonology

257

206

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SummaryBackground: Respiratory syncytial virus (RSV) is a major public health burden worldwide. We aimed to review the current literature on the incidence and mortality of severe RSV in children globally. Methods: Systematic literature review and meta‐analysis of published data from 2000 onwards, reporting on burden of acute respiratory infection (ARI) due to RSV in children. Main outcomes were hospitalization for severe RSV‐ARI and death. Results: Five thousand two hundred and seventy‐four references were identified. Fifty‐five studies were included from 32 countries. The global RSV‐ARI hospitalization estimates, reported per 1,000 children per year (95% Credible Interval (CrI), were 4.37 (2.98, 6.42) among children <5 years, 19.19 (15.04, 24.48) among children <1 year, 20.01 (9.65, 41.31) among children <6 months and 63.85 (37.52, 109.70) among premature children <1 year. The RSV‐ARI global case‐fatality estimates, reported per 1,000 children, (95% Crl) were 6.21 (2.64, 13.73) among children <5 years, 6.60 (1.85, 16.93) for children <1 year, and 1.04 (0.17, 12.06) among preterm children <1 year. Conclusions: A substantial proportion of RSV‐associated morbidity occurs in the first year of life, especially in children born prematurely. These data affirm the importance of RSV disease in the causation of hospitalization and as a significant contributor to pediatric mortality and further demonstrate gestational age as a critical determinant of disease severity. An important limitation of case‐fatality ratios is the absence of individual patient characteristics of non‐surviving patients. Moreover, case‐fatality ratios cannot be translated to population‐based mortality. Pediatr Pulmonol. 2017;52:556–569. © 2016 The Authors. Pediatric Pulmonology. Published by Wiley Periodicals, Inc.

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Section: Resultsmentioning

confidence: 99%

Respiratory syncytial virus hospitalization and mortality: Systematic review and meta‐analysis

Stein

Bont

Zar

et al. 2016

Pediatric Pulmonology

257

206

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“…Serotype was reported in 15 studies, primarily from Southern Africa (92.3%), 23,35,36 with 14,154 isolates from sterile sites 15,23,29,30,33,35–44 and 4 studies with 333 isolates from noninvasive sites (nasopharyngeal and respiratory tract, ear pus, ocular). 29,37,43,45 The most common serotypes causing invasive disease (12,896 isolates) were serotype 14 (16.7%), followed by serotypes 6B and 6A (14.1% and 12.6%, respectively), serotype 23F (12.0%), and serotypes 19F and 19A (10.7% and 7.6% respectively; Figure 4).…”

Section: Resultsmentioning

confidence: 99%

“…29,37,43,45 The most common serotypes causing invasive disease (12,896 isolates) were serotype 14 (16.7%), followed by serotypes 6B and 6A (14.1% and 12.6%, respectively), serotype 23F (12.0%), and serotypes 19F and 19A (10.7% and 7.6% respectively; Figure 4). The most common serotypes identified in noninvasive studies were 19B/C/F (20.4%), nontypeable/serotypes of unknown designation (16.8%), 6/A/B (15.6%), and serotype 14 (11.7%).…”

Section: Resultsmentioning

confidence: 99%

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

Tam

Thielen

Obaro

et al. 2017

Vaccine

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Background Determining the incidence, disease-associated serotypes and antimicrobial susceptibility of invasive pneumococcal disease (IPD) among children in Africa is essential in order to monitor the impact of these infections prior to widespread introduction of the pneumococcal conjugate vaccine (PCV). Methods To provide updated estimates of the incidence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae causing disease in Africa, we performed a systematic review of articles published from 2000–2015 using Ovid Medline and Embase. We included prospective and surveillance studies that applied predefined diagnostic criteria. Meta-analysis for all pooled analyses was based on random-effects models. Results We included 38 studies consisting of 386,880 participants in 21 countries over a total of 350,613 person-years. The pooled incidence of IPD was 62.6 (95% CI 16.9, 226.5) per 100,000 person-years, including meningitis which had a pooled incidence of 24.7 (95% CI 11.9, 51.6) per 100,000 person-years. The pooled prevalence of penicillin susceptibility was 78.1% (95% CI 61.9, 89.2). Cumulatively, PCV10 and PCV13 included 66.9% (95% CI 55.9, 76.7) and 80.6% (95% CI 66.3, 90.5) of IPD serotypes, respectively. Conclusions Our study provides an integrated and robust summary of incidence data, serotype distribution and antimicrobial susceptibility for S. pneumoniae in children ≤5 years of age in Africa prior to widespread introduction of PCV on the continent. The heterogeneity of studies and wide range of incidence rates across the continent indicate that surveillance efforts should be intensified in all regions of Africa to improve the integrity of epidemiologic data, vaccine impact and cost benefit. Although the incidence of IPD in young children in Africa is substantial, currently available conjugate vaccines are estimated to cover the majority of invasive disease-causing pneumococcal serotypes. These data provide a reliable baseline from which to monitor the impact of the broad introduction of PCV.

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“…[15] In this same study, a full panel of respiratory viruses was screened among all study participants (n=700), yielding extremely high (>90%) nasopharyngeal mono or multiples infection rates. Most commonly identified viruses included Rhinovirus followed by respiratory syncytial virus (RSV) and Adenovirus.…”

Section: Resultsmentioning

confidence: 99%

“…Another study conducted in a hospital setting described slightly higher exposure rates (up to 40%) among children admitted with ARI [15]. …”

Section: Resultsmentioning

confidence: 99%

Knowledge gaps on paediatric respiratory infections in Morocco, Northern Africa

Jroundi

Mahraoui²,

Benmessaoud

et al. 2015

Arch Public Health

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BackgroundThe burden of acute respiratory infections (ARI) among Moroccan children remains significant. However, scarce information is available regarding trends in its epidemiology and etiology, or regarding its associated prognostic factors.The purpose of this work was to review available data on the burden of ARI among children under five years of age in Morocco.MethodsA systematic review was conducted for the period 1997–2014 using the PRISMA proposed methodology. Various online databases were screened, in addition to physical libraries of Moroccan medical schools, and official reports of the Moroccan Ministry of Health. Search queries in English and French languages included: Respiratory Tract Infections, pneumonia, epidemiology, etiology, microbiology, mortality and Morocco. The documents were included for analysis when they reported original data on the incidence, distribution, or a clinical description of the diseases or their etiology or described clinical management or national preventive strategies.ResultsThirty-two documents were included in the final analysis. 21 of which had been published. In 2012, ARI caused 13% of paediatric deaths, half of the consultations at health facilities and third of the paediatric admissions. The microorganisms more frequently identified among hospitalized children were Streptococcus pneumoniae (38%) and Haemophilus influenza type b (Hib) (15%). The MOH introduced Hib vaccines into the national immunization program (PNI) in 2007and the 13-valent vaccine against pneumococcus in 2010. The national first line antibiotics recommended for non-severe ambulatory treatment is Amoxicillin. Studies of antibiotic resistance showed from 1998 to 2008 a 22% increase in the rate of penicillin non-susceptibility among Streptococcus pneumoniae isolates. Viral respiratory infections and the role attributed to air pollution in the incidence of ARI have been poorly characterized.ConclusionsFurther efforts should be made towards the development of adequate surveillance programs to better clarify the epidemiology, etiology, antimicrobial susceptibility patterns and the effectiveness of the preventives and curatives strategies in place against paediatric ARIs in Morocco. Additionally, a holistical approach should be used to identify the heath determinants of ARIs among children.

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The Epidemiology and Aetiology of Infections in Children Admitted with Clinical Severe Pneumonia to a University Hospital in Rabat, Morocco

Cited by 36 publications

References 21 publications

Respiratory syncytial virus hospitalization and mortality: Systematic review and meta‐analysis

Respiratory syncytial virus hospitalization and mortality: Systematic review and meta‐analysis

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

Knowledge gaps on paediatric respiratory infections in Morocco, Northern Africa

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