(2021) The etiology of pneumonia in HIV-uninfected children in Kilifi, Kenya : findings from the pneumonia etiology research for child health (PERCH) Study. The Pediatric infectious disease journal, 40 (9S). S29-S39. doi:10.1097/INF.0000000000002653

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Abstract

In the 1980s, Streptococcus pneumoniae and Haemophilus influenzae were identified as the principal causes of severe pneumonia in children. We investigated the etiology of severe childhood pneumonia in Kenya after introduction of conjugate vaccines against H. influenzae type b, in 2001, and S. pneumoniae, in 2011. We conducted a case-control study between August 2011 and November 2013 among residents of the Kilifi Health and Demographic Surveillance System 28 days to 59 months of age. Cases were hospitalized at Kilifi County Hospital with severe or very severe pneumonia according to the 2005 World Health Organization definition. Controls were randomly selected from the community and frequency matched to cases on age and season. We tested nasal and oropharyngeal samples, sputum, pleural fluid, and blood specimens and used the Pneumonia Etiology Research for Child Health Integrated Analysis, combining latent class analysis and Bayesian methods, to attribute etiology. We enrolled 630 and 863 HIV-uninfected cases and controls, respectively. Among the cases, 282 (44%) had abnormal chest radiographs (CXR positive), 33 (5%) died in hospital, and 177 (28%) had diagnoses other than pneumonia at discharge. Among CXR-positive pneumonia cases, viruses and bacteria accounted for 77% (95% CrI: 67%-85%) and 16% (95% CrI: 10%-26%) of pneumonia attribution, respectively. Respiratory syncytial virus, S. pneumoniae and H. influenza, accounted for 37% (95% CrI: 31%-44%), 5% (95% CrI: 3%-9%), and 6% (95% CrI: 2%-11%), respectively. Respiratory syncytial virus was the main cause of CXR-positive pneumonia. The small contribution of H. influenzae type b and pneumococcus to pneumonia may reflect the impact of vaccine introductions in this population. [Abstract copyright: Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.]

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology R Medicine > RA Public aspects of medicine R Medicine > RJ Pediatrics
Divisions:	Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
SWORD Depositor:	Library Publications Router
Library of Congress Subject Headings (LCSH):	Pneumonia , Pneumonia in children , Pneumonia in children -- Kenya -- Kilifi, Pneumonia -- Etiology
Journal or Publication Title:	The Pediatric infectious disease journal
Publisher:	Lippincott Williams & Wilkins
ISSN:	1532-0987
Official Date:	1 September 2021
Dates:	Date Event 1 September 2021 Published 13 January 2020 Accepted
Volume:	40
Number:	9S
Page Range:	S29-S39
DOI:	10.1097/INF.0000000000002653
Status:	Peer Reviewed
Publication Status:	Published
Reuse Statement (publisher, data, author rights):	** From PubMed via Jisc Publications Router
Access rights to Published version:	Open Access
Copyright Holders:	Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID 48968 Bill and Melinda Gates Foundation http://dx.doi.org/10.13039/100000865 107769/Z/10/Z Wellcome Trust http://dx.doi.org/10.13039/100010269 098532 Wellcome Trust http://dx.doi.org/10.13039/100010269 203077/Z/16/Z Wellcome Trust http://dx.doi.org/10.13039/100010269

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