The Etiology of Childhood Pneumonia in Mali: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study
Author
Tapia, Milagritos DSylla, Mamadou
Driscoll, Amanda J
Touré, Aliou
Kourouma, Nana
Sissoko, Seydou
Tamboura, Boubou
Diakité, Abdoul Aziz
Panchalingam, Sandra
Keïta, Adama M
Tennant, Sharon
Onwuchekwa, Uma
Roose, Anna
Deloria Knoll, Maria
Higdon, Melissa M
Prosperi, Christine
Hammitt, Laura L
Feikin, Daniel R
Murdoch, David R
O'Brien, Katherine L
Sow, Samba O
Kotloff, Karen L
Date
2021-09-01Journal
Pediatric Infectious Disease JournalPublisher
Wolters Kluwer HealthType
Article
Metadata
Show full item recordSee at
https://doi.org/10.1097/INF.0000000000002767http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8448406/
Abstract
Background: We present findings from the Pneumonia Etiology Research for Child Health (PERCH) site in Bamako, Mali. Methods: Cases were patients 28 days to 59 months of age, admitted to hospital with severe or very severe pneumonia (2005 World Health Organization definition). Community controls were frequency matched by age. Both provided nasopharyngeal and oropharyngeal swabs for multiplex polymerase chain reaction and Streptococcus pneumoniae culture. Cases underwent blood culture and induced sputum culture for Mycobacterium tuberculosis. A subset had pleural fluid and lung aspirates collected for culture and polymerase chain reaction. Primary analyses included participants with negative or unknown HIV status (HIV-) and cases with abnormal chest radiographs (CXR+). Cases and controls were compared using logistic regression adjusting for age. Etiologic fractions were calculated by a Bayesian nested partially latent class analysis, the PERCH integrated analysis. Results: Between January 1, 2012, and January 14, 2014, we enrolled 241 CXR+/HIV- cases and 725 HIV- controls. Compared with controls, cases were more likely to have moderate-to-severe wasting (43.1% vs. 14.1%, P < 0.001) and stunting (26.6% vs. 9.4%, P < 0.001). Predominant etiologies were respiratory syncytial virus [24.0%; 95% credible interval (CrI): 18.3%-31.1%], S. pneumoniae (15.2%; 95% CrI: 9.5-21.6), human metapneumovirus (11.8%; 95% CrI: 8.3%-16.2%) and parainfluenza virus type 3 (9.0%; 95% CrI: 5.8%-13.3%). Case fatality was 13.3%, with Staphylococcus aureus, Pneumocystis jirovecii and Haemophilus influenzae type b predominating (40% of fatal cases). Conclusions: PERCH uncovered high case fatality among children with severe pneumonia in Mali, highlighting a role for new interventions (eg, respiratory syncytial virus vaccines) and a need to improve vaccine coverage and strengthen healthcare delivery.Rights/Terms
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.Keyword
Pneumonia Etiology Research for Child HealthChild
Streptococcus pneumoniae
Child Health
Mali
Multiplex Polymerase Chain Reaction
Mycobacterium tuberculosis
HIV Infections
Identifier to cite or link to this item
http://hdl.handle.net/10713/16703ae974a485f413a2113503eed53cd6c53
10.1097/INF.0000000000002767
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