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dc.contributor.authorTapia, Milagritos D
dc.contributor.authorSylla, Mamadou
dc.contributor.authorDriscoll, Amanda J
dc.contributor.authorTouré, Aliou
dc.contributor.authorKourouma, Nana
dc.contributor.authorSissoko, Seydou
dc.contributor.authorTamboura, Boubou
dc.contributor.authorDiakité, Abdoul Aziz
dc.contributor.authorPanchalingam, Sandra
dc.contributor.authorKeïta, Adama M
dc.contributor.authorTennant, Sharon
dc.contributor.authorOnwuchekwa, Uma
dc.contributor.authorRoose, Anna
dc.contributor.authorDeloria Knoll, Maria
dc.contributor.authorHigdon, Melissa M
dc.contributor.authorProsperi, Christine
dc.contributor.authorHammitt, Laura L
dc.contributor.authorFeikin, Daniel R
dc.contributor.authorMurdoch, David R
dc.contributor.authorO'Brien, Katherine L
dc.contributor.authorSow, Samba O
dc.contributor.authorKotloff, Karen L
dc.date.accessioned2021-09-23T20:05:41Z
dc.date.available2021-09-23T20:05:41Z
dc.date.issued2021-09-01
dc.identifier.urihttp://hdl.handle.net/10713/16703
dc.description.abstractBackground: 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.en_US
dc.description.urihttps://doi.org/10.1097/INF.0000000000002767en_US
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc8448406/en_US
dc.language.isoenen_US
dc.publisherWolters Kluwer Healthen_US
dc.relation.ispartofPediatric Infectious Disease Journalen_US
dc.rightsCopyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.en_US
dc.subjectPneumonia Etiology Research for Child Healthen_US
dc.subject.meshChilden_US
dc.subject.meshStreptococcus pneumoniaeen_US
dc.subject.meshChild Healthen_US
dc.subject.meshMalien_US
dc.subject.meshMultiplex Polymerase Chain Reactionen_US
dc.subject.meshMycobacterium tuberculosisen_US
dc.subject.meshHIV Infectionsen_US
dc.titleThe Etiology of Childhood Pneumonia in Mali: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Studyen_US
dc.typeArticleen_US
dc.identifier.doi10.1097/INF.0000000000002767
dc.identifier.pmid34448741
dc.source.volume40
dc.source.issue9S
dc.source.beginpageS18
dc.source.endpageS28
dc.source.countryUnited States


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