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JMIR Res Protoc. 2019 Jan 10;8(1):e10854. doi: 10.2196/10854.
Determining the Cause of Death Among Children Hospitalized With Respiratory Illness in Kenya: Protocol for Pediatric Respiratory Etiology Surveillance Study (PRESS).
Njuguna HN1, Zaki SR2, Roberts DJ3, Fligner CL4, Keating MK2, Rogena E5, Walong E5, Gachii AK6, Maleche-Obimbo E5, Irimu G5, Mathaiya J5, Orata N5, Lopokoiyit R5, Maina J5, Emukule GO7, Onyango CO8, Gikunju S8, Owuor C8, Kinuthia P9, Bunei M9, Fields B1, Widdowson MA8, Mott JA10, Chaves SS7,10.
Author information
Abstract
BACKGROUND:
In sub-Saharan Africa, where the burden of respiratory disease-related deaths is the highest, information on the cause of death remains inadequate because of poor access to health care and limited availability of diagnostic tools. Postmortem examination can aid in the ascertainment of causes of death. This manuscript describes the study protocol for the Pediatric Respiratory Etiology Surveillance Study (PRESS).
OBJECTIVE:
This study protocol aims to identify causes and etiologies associated with respiratory disease-related deaths among children (age 1-59 months) with respiratory illness admitted to the Kenyatta National Hospital (KNH), the largest public hospital in Kenya, through postmortem examination coupled with innovative approaches to laboratory investigation.
METHODS:
We prospectively followed children hospitalized with respiratory illness until the end of clinical care or death. In case of death, parents or guardians were offered grief counseling, and postmortem examination was offered. Lung tissue specimens were collected using minimally invasive tissue sampling and conventional autopsy where other tissues were collected. Tissues were tested using histopathology, immunohistochemistry, and multipathogen molecular-based assays to identify pathogens. For each case, clinical and laboratory data were reviewed by a team of pathologists, clinicians, laboratorians, and epidemiologists to assign a cause of and etiology associated with death.
RESULTS:
We have enrolled pediatric cases of respiratory illness hospitalized at the KNH at the time of this submission; of those, 14.8% (140/945) died while in the hospital. Both analysis and interpretation of laboratory results and writing up of findings are expected in 2019-2020.
CONCLUSIONS:
Postmortem studies can help identify major pathogens contributing to respiratory-associated deaths in children. This information is needed to develop evidence-based prevention and treatment policies that target important causes of pediatric respiratory mortality and assist with the prioritization of local resources. Furthermore, PRESS can provide insights into the interpretation of results using multipathogen testing platforms in resource-limited settings.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):
DERR1-10.2196/10854.
?Henry N Njuguna, Sherif R Zaki, Drucilla J Roberts, Corinne L Fligner, M Kelly Keating, Emily Rogena, Edwin Walong, Andrew K Gachii, Elizabeth Maleche-Obimbo, Grace Irimu, John Mathaiya, Noelle Orata, Rosemarie Lopokoiyit, Jackson Maina, Gideon O Emukule, Clayton O Onyango, Stella Gikunju, Collins Owuor, Peter Kinuthia, Milka Bunei, Barry Fields, Marc-Alain Widdowson, Joshua A Mott, Sandra S Chaves. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.01.2019.
KEYWORDS:
cause of death; etiology; infectious disease; mortality; pneumonia; postmortem; respiratory illness
PMID: 30632968 DOI: 10.2196/10854
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Determining the Cause of Death Among Children Hospitalized With Respiratory Illness in Kenya: Protocol for Pediatric Respiratory Etiology Surveillance Study (PRESS).
Njuguna HN1, Zaki SR2, Roberts DJ3, Fligner CL4, Keating MK2, Rogena E5, Walong E5, Gachii AK6, Maleche-Obimbo E5, Irimu G5, Mathaiya J5, Orata N5, Lopokoiyit R5, Maina J5, Emukule GO7, Onyango CO8, Gikunju S8, Owuor C8, Kinuthia P9, Bunei M9, Fields B1, Widdowson MA8, Mott JA10, Chaves SS7,10.
Author information
Abstract
BACKGROUND:
In sub-Saharan Africa, where the burden of respiratory disease-related deaths is the highest, information on the cause of death remains inadequate because of poor access to health care and limited availability of diagnostic tools. Postmortem examination can aid in the ascertainment of causes of death. This manuscript describes the study protocol for the Pediatric Respiratory Etiology Surveillance Study (PRESS).
OBJECTIVE:
This study protocol aims to identify causes and etiologies associated with respiratory disease-related deaths among children (age 1-59 months) with respiratory illness admitted to the Kenyatta National Hospital (KNH), the largest public hospital in Kenya, through postmortem examination coupled with innovative approaches to laboratory investigation.
METHODS:
We prospectively followed children hospitalized with respiratory illness until the end of clinical care or death. In case of death, parents or guardians were offered grief counseling, and postmortem examination was offered. Lung tissue specimens were collected using minimally invasive tissue sampling and conventional autopsy where other tissues were collected. Tissues were tested using histopathology, immunohistochemistry, and multipathogen molecular-based assays to identify pathogens. For each case, clinical and laboratory data were reviewed by a team of pathologists, clinicians, laboratorians, and epidemiologists to assign a cause of and etiology associated with death.
RESULTS:
We have enrolled pediatric cases of respiratory illness hospitalized at the KNH at the time of this submission; of those, 14.8% (140/945) died while in the hospital. Both analysis and interpretation of laboratory results and writing up of findings are expected in 2019-2020.
CONCLUSIONS:
Postmortem studies can help identify major pathogens contributing to respiratory-associated deaths in children. This information is needed to develop evidence-based prevention and treatment policies that target important causes of pediatric respiratory mortality and assist with the prioritization of local resources. Furthermore, PRESS can provide insights into the interpretation of results using multipathogen testing platforms in resource-limited settings.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):
DERR1-10.2196/10854.
?Henry N Njuguna, Sherif R Zaki, Drucilla J Roberts, Corinne L Fligner, M Kelly Keating, Emily Rogena, Edwin Walong, Andrew K Gachii, Elizabeth Maleche-Obimbo, Grace Irimu, John Mathaiya, Noelle Orata, Rosemarie Lopokoiyit, Jackson Maina, Gideon O Emukule, Clayton O Onyango, Stella Gikunju, Collins Owuor, Peter Kinuthia, Milka Bunei, Barry Fields, Marc-Alain Widdowson, Joshua A Mott, Sandra S Chaves. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.01.2019.
KEYWORDS:
cause of death; etiology; infectious disease; mortality; pneumonia; postmortem; respiratory illness
PMID: 30632968 DOI: 10.2196/10854
Free full text