tetano
Editor, Senior Moderator
Pediatr Infect Dis J. 2013 Sep 11. [Epub ahead of print]
Incidence and Etiology of Acute Lower Respiratory Tract Infections in Hospitalized Children Younger than Five Years in Rural Thailand.
Hasan R, Rhodes J, Thamthitiwat S, Olsen SJ, Prapasiri P, Naorat S, Chittaganpitch M, Henchaichon S, Dejsirilert S, Srisaengchai P, Sawatwong P, Jorakate P, Kaewpwan A, Fry AM, Erdman D, Chuananon S, Amornintapichet T, Maloney SA, Baggett HC.
Source
aCDC-Hubert Global Health Fellow bInternational Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health- US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand cInfluenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia dNational Institute of Health, Thailand Ministry of Public Health, Nonthaburi, Thailand eDivision of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia fDivision of Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia gNakhon Phanom Provincial Hospital, Nakhon Phanom, Thailand hCrown Prince Hospital, Sa Kaeo, Thailand.
Abstract
BACKGROUND::
Pneumonia remains a leading cause of under-five morbidity and mortality globally. Comprehensive incidence, epidemiologic, and etiologic data are needed to update prevention and control strategies.
METHODS::
We conducted active, population-based surveillance for hospitalized cases of acute lower respiratory infections (ALRI) among children aged <5 years in rural Thailand. ALRI cases were systematically sampled for an etiology study that tested nasopharyngeal specimens by PCR; children without ALRI were enrolled as controls from outpatient clinics.
RESULTS::
We identified 28,543 hospitalized ALRI cases from 2005-2010. Among the 49% with chest radiographs, 76% had findings consistent with pneumonia as identified by two study radiologists. The hospitalized ALRI incidence rate (IR) was 5,772 per 100,000 child-years (95% CI 5,707, 5,837), and was higher in boys vs. girls (IR Ratio (IRR) 1.38, 95% CI 1.35, 1.41) and in children aged 6-23 months vs. other age groups (IRR 1.76, 95% CI 1.69, 1.84). Viruses most commonly detected in ALRI cases were respiratory syncytial virus (RSV, 19.5%), rhinoviruses (18.7%), bocavirus (12.8%), and influenza viruses (8%). Compared to controls, ALRI cases were more likely to test positive for RSV, influenza, adenovirus, human metapneumovirus, and parainfluenza viruses 1 and 3 (p≤0.01 for all). Bloodstream infections, most commonly Streptococcus pneumoniae and non-typhoidal Salmonella, accounted for 1.8% of cases.
CONCLUSIONS::
Our findings underscore the high burden of hospitalization for ALRI and the importance of viral pathogens among children in Thailand. Interventions targeting viral pathogens coupled with improved diagnostic approaches, especially for bacteria, are critical for better understanding of ALRI etiology, prevention and control.
PMID:
24030346
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24030346
Incidence and Etiology of Acute Lower Respiratory Tract Infections in Hospitalized Children Younger than Five Years in Rural Thailand.
Hasan R, Rhodes J, Thamthitiwat S, Olsen SJ, Prapasiri P, Naorat S, Chittaganpitch M, Henchaichon S, Dejsirilert S, Srisaengchai P, Sawatwong P, Jorakate P, Kaewpwan A, Fry AM, Erdman D, Chuananon S, Amornintapichet T, Maloney SA, Baggett HC.
Source
aCDC-Hubert Global Health Fellow bInternational Emerging Infections Program, Global Disease Detection Regional Center, Thailand Ministry of Public Health- US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand cInfluenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia dNational Institute of Health, Thailand Ministry of Public Health, Nonthaburi, Thailand eDivision of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia fDivision of Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention, Atlanta, Georgia gNakhon Phanom Provincial Hospital, Nakhon Phanom, Thailand hCrown Prince Hospital, Sa Kaeo, Thailand.
Abstract
BACKGROUND::
Pneumonia remains a leading cause of under-five morbidity and mortality globally. Comprehensive incidence, epidemiologic, and etiologic data are needed to update prevention and control strategies.
METHODS::
We conducted active, population-based surveillance for hospitalized cases of acute lower respiratory infections (ALRI) among children aged <5 years in rural Thailand. ALRI cases were systematically sampled for an etiology study that tested nasopharyngeal specimens by PCR; children without ALRI were enrolled as controls from outpatient clinics.
RESULTS::
We identified 28,543 hospitalized ALRI cases from 2005-2010. Among the 49% with chest radiographs, 76% had findings consistent with pneumonia as identified by two study radiologists. The hospitalized ALRI incidence rate (IR) was 5,772 per 100,000 child-years (95% CI 5,707, 5,837), and was higher in boys vs. girls (IR Ratio (IRR) 1.38, 95% CI 1.35, 1.41) and in children aged 6-23 months vs. other age groups (IRR 1.76, 95% CI 1.69, 1.84). Viruses most commonly detected in ALRI cases were respiratory syncytial virus (RSV, 19.5%), rhinoviruses (18.7%), bocavirus (12.8%), and influenza viruses (8%). Compared to controls, ALRI cases were more likely to test positive for RSV, influenza, adenovirus, human metapneumovirus, and parainfluenza viruses 1 and 3 (p≤0.01 for all). Bloodstream infections, most commonly Streptococcus pneumoniae and non-typhoidal Salmonella, accounted for 1.8% of cases.
CONCLUSIONS::
Our findings underscore the high burden of hospitalization for ALRI and the importance of viral pathogens among children in Thailand. Interventions targeting viral pathogens coupled with improved diagnostic approaches, especially for bacteria, are critical for better understanding of ALRI etiology, prevention and control.
PMID:
24030346
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24030346