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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bacteremia among children admitted to a rural hospital in Kenya
New England Journal of Medicine, Volume 352, No. 1, Year 2005
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Description
BACKGROUND: There are few epidemiologic data on invasive bacterial infections among children in sub-Saharan Africa. We studied every acute pediatric admission to a rural district hospital in Kenya to examine the prevalence, incidence, types, and outcome of community-acquired bacteremia. METHODS: Between August 1998 and July 2002, we cultured blood on admission from 19,339 inpatients and calculated the incidence of bacteremia on the basis of the population served by the hospital. RESULTS: Of a total of 1783 infants who were under 60 days old, 228 had bacteremia (12.8 percent), as did 866 of 14,787 children who were 60 or more days of age (5.9 percent). Among infants who were under 60 days old, Escherichia coli and group B streptococci predominated among a broad range of isolates (14 percent and 11 percent, respectively). Among infants who were 60 or more days of age, Streptococcus pneumoniae, nontyphoidal salmonella species, Haemophilus influenzae, and E. coli accounted for more than 70 percent of isolates. The minimal annual incidence of community-acquired bacteremia was estimated at 1457 cases per 100,000 children among infants under a year old, 1080 among children under 2 years, and 505 among children under 5 years. Of all in-hospital deaths, 26 percent were in children with community-acquired bacteremia. Of 308 deaths in children with bacteremia, 103 (33.4 percent) occurred on the day of admission and 217 (70.5 percent) within two days. CONCLUSIONS: Community-acquired bacteremia is a major cause of death among children at a rural sub-Saharan district hospital, a finding that highlights the need for prevention and for overcoming the political and financial barriers to widespread use of existing vaccines for bacterial diseases. Copyright © 2005 Massachusetts Medical Society.
Authors & Co-Authors
Berkley, James A.
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
United Kingdom
Ctr. Clin. Vaccinology Trop. Med.
United Kingdom, London
Wellcome Trust
Lowe, Brett S.
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
United Kingdom
Ctr. Clin. Vaccinology Trop. Med.
Mwangi, Isaiah
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
Williams, Thomas Neil
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
Bauni, Evasius K.
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
Mwarumba, Salim
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
Ngetsa, Caroline J.
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
Slack, Mary Paulina Elizabeth
United Kingdom, Oxford
John Radcliffe Hospital
Njenga, Sally
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
Hart, Charles Anthony
United Kingdom, Liverpool
University of Liverpool
Maitland, Kathryn M.
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
English, Michael C.
United Kingdom, Oxford
University of Oxford
Marsh, Kevin
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
United Kingdom
Ctr. Clin. Vaccinology Trop. Med.
Scott, John Anthony Gerard
Kenya, Kilifi
Ctr. for Geogr. Medicine Research
United Kingdom
Ctr. Clin. Vaccinology Trop. Med.
Statistics
Citations: 863
Authors: 14
Affiliations: 6
Identifiers
Doi:
10.1056/NEJMoa040275
ISSN:
00284793
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Kenya