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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Viral etiology of severe pneumonia among Kenyan infants and children
JAMA, Volume 303, No. 20, Year 2010
Notification
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Description
Context: Pneumonia is the leading cause of childhood death in sub-Saharan Africa. Comparative estimates of the contribution of causative pathogens to the burden of disease are essential for targeted vaccine development. Objective: To determine the viral etiology of severe pneumonia among infants and children at a rural Kenyan hospital using comprehensive and sensitive molecular diagnostic techniques. Design, Setting, and Participants: Prospective observational and case-control study during 2007 in a rural Kenyan district hospital. Participants were children aged 1 day to 12 years, residing in a systematically enumerated catchment area, and who either were admitted to Kilifi District Hospital meeting World Health Organization clinical criteria for severe pneumonia or very severe pneumonia; (2) presented with mild upper respiratory tract infection but were not admitted; or (3) were well infants and children attending for immunization. Main Outcome Measures: The presence of respiratory viruses and the odds ratio for admission with severe disease. Results: Of 922 eligible admitted patients, 759 were sampled (82% [median age, 9 months]). One or more respiratory viruses were detected in 425 of the 759 sampled (56% [95% confidence interval {Cl}, 52%-60%]). Respiratory syncytial virus (RSV) was detected in 260 participants (34% [95% Cl, 31%-38%]) and other respiratory viruses were detected in 219 participants (29%; 95% Cl, 26%-32%), the most common being Human coronavirus 229E (n=51 [6.7%]), influenza type A (n=44 [5.8%]), Parainfluenza type 3 (n=29 [3.8%]), Human adenovirus (n=29 [3.8%]), and Human metapneumovirus (n=23 [3.0%]). Compared with well control participants, detection of RSV was associated with severe disease (5% in control participants; adjusted odds ratio, 6.11 [95% Cl, 1.65-22.6]) while collectively, other respiratory viruses were not associated with severe disease (23% in control participants; adjusted odds ratio, 1.27 [95% Cl, 0.64-2.52]). Conclusion: In a sample of Kenyan infants and children admitted with severe pneumonia to a rural hospital, RSV was the predominant viral pathogen. ©2010 American Medical Association. All rights reserved.
Authors & Co-Authors
Berkley, James A.
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, Oxford
University of Oxford
Munywoki, Patrick Kiio
Kenya, Kilifi
Centre for Geographic Medicine Research
Ngama, Mwanajuma J.
Kenya, Kilifi
Centre for Geographic Medicine Research
Kazungu, Sidi D.
Kenya, Kilifi
Centre for Geographic Medicine Research
Abwao, John
Kenya, Kilifi
Centre for Geographic Medicine Research
Bett, Anne
Kenya, Kilifi
Centre for Geographic Medicine Research
Lassaunière, Ria
South Africa, Pretoria
Faculty of Health Sciences
Kresfelder, Tina Louise
South Africa, Pretoria
Faculty of Health Sciences
Cane, Patricia A.
United Kingdom, London
Public Health England
Venter, Marietjie
South Africa, Pretoria
Faculty of Health Sciences
South Africa, Johannesburg
National Institute for Communicable Diseases
Scott, John Anthony Gerard
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, Oxford
University of Oxford
Nokes, David James
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, Coventry
University of Warwick
Statistics
Citations: 293
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1001/jama.2010.675
ISSN:
00987484
e-ISSN:
15383598
Research Areas
Covid
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study