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10 - Pneumonia and other acute lower respiratory tract infections in children

from Section 2 - Mother and child health

Published online by Cambridge University Press:  05 March 2013

By
Martin W. Weber  and
E. Kim Mulholland
Edited by
David Mabey ,
Geoffrey Gill ,
Eldryd Parry ,
Martin W. Weber  and
Christopher J. M. Whitty
David Mabey
Affiliation:
London School of Hygiene and Tropical Medicine
Geoffrey Gill
Affiliation:
University of Liverpool
Eldryd Parry
Affiliation:
Tropical Health Education Trust
Martin W. Weber
Affiliation:
World Health Organization, Jakarta
Christopher J. M. Whitty
Affiliation:
London School of Hygiene and Tropical Medicine
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Summary

The problem in Africa

Minor viral respiratory infections are common in childhood, while pneumonia is the most important cause of serious illness and death in young children globally. It is estimated that pneumonia causes almost 2 million deaths in children under 5 years of age each year. In African countries where malaria is an important problem, pneumonia causes a similar number of child deaths (Fig. 7.1). Pneumonia is generally a more common cause of death in those countries that have the highest infant mortality rates. Risk factors are malnutrition and exposure to indoor smoke, and lack of access to basic medical care is behind most pneumonia deaths. This remains a problem in many African countries. Untreated, the case-fatality rate is particularly high in the first 6 months of life.

Wheezing disorders are less common in African countries than in developed parts of the world. Acute bronchiolitis, usually due to respiratory syncytial virus (RSV), is an important cause of severe respiratory infections in young infants, yet asthma remains uncommon, except in urban areas. Viral laryngotracheobronchitis (‘croup’) is uncommon in African countries, so an acute presentation with upper airways obstruction should prompt a search for more serious conditions such as abscess, foreign body or diphtheria.

Type
Chapter
Information
Principles of Medicine in Africa , pp. 123 - 134
Publisher: Cambridge University Press
Print publication year: 2013

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References

Adegbola, RA, Falade, AG, Sam, BE et al. (1994). The etiology of pneumonia in malnourished and well-nourished Gambian children. Pediatr Infect Dis J; 13: 975–82.CrossRefGoogle ScholarPubMed
Adegbola, RA, Secka, O, Lahai, G et al. (2005). Elimination of Haemophilus influenzae type b (Hib) disease from The Gambia after the introduction of routine immunisation with a Hib conjugate vaccine: a prospective study. Lancet; 366: 144–50.CrossRefGoogle ScholarPubMed
Armstrong, JR, Campbell, H. (1991). Indoor air pollution exposure and lower respiratory infectious in young Gambian children. Int J Epidemiol; 20: 424–9.CrossRefGoogle Scholar
Asghar, R, Banajeh, S, Egas, J et al. (2008). Chloramphenicol versus ampicillin plus gentamicin for community acquired very severe pneumonia among children aged 2–59 months in low resource settings: multicentre randomised controlled trial (SPEAR study). Br Med J; 336: 80–4.CrossRefGoogle Scholar
Awasthi, S, Kabra, SK, Kulkarni, M et al. (2004). Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial. Br Med J; 328: 791–94.Google Scholar
Bari, A, Sadruddin, S, Khan, A, et al. (2011). Community case management of severe pneumonia with oral amoxicillin in children aged 2–59 months in Haripur district, Pakistan: a cluster randomised trial. Lancet;378(9805):1796–803.CrossRefGoogle ScholarPubMed
Berkley, JA, Munywoki, P, Ngama, M et al. (2010). Viral etiology of severe pneumonia among Kenyan infants and children. JAMA; 303: 2051–7.CrossRefGoogle ScholarPubMed
Cutts, FT, Zaman, SM, Enwere, G, et al. (2005). Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double-blind, placebo-controlled trial. Lancet; 365(9465):1139–46.CrossRefGoogle ScholarPubMed
Dherani, M, Pope, D, Mascarenhas, M et al. (2008). Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: a systematic review and meta-analysis. Bull World Hlth Org; 86: 390–8.Google ScholarPubMed
Falade, AG, Mulholland, EK, Adegbola, RA et al. (1997). Bacterial isolates from blood and lung aspirate cultures in Gambian children with lobar pneumonia. Ann Trop Paediatr; 17: 315–19.CrossRefGoogle ScholarPubMed
Falade, AG, Tschappeler, H, Greenwood, BM et al. (1995). Use of simple clinical signs to predict pneumonia in young Gambian children: the influence of malnutrition. Bull World Hlth Org; 73: 299–304.Google ScholarPubMed
Grant, GB, Campbell, H, Dowell, SF et al. (2009). Recommendations for treatment of childhood non-severe pneumonia. Lancet Infect Dis; 9: 185–96.CrossRefGoogle ScholarPubMed
Klugman, KP, Madhi, SA, Huebner, RE, et al. (2003). A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. N Engl J Med; 349(14):1341–8.CrossRefGoogle ScholarPubMed
Mangtani, P, Mulholland, K, Madhi, SA et al. (2010). Haemophilus influenzae type b disease in HIV-infected children: a review of the disease epidemiology and effectiveness of Hib conjugate vaccines. Vaccine; 28: 1677–83.CrossRefGoogle ScholarPubMed
Mulholland, EK, Simoes, EA, Costales, MO et al. (1992). Standardized diagnosis of pneumonia in developing countries. Pediatr Infect Dis J; 11: 77–81.CrossRefGoogle ScholarPubMed
Mulholland, K, Hilton, S, Adegbola, R et al. (1997). Randomised trial of Haemophilus influenzae type-b tetanus protein conjugate vaccine for prevention of pneumonia and meningitis in Gambian infants. Lancet; 349: 1191–7.CrossRefGoogle ScholarPubMed
Mulholland, K, Levine, O, Nohynek, H et al. (1999a). Evaluation of vaccines for the prevention of pneumonia in children in developing countries. Epidemiol Rev; 21: 43–55.CrossRefGoogle ScholarPubMed
Mulholland, K, Margolis, P, Mason, K et al. (1999b). Bacterial etiology of serious infections in young infants in developing countries: results of a multicenter study. Pediatr Infect Dis J; 18: S17-S22.CrossRefGoogle Scholar
Nair, H, Nokes, DJ, Gessner, BD et al. (2010). Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet; 375: 1545–5.CrossRefGoogle ScholarPubMed
Nokes, DJ, Okiro, EA, Ngama, M et al. (2004). Respiratory syncytial virus epidemiology in a birth cohort from Kilifi district, Kenya: infection during the first year of life. J Infect.Dis; 190: 1828–32.CrossRefGoogle Scholar
Nokes, JD, Cane, PA (2008). New strategies for control of respiratory syncytial virus infection. Curr Opin Infect Dis; 21: 639–43.CrossRefGoogle ScholarPubMed
Rudan, I, Boschi-Pinto, C, Biloglav, Z et al. (2008). Epidemiology and etiology of childhood pneumonia. Bull World Hlth Org; 86: 408–16.CrossRefGoogle ScholarPubMed
Russell, FM.Carapetis, JR.Balloch, A. et al. (2010). Hyporesponsiveness to re-challenge dose following pneumococcal polysaccharide vaccine at 12 months of age, a randomized controlled trial. Vaccine; 28(19):3341–9.CrossRefGoogle ScholarPubMed
Smith, KR, McCracken, JP, Weber, MW et al. (2011) Effect of reduction in household air pollution on childhood pneumonia in Guatemala (RESPIRE): a randomized controlled trial. Lancet; 378: 1717–26.CrossRefGoogle Scholar
Usen, S, Weber, M, Mulholland, K et al. (1999). Clinical predictors of hypoxaemia in Gambian children with acute lower respiratory tract infection: prospective cohort study. BMJ; 318: 86–91.CrossRefGoogle ScholarPubMed
Weber, MW, Dackour, R, Usen, S et al. (1998a). The clinical spectrum of RSV disease in The Gambia. Pediatr Infect Dis J; 17: 224–30.CrossRefGoogle ScholarPubMed
Weber, MW, Milligan, P, Hilton, S et al. (1999). Risk factors for severe RSV infection leading to hospital admission in children in The Gambia. Int J Epidemiol; 28: 157–62.CrossRefGoogle ScholarPubMed
Weber, MW, Milligan, P, Sanneh, M et al. (2002). An epidemiological study of RSV infection in The Gambia. Bull World Hlth Org; 80: 562–8.Google ScholarPubMed
Weber, MW, Mulholland, EK, Greenwood, BM (1998b). Respiratory syncytial virus infection in tropical and developing countries. Trop Med Int Hlth; 3: 268–80.CrossRefGoogle ScholarPubMed
Weber, MW, Palmer, A, Oparaugo, A et al. (1995). Comparison of nasal prongs and nasopharyngeal catheter for the delivery of oxygen in children with hypoxemia because of a lower respiratory tract infection. J Pediatr; 127: 378–83.CrossRefGoogle ScholarPubMed
WHO (2005). Pocket Book of Hospital Care for Children. Geneva: WHO.Google Scholar
WHO (2008a). IMCI Chart Booklet. 2nd edn. Geneva: WHO.Google Scholar
WHO (2008b). IMCI Chart Booklet for High HIV Settings. Geneva: WHO.
WHO (2012). The Clinical Use of Oxygen in Hospitals with Limited Resources: Guidelines for Health-Care Workers, Hospital Engineers and Managers. Geneva: WHO.Google Scholar

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