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Int. J. Mol. Sci. 2017, 18(3), 623; doi:10.3390/ijms18030623

Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania

1
Respiratory Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
2
Department of Pediatrics, Sapienza University of Rome, Umberto I Hospital, 00161 Rome, Italy
3
Department of Clinical Immunology, University of Florence and Children’s University Hospital A. Meyer, 50139 Florence, Italy
4
Pediatric Unit, St. Gaspar Hospital, Box 12, Itigi, Tanzania
*
Author to whom correspondence should be addressed.
Academic Editors: Susanna Esposito and Francesco B. Blasi
Received: 6 December 2016 / Accepted: 17 February 2017 / Published: 13 March 2017
(This article belongs to the Special Issue Pneumonia: Pathogenesis, Diagnostics, Therapeutics, and Prevention)
View Full-Text   |   Download PDF [239 KB, uploaded 15 March 2017]

Abstract

Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died. Surprisingly, 54% of patients were admitted with a wrong diagnosis, which increased complications, the need for antibiotics and chest X-rays, and the length of hospitalization. Comorbidity, found in 32% of children, significantly increased severity, complications, deaths, need for chest X-rays, and oxygen therapy. Malnourished children (29%) required more antibiotics. Microbiologically, Streptococcus pneumonia (S. p.), Haemophilus influenza type b (Hib) and Staphylococcus aureus (S. a.) were the bacteria more frequently isolated. Seventy-five percent of patients had mono-infection. Etiology was not correlated with severity, complications, deaths, oxygen demand, or duration of hospitalization. Our study highlights that difficult diagnoses and comorbidities negatively affect clinical evolution. S. p. and Hib still play a large role; thus, implementation of current vaccine strategies is needed. DBS is a simple and efficient diagnostic method for bacterial identification in countries with scarce resources. View Full-Text
Keywords: community-acquired pneumonia; developing countries; prevention; vaccines; molecular diagnostic; antibiotic therapy community-acquired pneumonia; developing countries; prevention; vaccines; molecular diagnostic; antibiotic therapy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Caggiano, S.; Ullmann, N.; De Vitis, E.; Trivelli, M.; Mariani, C.; Podagrosi, M.; Ursitti, F.; Bertolaso, C.; Putotto, C.; Unolt, M.; Pietravalle, A.; Pansa, P.; Mphayokulela, K.; Lemmo, M.I.; Mkwambe, M.; Kazaura, J.; Duse, M.; Nieddu, F.; Azzari, C.; Cutrera, R. Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania. Int. J. Mol. Sci. 2017, 18, 623.

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