Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/31088
Title: High Rates of Pneumonia in Children under Two Years of Age in a South East Asian Refugee Population
Authors: Claudia Turner
Paul Turner
Verena Carrara
Kathy Burgoine
Saw Tha Ler Htoo
Wanitda Watthanaworawit
Nicholas P. Day
Nicholas J. White
David Goldblatt
François Nosten
Shoklo Malaria Research Unit
Mahidol University
University of Oxford
UCL Institute of Child Health
Keywords: Agricultural and Biological Sciences;Biochemistry, Genetics and Molecular Biology
Issue Date: 8-Jan-2013
Citation: PLoS ONE. Vol.8, No.1 (2013)
Abstract: Background: There are an estimated 150 million episodes of childhood pneumonia per year, with 11-20 million hospital admissions and 1.575 million deaths. Refugee children are particularly vulnerable, with poorly defined pneumonia epidemiology. Methods: We followed a birth cohort of 955 refugee infants, born over a one-year period, until two years of age. Clinical and radiographic pneumonia were diagnosed according to WHO criteria. Detailed characteristics were collected to determine risk factors for clinical, radiological and multiple episodes of pneumonia. Investigations were taken during a pneumonia episode to help determine or to infer an aetiological diagnosis. Findings: The incidence of clinical pneumonia was 0.73 (95% CI 0.70-0.75) episodes per child year (/CY) and of radiological primary endpoint pneumonia (PEP) was 0.22/CY (95% CI 0.20-0.24). The incidence of pneumonia without severe signs was 0.50/CY (95% CI 0.48-0.53), severe pneumonia 0.15/CY (95% CI 0.13-0.17) and very severe pneumonia 0.06/CY (0.05-0.07). Virus was detected, from a nasopharyngeal aspirate, in 61.3% of episodes. A reduced volume of living space per person (IRR 0.99, 95% CI 0.99-1.0, p = 0.003) and young maternal age (IRR 1.59, 95% CI 1.12-2.27, p = 0.01) were risk factors for developing pneumonia. The risk of a child having >1 episode of pneumonia was increased by having a shorter distance to the next house (IRR 0.86, 95% CI 0.74-1.00, p = 0.04). Infants were at risk of having an episode of PEP if there was a shorter distance from stove to bed (IRR 0.89, 95% CI 0.80-0.99, p = 0.03). Raised CRP and neutrophil values were associated with PEP. Conclusions: There was a high incidence of pneumonia in young children in this SE Asian refugee population. Viral infections were important, however CXR and non-specific marker findings suggested that bacteria may be involved in up to a third of cases. © 2013 Turner et al.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84872182774&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/31088
ISSN: 19326203
Appears in Collections:Scopus 2011-2015

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