Factors that negatively affect the prognosis of pediatric community-acquired pneumonia in district hospital in Tanzania

Serena Caggiano, Nicola Ullmann, Elisa de Vitis, Marzia Trivelli, Chiara Mariani, Maria Podagrosi, Fabiana Ursitti, Chiara Bertolaso, Carolina Putotto, Marta Unolt, Andrea Pietravalle, Paola Pansa, Kajoro Mphayokulela, Maria Incoronata Lemmo, Michael Mkwambe, Joseph Kazaura, Marzia Duse, Francesco Nieddu, Chiara Azzari, Renato Cutrera

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article number623
JournalInternational Journal of Molecular Sciences
Volume18
Issue number3
DOIs
Publication statusPublished - Mar 13 2017

Keywords

  • Antibiotic therapy
  • Community-acquired pneumonia
  • Developing countries
  • Molecular diagnostic
  • Prevention
  • Vaccines

ASJC Scopus subject areas

  • Catalysis
  • Molecular Biology
  • Spectroscopy
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Inorganic Chemistry

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  • Cite this

    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. (2017). Factors that negatively affect the prognosis of pediatric community-acquired pneumonia in district hospital in Tanzania. International Journal of Molecular Sciences, 18(3), [623]. https://doi.org/10.3390/ijms18030623