Journal Article

Severe Pneumonia in Mozambican Young Children: Clinical and Radiological Characteristics and Risk Factors

Betuel Sigaúque, Anna Roca, Quique Bassat, Luís Morais, Llorenç Quintó, Anna Berenguera, Sónia Machevo, Azucena Bardaji, Manuel Corachan, Josep Ribó, Clara Menéndez, Anne Schuchat, Brendan Flannery, Montse Soriano-Gabarró and Pedro L. Alonso

in Journal of Tropical Pediatrics

Volume 55, issue 6, pages 379-387
Published in print December 2009 | ISSN: 0142-6338
Published online April 2009 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmp030
Severe Pneumonia in Mozambican Young Children: Clinical and Radiological Characteristics and Risk Factors

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Background: Pneumonia is a leading cause of hospitalization and death among children in Africa. We describe the clinical presentation of severe pneumonia among hospitalized children in a malaria endemic area with a high prevalence of HIV infection. Methods: As part of a 2-year prospective study of radiologically confirmed pneumonia, chest radiographs, malaria parasite counts and bacterial blood cultures were systematically performed for children 0–23 months admitted with severe pneumonia. Radiographs were interpreted according to WHO guidelines. HIV tests were performed during a 12-month period. Results: Severe pneumonia accounted for 16% of 4838 hospital admissions among children 0–23 months; 43% of episodes had endpoint consolidation, 15% were associated with bacteremia and 11% were fatal. Fever, cough >3 days, crepitations, hypoxemia and absence of malaria parasitemia were associated with radiologically confirmed pneumonia. Nineteen per cent of children with severe pneumonia and 27% with radiologically confirmed pneumonia had clinical malaria. HIV-prevalence was 26% among children hospitalized with severe pneumonia and HIV-testing results. HIV infection, anaemia, malnutrition, hypoxemia and bacteremia were associated with fatal episodes of severe pneumonia. Conclusion: Treatment of admitted children with severe pneumonia is complicated in settings with prevalent HIV and malaria. Children with severe pneumonia and clinical malaria require antibiotic and antimalarial treatment. In addition to vertical programs, integrated approaches may greatly contribute to reduction of pneumonia-related mortality.

Keywords: Mozambique; children; pneumonia; risk factors; mortality

Journal Article.  4446 words. 

Subjects: Paediatrics

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