Detection of Pneumococcal DNA in Blood by Polymerase Chain Reaction for Diagnosing Pneumococcal Pneumonia in Young Children From Low- and Middle-Income Countries.

BACKGROUND.: We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. METHODS.: We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumonia Etiology Research for Child Health (PERCH) study. Children had World Health Organization-defined severe or very severe pneumonia or were age-frequency-matched community controls. Additionally, we tested blood from general pediatric admissions in Kilifi, Kenya, a PERCH site. The proportion PCR-positive was compared among cases with microbiologically confirmed pneumococcal pneumonia (MCPP), cases without a confirmed bacterial infection (nonconfirmed), cases confirmed for nonpneumococcal bacteria, and controls. RESULTS.: In PERCH, 7.3% (n = 291/3995) of cases and 5.5% (n = 273/4987) of controls were blood pneumococcal PCR-positive (P < .001), compared with 64.3% (n = 36/56) of MCPP cases and 6.3% (n = 243/3832) of nonconfirmed cases (P < .001). Blood pneumococcal PCR positivity was higher in children from the 5 African countries (5.5%-11.5% among cases and 5.3%-10.2% among controls) than from the 2 Asian countries (1.3% and 1.0% among cases and 0.8% and 0.8% among controls). Among Kilifi general pediatric admissions, 3.9% (n = 274/6968) were PCR-positive, including 61.7% (n = 37/60) of those with positive blood cultures for pneumococcus. DISCUSSION.: The utility of pneumococcal PCR on blood for diagnosing childhood pneumococcal pneumonia in the 7 low- and middle-income countries studied is limited by poor specificity and by poor sensitivity among MCPP cases

Intrathoracic Cysts and Tumours: A Clinico-Pathological Study of Cases Coming to Operation in a Thoracic Surgical Unit Within a 10 Year Period

Abstract Not Provided

Acute Respiratory Infections in Infants and Children

Abstract Not Provided

The impact of the pneumococcal conjugate vaccine on the epidemiology and aetiology of childhood pneumonia

PhD ThesisBackground The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced routinely in the UK in September 2006 and replaced by PCV13 from April 2010. Aims To evaluate the impact of PCV7 on the incidence of all-cause community-acquired pneumonia (CAP) in children. Also to investigate the aetiology of CAP before and after the introduction of PCV as well as serotype the pneumococcal infections. Methods Enrolled children were from North East England (excluding Cumbria) who were aged 0–16 years and presented with clinical and radiological features suggestive of pneumonia. Epidemiology survey was prospectively undertaken in 2008–2009 at 11 hospitals in North East England. Data were compared to those from a similar survey undertaken in the same hospitals in 2001–2002. Aetiology studies were prospectively conducted in 2001–2002 (pre-vaccine) and 2009–2011 (post-vaccine) in Newcastle and Middlesbrough. Investigations included culture, serology, immunofluorescence antibody, urinary pneumococcal antigen and PCR assays. Epidemiology Results A total of 542 children were enrolled, of which 74% were aged <5 years. PCV7 uptake was 90.7%. The annual incidence of pneumonia was 11.8/10 000 (95% CI 10.9–12.9), and the hospitalisation rate was 9.9/10 000 (95% CI 9.0–10.9). Compared to 2001, there was a 19% (95% CI 8–29) reduction in the annual rate of CAP in those aged <5 years, and in those <2 years a 33.1% (95% CI 20–45) reduction in the annual incidence of CAP and 38.1% (95% CI 24–50) reduction in hospitalisation rates. However, for those unvaccinated aged ≥5 years, there was no difference in the annual incidence of CAP and hospitalisation rate between both surveys. Since 2001, the overall reduction in annual incidence was 17.7% (95% CI 8–26) and for hospitalisation 18.5% (95% CI 8–28). Aetiology Results A total of 401 children were enrolled; 241 and 160 respectively in the pre- and post- vaccine studies (73% aged <5 years), for whom at least one diagnostic investigation had been performed. Identification of a definite pathogen was higher post-vaccine (61%) than pre-vaccine (48.5%) [p=0.019]. Rates of bacterial infections were not different between post- and pre-vaccine (17.5% versus 24%, p=0.258). Viral (31%) and mixed infections (12.5%) found more often post-vaccine than pre-vaccine (19.5% [p=0.021] and 5% [p=0.015] respectively). Pneumococcal detection post-vaccine was substantially improved when PCR assays were used compared to culture (21.6% versus 6%, p=0.0004). A serotype was identified in 75% (18/24) post-vaccine including serotypes 1 (44.4%), 3 (27.8%), 19A (22.2%) and 7A/F (5.6%). Conclusions PCV7 has reduced both the annual incidence and rate of hospitalisation of pneumonia in children, particularly those aged <2 years. Pneumococcal serotypes which are included in PCV13 but not PCV7 predominated. This suggests that the replacement with PCV13 likely to be associated with a reduction in the incidence of pneumococcal-related pneumonia. Continued surveillance is required to monitor for emerging serotypes.Ministry of Education in Libya and Libyan Embassy in London, Pfize

Pneumonia in pre-school children : Terveysnetti

Pneumonia is an illness, usually caused by bacterial, viral or more rarely fungal organisms. Common symptoms in children and infants include difficult breathing, cough, and wheezing. Diagnosis involves confirmatory chest radiography and laboratory tests. Antibiotics are the preferred choice for treatment and management. Risks factors include low paternal education, low birth weight, lack of breastfeeding. Key strategies for the prevention of childhood pneumonia are community –based case management, adequate nutrition and zinc intake. Main aim is produce guidelines for these families by producing web pages to be published in Terveysnetti so that they can be able to understand and recognize the disease well. The purpose of my bachelor thesis is to provide information to families with pre-school children about pneumonia. Literature review was used in analysis of research articles which were obtained from electronic sources in our school library. Main search engine used to retrieve the articles was CINAHL. Searches were limited and compared against each other thus the relevant information was retrieved by selecting meaningful articles and abstracts. Results concluded that pneumonia kills more children than any other illness- more than AIDS, malaria and measles combined resulting to over two million deaths each year. In conclusion, increased understanding about etiology and pathophysiology of the disease should guide new approaches to tackle the immense global problem of child deaths from pneumonia, the most effective intervention to reduce pneumonia related deaths would be to improve access to early care where simple, appropriate interventions are provided, including referral where necessary

Diphtheria (with cases)

DIPHTHERIA is an acute inflammatory infectious disease generally of mucous membranes, due to the invasion of a specific micro-organism, the bacillus diphtheriae of Klebs-Loeffler, characterised by the production in most cases of a false membrane at the seat of the infection and leading in many cases to a peculiar form of paralysis due to the absorption of toxic products generated by the bacillus.From the derivation of the word it would appear as though the disease Diphtheria was dangerous mainly from a mechanical or obstructive point of view-but while this is, of course, important in cases affecting the Larynx and Trachea, the chief danger in the majority of cases arises the Toxaemia resulting from absorption of the Toxines