Rockers et al (2018)

Data from 377 caregiver-child pairs collected at baseline (2015) and year two follow-up (2017) of a cluster-randomized controlled trial conducted in Zambia. Includes household demographics, child anthropometry including stunting status, and child development scores using Bayley Scale for Infant and Toddler Development, 3rd Edition (BSID-III)

Etiology of severe pneumonia in Ecuadorian children

<div><p>Background</p><p>In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador.</p><p>Methods</p><p>This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2–59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated.</p><p>Results</p><p>Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. <i>Streptococcus pneumoniae</i> was identified in 37 (9.2%) samples and <i>Mycoplasma pneumoniae</i> in three (0.74%) samples. The yearly circulation pattern of RSV (<i>P</i> = 0.0003) overlapped with <i>S</i>. <i>pneumoniae</i>, (<i>P</i> = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, <i>P</i> = 0.01) and being underweight (aOR = 1.8, <i>P</i> = 0.04). Maternal education (aOR = 0.82, <i>P</i> = 0.003), pulse oximetry (aOR = 0.93, <i>P</i> = 0.005), and rales (aOR = 0.25, <i>P</i> = 0.007) were associated with influenza A. Younger age (aOR = 3.5, <i>P</i> = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, <i>P</i> = 0.03).</p><p>Conclusion</p><p>These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available.</p><p>Trial registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT00513929?term=NCT+00513929&rank=1" target="_blank">NCT 00513929</a></p></div

Multivariable regression analysis of common pathogens by explanatory variables.

<p>Multivariable regression analysis of common pathogens by explanatory variables.</p

Pneumonia etiology by age category.

<p>Pneumonia etiology by age category.</p

Study profile and analysis of sample pathogens.

<p>Study profile and analysis of sample pathogens.</p

Seasonal distribution of viral pathogens among children with severe pneumonia between February 2008 and April 2010.

<p>Seasonal distribution of viral pathogens among children with severe pneumonia between February 2008 and April 2010.</p

Seasonal distribution of bacterial pathogens among children with severe pneumonia between February 2008 and April 2010.

<p>Seasonal distribution of bacterial pathogens among children with severe pneumonia between February 2008 and April 2010.</p

Baseline characteristics of children with severe pneumonia (N = 406).

<p>Baseline characteristics of children with severe pneumonia (N = 406).</p

Impact of the intervention on secondary outcomes at year 2 follow-up.

<p>Impact of the intervention on secondary outcomes at year 2 follow-up.</p

Per-protocol analysis of impact of the intervention on primary outcomes.

<p>Per-protocol analysis of impact of the intervention on primary outcomes.</p