Aetiology of pneumonia in children aged 2 - 59months with severe and very severe pneumonia in the HIV and the post Hib Vaccination era at Kenyatta national Hospital.
Abstract
Pneumonia is the leading cause of death in children under five. Knowledge of the current
pathogens causing paediatric pneumonia is scarce. We hope to demonstrate the bacterial
pathogens currently contributing to the burden of pneumonia in children less than 59
months.
OBJECTIVES
The goal of this study was to determine the patterns of bacterial pathogens isolated from
blood cultures in children aged 2 to 59 months admitted with severe and very severe
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pneumonia. Our secondary objectives were to determine the correlates of culture positive
bacterial pneumonia and the prevalence of Pneumocystis jirovecii pneumonia in those
children also infected with HlV.
DESIGN
Descriptive cross-sectional study
SETTING
Kenyatta National Hospital situated in Nairobi, Kenya and is one of the 2 national tertiary
hospitals and is also the teaching hospital ofthe University of Nairobi.
STUDY DURATION
June 2009 to September 2009
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POPULATION
Children aged 2-59 months who presented at Paediatric Emergency Unit with WHO
criteria of severe and very severe pneumonia.
METHOD
Blood for culture was collected from 335 patients who met the inclusion criteria. mv
antibody tests were done on 306 patients. Confirmatory PCR was done seroreactive
patients aged less than 18 months. NPA was done on 29 seropositive children aged
between 2 - 24 months to screen for PCP.
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RESULTS
Bacteremia was found in eleven patients giving a prevalence of 3.3%. The significant
pathogens isolated were Streptococcus pneumonia 5(45.5%), Salmonella typhimurium
3(27.3%), Escherichia coli 2(18.2%) and Pseudomonas 1 (9<>10). H.influenza was not
isolated. Pneumocystis jirovecii was isolated in 4 out of 29 HIV infected children, giving
a prevalence of 13.8%.
CONCLUSION
The bacterial yield obtained was low (3.3%) making conclusions difficult. Hinfluenza
was not isolated. PCP prevalence among HIV infected children was 13.8% and therefore
remains an important cause of morbidity.
Citation
Masters Of Medicine In Paediatrics And Child HealthPublisher
University Of Nairobi College of Health Sciences