Clinical and epidemiological characteristics of severe community-acquired pneumonia in children after introduction of the 10-valent pneumococcal vaccine

Clinical and epidemiological characteristics of severe community-acquired pneumonia in children after introduction of the 10-valent pneumococcal vaccine

Pneumonia is an important cause of morbimortality in Brazil, despite the extensive vaccination coverage and the socioeconomic improvement in the past years. To describe the epidemiological and clinical characteristics of severe community-acquired pneumonia in children after the introduction of the 1...

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Bibliographic Details
Published in:Pediatric health, medicine and therapeutics Vol. 6; no. default; pp. 131 - 138
Main Authors: Lima, Eduardo Jf, Mello, Maria Jg, Albuquerque, Maria Fpm, Lopes, Maria Il, Serra, George Hc, Abreu-Lima, Maria Az, Correia, Jailson B
Format: Journal Article
Language:English
Published: New Zealand Dove Medical Press Limited 01-01-2015
Taylor & Francis Ltd
Dove Medical Press
Subjects:
Care and treatment
Childhood pneumonia
Complications and side effects
Immunization
Mortality
Original Research
Patient outcomes
Prevention
Streptococcus infections
Systematic review
Vaccines
Brazil
respiratory tract infections
descriptive epidemiology
pneumonia
child
pneumococcal conjugate vaccine
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Summary:Pneumonia is an important cause of morbimortality in Brazil, despite the extensive vaccination coverage and the socioeconomic improvement in the past years. To describe the epidemiological and clinical characteristics of severe community-acquired pneumonia in children after the introduction of the 10-valent pneumococcal conjugate vaccine (PCV10). A prospective study included children <5 years old hospitalized for pneumonia between October 2010 and September 2013 in a tertiary hospital. Newborns and children with comorbidities were excluded. Pneumonia classification followed the clinical and radiological criteria established by World Health Organization (WHO). Clinical history, nutritional status, immunizations, diagnosis, disease course, and prognosis were analyzed. Among 452 children, almost 70% were <2 years, with no sex differences, and 10% had weight-for-age z score below than -2.0. Family income was up to one minimum wage in half the households, and 40% of mothers had completed high school. The suitability of both influenza and PCV10 vaccine schedules was ∼50%. The first medical care happened later than 72 hours after the onset of symptoms in 42% of cases. Pneumonia was classified as severe or very severe in 83.9% of patients and for 23% as complicated. Global mortality was 1.5%. Hypoxia, diagnosed in 51.5% of children, looked like a better prognosis predictor than the WHO classification. New strategies for health care are necessary, such as the incorporation of peripheral saturometry as the "fifth signal", investment in vaccine coverage, and the adequacy of hospital infrastructure for assistance of severely affected patients.
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ISSN:1179-9927
1179-9927
DOI:10.2147/PHMT.S88132