Shabir A. Madhi, South Africa
Presenter of 2 Presentations
IMMUNOGENICITY OF SINGLE COMPARED TO TWO-DOSE PRIMARY SERIES FOLLOWED BY BOOSTER DOSE OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV) IN SOUTH AFRICA: OPEN-LABEL, RANDOMISED, NON-INFERIORITY TRIAL (ID 1153)
HEAD-TO-HEAD COMAPRISON OF TEN-VALENT (PCV10) AND 13-VALENT (PCV13) PNEUMOCOCCAL CONJUGATE VACCINE FOLLWING TWO-DOSE PRIMARY SERIES AND AFTER BOOSTER- DOSE IN SOUTH AFRICA: RANDOMISED CONTROLED TRIAL (ID 1164)
Author Of 8 Presentations
ASSOCIATION OF ROUTINE INFANT 2+1 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV) WITH STREPTOCOCCUS PNEUMONIAE CARRIAGE AND SEROTYPE EPIDEMIOLOGY IN URBAN-DWELLING SOUTH AFRICAN CHILDREN AGED ≤5YEARS. (ID 590)
IMMUNOGENICITY OF SINGLE COMPARED TO TWO-DOSE PRIMARY SERIES FOLLOWED BY BOOSTER DOSE OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV) IN SOUTH AFRICA: OPEN-LABEL, RANDOMISED, NON-INFERIORITY TRIAL (ID 1153)
HIGH-THROUGHPUT NANOFLUIDIC REAL-TIME PCR ASSAY TO EVALUATE SEROTYPE-SPECIFIC STREPTOCOCCUS PNEUMONIAE COLONIZATION IN THE NASOPHARYNX OF HEALTHY SOUTH AFRICAN CHILDREN. (ID 593)
HEAD-TO-HEAD COMAPRISON OF TEN-VALENT (PCV10) AND 13-VALENT (PCV13) PNEUMOCOCCAL CONJUGATE VACCINE FOLLWING TWO-DOSE PRIMARY SERIES AND AFTER BOOSTER- DOSE IN SOUTH AFRICA: RANDOMISED CONTROLED TRIAL (ID 1164)
PNEUMOCOCCAL COLONIZATION EPIDEMIOLOGY IN RURAL-DWELLING PRIMARY-CARE-GIVERS OF CHILDREN ≤5YEARS OF AGE, 8 YEARS FOLLOWING ROUTINE PNEUMOCOCCAL CONJUGATE VACCINE (PCV) IMMUNIZATION OF SOUTH AFRICAN INFANTS. (ID 597)
NANOFLUIDIC REAL-TIME PCR TO DISCRIMINATE PNEUMOCOCCAL CONJUGATE VACCINE (PCV) ASSOCIATED SEROGROUP 6 TO INDIVIDUAL SEROTYPES. (ID 599)
TEMPORAL CHANGES IN PNEUMOCOCCAL COLONIZATION IN UNDER-5 YEAR OLD CHILDREN EIGHT YEARS FOLLOWING ROUTINE INFANT IMMUNIZATION WITH PNEUMOCOCCAL CONJUGATE VACCINE (PCV) IN RURAL SOUTH AFRICA (ID 413)
CHILDREN ADMITTED TO HOSPITAL WITH LOWER-CHEST-WALL INDRAWING PNEUMONIA IN SEVEN LOW AND MIDDLE-INCOME COUNTRIES: WHO DIED AND WHO SURVIVED? (ID 758)
- Katherine E. Gallagher, United Kingdom
- Juliet O. Awori, Kenya
- Maria D. Knoll, United States of America
- Chrissy Prosperi, United States of America
- Henry C. Baggett, United States of America
- W. A. Brooks, United States of America
- Daniel R. Feiken, United States of America
- Laura L. Hammitt, United States of America
- Stephen Howie, Gambia
- Karen L. Kotloff, United States of America
- Orin S. Levine, United States of America
- Shabir A. Madhi, South Africa
- David Murdoch, New Zealand
- Katherine L. O'Brien, United States of America
- Donald M. Thea, United States of America
- Vicky L. Baillie, South Africa
- Bernard E. Ebruke, Gambia
- Doli Goswami, Bangladesh
- Alice Kamau, Kenya
- David P. Moore, South Africa
- Lawrence Mwananyanda, United States of America
- Emmanuel O. Olutunde, Gambia
- Phil Seidenberg, United States of America
- Seydou Sissoko, Mali
- Mamadou Sylla, Mali
- Somsak Thamthitiwat, Thailand
- Khalequ Zaman, Bangladesh
- J.A.G Scott, Kenya
Abstract
Background
In 2013, to increase effective distribution of antibiotics, WHO revised treatment guidelines for childhood pneumonia with lower chest wall indrawing (LCWI) to recommend home-based-treatment with oral antibiotics rather than hospital-based management. We analysed the implications of this policy in the PERCH study, where all children were hospitalised.
Methods
In PERCH, 2113 children aged 2-59 months were admitted with LCWI pneumonia between 2011-2014 in Kenya, Zambia, South Africa, Mali, The Gambia, Bangladesh and Thailand. We analysed their mortality risk, and risk factors for mortality using logistic regression.
Results
Among cases with LCWI pneumonia, 76 (3.6%) died in hospital or within 7 days of discharge. Factors associated with fatal outcome included age (aOR 2.03 (95%CI 1.05-3.93) for infants vs older children), absence of cough, oxygen saturation (80-91% oxygen aOR 2.04 (1.07-3.90), <80% aOR 6.51 (2.82-15.0)), low anthropometric scores and HIV exposure.
Conclusions
Despite hospital admission, 3.6% of children with LCWI pneumonia died; mortality may be higher among similar children if treated in the community. Among children with LCWI pneumonia presenting to hospital, selective admission for those who also have hypoxia, features of malnutrition and young age may ensure that those with the greatest risk of death receive optimal supportive therapy.