Moderator of 2 Sessions
In this session, we will present findings and case studies on the etiology of pneumonia deaths from Child Health and Mortality Prevention Surveillance (CHAMPS), an ongoing program enrolling stillbirths and deaths in children <5 years of age in 7 countries in Africa and south Asia.
CHAMPS teams collect clinical information, verbal autopsy, and results of pathology and molecular examination of post-mortem specimens, including lung tissue. The results are surprising and may change how you think about pneumonia.
Please note: All MTE sessions are designed to encourage active learning and to concentrate on close interaction between audience and speakers. The MTE session organisers have provided at least 15 minutes for active discussions in their agenda.
Presenter of 2 Presentations
Pneumonia pathogenesis: Viral, bacterial, or both? (ID 926)
O003 - STREPTOCOCCUS PNEUMONIAE ASSOCIATED CHILD MORTALITY IN THE PNEUMOCOCCAL CONJUGATE VACCINE ERA (ID 406)
Abstract
Background
The Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to better understand child mortality causes through longitudinal surveillance and etiologic investigation of under-five deaths and stillbirths. Deaths enrolled in CHAMPS were examined to describe deaths attributed to pneumococcus by age group in seven surveillance sites all of which use pneumococcal conjugate vaccine (PCV).
Methods
The CHAMPS protocol includes postmortem minimally invasive tissue sampling (MITS) with molecular, microbiologic, and histopathologic testing, clinical record review, and verbal autopsy. Underlying, co-morbid, and immediate causes of death (causal chain) are ascribed according to ICD-10 guidelines by local panels reviewing all data on each case.
Results
Pneumococcal diagnoses were in the causal chain for 6.2% (124/2012) of deaths, ranging from 0.5% (3/560) for stillbirths, 1.4% (12/838) for neonates, and 18.0% (109/614) for deaths from infants and children <5 years. Of these 124 pneumococcal-associated deaths, 88% (109) were deaths that occurred in the community or within 72 hours of hospitalization. Conditions in the causal chain included lower respiratory infections (87.1%), meningitis (14.3%), and sepsis (47.1%); many deaths had multiple conditions.
Conclusions
These findings support focus on preventing pneumococcal disease and associated child mortality, including assessing proportion of deaths due to vaccine serotypes and factors for under-immunization with PCV.