Wits health consortium
VIDA
Dr Sana Mahtab is a senior program manager the Vaccines and Infectious Diseases Analytics (VIDA) Research Unit of the University of the Witwatersrand. She qualified with a Bachelor of Medicine and Surgery (MBBS) in 2007 from University of Karachi and Maters in Public Health (Epidemiology) from University of Cape Town, in 2015, and is currently a PhD candidate at University of Cape Town. Her research focus with Wits VIDA is on reducing under 5 years mortality from leading causes of death. Her current responsibility includes planning, implementation and management of the surveillance and epidemiological trials, mainly in under 5 population to get better identifying and understanding the causes of death, and preparation of research outputs from the research studies.

Presenter Of 1 Presentation

O002 - PATHOGEN-SPECIFIC CAUSES OF PNEUMONIA DEATHS IN CHILDREN 1-59 MONTHS DETERMINED USING MINIMALLY INVASIVE TISSUE SAMPLING (MITS): RESULTS FROM CHILD HEALTH AND MORTALITY PREVENTION SURVEILLANCE (CHAMPS). (ID 166)

Session Type
Parallel Session
Date
Mon, 20.06.2022
Session Time
15:20 - 16:35
Room
Grand Ballroom Centre
Lecture Time
15:35 - 15:45

Abstract

Background

Determining pneumonia etiology is difficult because samples from inside the lung are rarely available. We describe fatal pneumonia etiology, determined using MITS, to investigate cause of death (CoD) in children aged 1-59 months from seven countries in Africa and South Asia.

Methods

Deaths that occurred between December 2016 and February 2020 were investigated post-mortem using blood samples (tested by culture and PCR) and MITS per lung (histopathology, PCR for 44 organisms [all sites] and culture [South Africa only]). Expert panels reviewed clinical data, MITS and culture results, and verbal autopsy and assigned underlying, antecedent/comorbid and immediate (final event) CoD per WHO recommendations.

Results

Pneumonia was the underlying (n=54), antecedent (n=108) and/or immediate (n=128) CoD in 273/594 (46%) deaths; South Africa, Kenya, Mozambique, Sierra Leone, Mali, Ethiopia and Bangladesh contributed 113, 50, 47, 28, 24, 10 and 1 pneumonia-related deaths, respectively. Median age was 8.4 (IQR: 3.3-19.4) months. Pneumonia deaths had a median of 2 (IQR: 1-3) implicated pathogens. The 10 leading pathogens (including co-infections) were Streptococcus pneumoniae (31.9%), Klebsiella pneumoniae (31.5%), Cytomegalovirus (14.3%), Haemophilus influenzae (10.7%), Staphylococcus aureus (9.9%), Respiratory syncytial virus (7.0%), Pneumocystis jirovecii (8.1%), Acinetobacter baumanii (5.1%), and adenovirus (5.1%).

Conclusions

CHAMPS methods provide a new way of examining pathogen-specific causes of pneumonia death, highlighting those deaths often had multiple pathogens and Klebsiella pneumoniae may cause more pneumonia deaths than previously thought. Despite use of pneumococcal conjugate vaccines at all sites, pneumococcus still caused 32% of childhood pneumonia-related deaths.

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