Vaccination key to preventing childhood pneumonia in sub-Saharan Africa

May 25, 2010

Researchers at the University of Warwick, and the Kenya Medical Research Institute, Kilifi, Kenya, have found that respiratory syncytial virus (RSV) appears to be the predominant virus detected among infants and children hospitalized in Kenya with severe pneumonia, according to a study in the May 26 issue of JAMA. The contribution to this severe disease by an individual pathogen stresses the need for effective infant vaccination.

The leading cause of childhood death in sub-Saharan Africa is pneumonia. "The main means for controlling disease and death due to pneumonia are infant vaccination and case management. Thus, establishing the contribution to severe disease of individual pathogens and efficacy in infancy are essential to reducing the burden of disease," say James A. Berkley, F.R.C.P.C.H., of the Kenya Medical Research Institute, Kilifi, Kenya, and Dr James Nokes of the University of Warwick's Department of Biological Sciences.

The University of Warwick and the Kenya Medical Research Institute researchers conducted a study to examine the viral causes of severe pneumonia among and children at a rural Kenyan district hospital using comprehensive and sensitive molecular diagnostic techniques. Participants were children aged 1 day to 12 years who were (1) admitted to Kilifi District Hospital meeting clinical criteria for severe or very severe pneumonia; (2) presented to the hospital with mild upper but were not admitted; or (3) were well infants and children attending for immunization. Nasal wash samples were obtained from the children and analyzed for the presence of respiratory viruses.

From January 1, 2007, through December 31, 2007, there were 922 eligible infants and children with severe or very severe pneumonia admitted, and viral screening was conducted on 759 patients (82 percent). Median (midpoint) age was 9.0 months. One or more respiratory viruses were detected in 425 participants in the case group (56 percent). The researchers found that RSV was the most commonly detected virus, present in 260 admissions overall (34 percent), and in 192 of 453 infants (42 percent).

Other respiratory viruses were detected in 219 admissions (29 percent), the most common being Human coronavirus 229E (6.7 percent), influenza type A (5.8 percent), Parainfluenza type 3 (3.8 percent), Human adenovirus (3.8 percent), and Human metapneumovirus (3.0 percent).

The authors write that detection of RSV was associated with admission with severe disease (34 percent) when compared with well control participants (5 percent), and that these findings offer support that RSV vaccination may offer considerable public health benefit. "There was no evidence of an association between viruses other than RSV and severe disease, (22 percent in those admitted with severe or very severe pneumonia and 23 percent in control participants)."

"In summary, our study of the occurrence of respiratory viruses in children admitted with clinical syndromes of severe or very severe pneumonia to a rural district hospital in coastal Kenya has identified more than 50 percent of case participants with a detectable virus in whom RSV was clearly predominant. We estimate that the prevention of RSV-associated severe pneumonia might reduce all-cause clinically severe or very severe pneumonia admissions to the Kilifi District Hospital by one-third. This contrasts with no evidence to suggest a marked effect on such admissions would occur from the prevention of any other , with the possible exception of FLUAV [influenza A]. Further molecular-based studies of respiratory virus etiology of severe pneumonia over longer periods and in multiple settings in sub-Saharan Africa are needed," the authors conclude.

Explore further: US orders farms to report pig virus infections

More information: JAMA. 2010;303[20]:2051-2057

add to favorites email to friend print save as pdf

Related Stories

More children need medical help for RSV than previously known

Feb 04, 2009

More than 2 million children with Respiratory Syncytial Virus (RSV) are seen in hospitals, emergency rooms and doctors' offices in the United States every year -- many more than doctors know. In fact, only 3 percent of children ...

Recommended for you

US orders farms to report pig virus infections

18 hours ago

The U.S. government is starting a new program to help monitor and possibly control the spread of a virus that has killed millions of pigs since showing up in the country last year.

Foreigner dies of MERS in Saudi

19 hours ago

A foreigner has died after she contracted MERS in the Saudi capital, the health ministry said on announced Friday, bringing the nationwide death toll to 73.

Vietnam battles fatal measles outbreak

22 hours ago

Vietnam is scrambling to contain a deadly outbreak of measles that has killed more than 100 people, mostly young children, and infected thousands more this year, the government said Friday.

New clues on tissue scarring in scleroderma

23 hours ago

A discovery by Northwestern Medicine scientists could lead to potential new treatments for breaking the cycle of tissue scarring in people with scleroderma.

User comments : 0

More news stories

Treating depression in Parkinson's patients

A group of scientists from the University of Kentucky College of Medicine and the Sanders-Brown Center on Aging has found interesting new information in a study on depression and neuropsychological function in Parkinson's ...

Health care site flagged in Heartbleed review

People with accounts on the enrollment website for President Barack Obama's signature health care law are being told to change their passwords following an administration-wide review of the government's vulnerability to the ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.