Katherine L. O’Brien, Henry C. Baggett, W. Abdullah Brooks, Daniel R. Feikin et al.
BACKGROUND: Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings. METHODS: We did a multi-site, international c...
Henry C. Baggett, Nora L. Watson, Maria Deloria Knoll, W. Abdullah Brooks et al.
BACKGROUND.: Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study, we assessed this potential association. METHODS....
Daniel R. Feikin, Wei Fu, Daniel E. Park, Qiyuan Shi et al.
BACKGROUND.: The etiologic inference of identifying a pathogen in the upper respiratory tract (URT) of children with pneumonia is unclear. To determine if viral load could provide evidence of causality of pneumonia, we compared viral load in the URT of children with World Health Organization-defined...
Nicholas Fancourt, Maria Deloria Knoll, Breanna Barger-Kamate, John de Campo et al.
BACKGROUND.: Chest radiographs (CXRs) are a valuable diagnostic tool in epidemiologic studies of pneumonia. The World Health Organization (WHO) methodology for the interpretation of pediatric CXRs has not been evaluated beyond its intended application as an endpoint measure for bacterial vaccine tri...
Nicholas Fancourt, Maria Deloria Knoll, Henry C. Baggett, W. Abdullah Brooks et al.
BACKGROUND.: Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. METHODS.: The Pneumonia Etiology Research for Child Health project enrolled 4232 case...
Daniel E. Park, Henry C. Baggett, Stephen R. C. Howie, Qiyuan Shi et al.
BACKGROUND.: There is limited information on the association between colonization density of upper respiratory tract colonizers and pathogen-specific pneumonia. We assessed this association for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii. METHODS....
Andrea N. DeLuca, Laura L. Hammitt, Julia Kim, Melissa M. Higdon et al.
BACKGROUND.: Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. METHODS.: IS specimens were obtained as part a 7-count...
David R. Murdoch, Susan C. Morpeth, Laura L. Hammitt, Amanda J. Driscoll et al.
BACKGROUND.: It is standard practice for laboratories to assess the cellular quality of expectorated sputum specimens to check that they originated from the lower respiratory tract. The presence of low numbers of squamous epithelial cells (SECs) and high numbers of polymorphonuclear (PMN) cells are ...
Salahuddin Ahmed, Tisungane Mvalo, Samuel Akech, Ambrose Agweyu et al.
A saving grace of the COVID-19 pandemic in high-income and upper middle-income countries has been the relative sparing of children. As the disease spreads across low-income and middle-income countries (LMICs), long-standing system vulnerabilities may tragically manifest, and we worry that children w...
Donald M. Thea, Phil Seidenberg, Daniel E. Park, Lawrence Mwananyanda et al.
BACKGROUND.: Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from...
Jane Crawley, Christine Prosperi, Henry C. Baggett, W. Abdullah Brooks et al.
BACKGROUND.: Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was...
Maria Deloria Knoll, Susan C. Morpeth, J. Anthony G. Scott, Nora L. Watson et al.
BACKGROUND.: Detection of pneumococcus by lytA polymerase chain reaction (PCR) in blood had poor diagnostic accuracy for diagnosing pneumococcal pneumonia in children in 9 African and Asian sites. We assessed the value of blood lytA quantification in diagnosing pneumococcal pneumonia. METHODS.: The ...
Ryo Miyakawa, Haijun Zhang, W. Abdullah Brooks, Christine Prosperi et al.
OBJECTIVES: After respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high-burden settings, which have limited data, by comparing with RSV-positive and other...
Bernard E. Ebruke, Maria Deloria Knoll, Meredith Haddix, Syed M. A. Zaman et al.
BACKGROUND: An improved understanding of childhood pneumonia etiology is required to inform prevention and treatment strategies. Lung aspiration is the gold standard specimen for pneumonia diagnostics. We report findings from analyses of lung and pleural aspirates collected in the Pneumonia Etiology...
Eric D. McCollum, Daniel E. Park, Nora L. Watson, Nicholas Fancourt et al.
BACKGROUND: Whether digitally recorded lung sounds are associated with radiographic pneumonia or clinical outcomes among children in low-income and middle-income countries is unknown. We sought to address these knowledge gaps. METHODS: We enrolled 1 to 59monthold children hospitalized with pneumonia...
Vicky L. Baillie, David P. Moore, Azwifarwi Mathunjwa, Henry C. Baggett et al.
Rhinovirus (RV) is commonly detected in asymptomatic children; hence, its pathogenicity during childhood pneumonia remains controversial. We evaluated RV epidemiology in HIV-uninfected children hospitalized with clinical pneumonia and among community controls. PERCH was a case-control study that enr...
Katherine E. Gallagher, Juliet O. Awori, Maria Deloria Knoll, Julia Rhodes et al.
INTRODUCTION: In 2012, the World Health Organization revised treatment guidelines for childhood pneumonia with lower chest wall indrawing (LCWI) but no 'danger signs', to recommend home-based treatment. We analysed data from children hospitalized with LCWI pneumonia in the Pneumonia Etiology Researc...