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...
Xin Wang, You Li, Katherine L. O’Brien, Shabir A. Madhi et al.
BACKGROUND: Seasonal influenza virus is a common cause of acute lower respiratory infection (ALRI) in young children. In 2008, we estimated that 20 million influenza-virus-associated ALRI and 1 million influenza-virus-associated severe ALRI occurred in children under 5 years globally. Despite this s...
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....
Melissa M. Higdon, Tham Le, Katherine L. O’Brien, David R. Murdoch et al.
BACKGROUND.: Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) ...
Amanda J. Driscoll, Maria Deloria Knoll, Laura L. Hammitt, Henry C. Baggett et al.
BACKGROUND.: Antibiotic exposure and specimen volume are known to affect pathogen detection by culture. Here we assess their effects on bacterial pathogen detection by both culture and polymerase chain reaction (PCR) in children. METHODS.: PERCH (Pneumonia Etiology Research for Child Health) is a ca...
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 ...
Breanna Barger-Kamate, Maria Deloria Knoll, E. Wangeci Kagucia, Christine Prosperi et al.
BACKGROUND: Few data exist describing pertussis epidemiology among infants and children in low- and middle-income countries to guide preventive strategies. METHODS: Children 1-59 months of age hospitalized with World Health Organization-defined severe or very severe pneumonia in 7 African and Asian ...
Maria Deloria Knoll, Wei Fu, Qiyuan Shi, Christine Prosperi et al.
In pneumonia, specimens are rarely obtained directly from the infection site, the lung, so the pathogen causing infection is determined indirectly from multiple tests on peripheral clinical specimens, which may have imperfect and uncertain sensitivity and specificity, so inference about the cause is...
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...
Susan C. Morpeth, Maria Deloria Knoll, J. Anthony G. Scott, Daniel E. Park et al.
BACKGROUND.: We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. METHODS.: We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumon...