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 ..
Xin Wang, You Li, Maria Deloria Knoll, Shabir A. Madhi et al.
BACKGROUND: Human metapneumovirus is a common virus associated with acute lower respiratory infections (ALRIs) in children. No global burden estimates are available for ALRIs associated with human metapneumovirus in children, and no licensed vaccines or drugs exist for human metapneumovirus infectio...
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, 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...
Amanda J. Driscoll, Ruth A. Karron, Susan C. Morpeth, Niranjan Bhat et al.
The Pneumonia Etiology Research for Child Health study was conducted across 7 diverse research sites and relied on standardized clinical and laboratory methods for the accurate and meaningful interpretation of pneumonia etiology data. Blood, respiratory specimens, and urine were collected from child...
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 ...
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...
David R. Murdoch, Susan C. Morpeth, Laura L. Hammitt, Amanda J. Driscoll et al.
BACKGROUND.: Sputum microscopy and culture are commonly used for diagnosing the cause of pneumonia in adults but are rarely performed in children due to difficulties in obtaining specimens. Induced sputum is occasionally used to investigate lower respiratory infections in children but has not been w...
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...
Melissa M. Higdon, Laura L. Hammitt, Maria Deloria Knoll, Henry C. Baggett et al.
Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of pneumonia etiology. We review 3 reasons investigators may choose to ex...
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...
Daniel E. Park, Melissa M. Higdon, Christine Prosperi, Henry C. Baggett et al.
BACKGROUND: Severity of viral respiratory illnesses can be increased with bacterial coinfection and can vary by sex, but influence of coinfection and sex on human endemic coronavirus (CoV) species, which generally cause mild to moderate respiratory illness, is unknown. We evaluated CoV and pneumococ...