Co-morbidity: exploring the clinical overlap between pneumonia and diarrhoea in a hospital in Dhaka, Bangladesh

Chisti, Mohammod Jobayer; Duke, Trevor; Robertson, Colin F.; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Bardhan, Pradip Kumar; Vincente, Sophie La; Salam, Mohammed Abdus

doi:10.1179/1465328111y.0000000033

Cited by 42 publications

(52 citation statements)

References 33 publications

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“…13 In this study, we found that housing variables were not independently associated with pneumonia; rather, we found that broader socioeconomic indicators such as higher education status of the mother and a higher family income were protective for coinfection, which is consistent with previous studies showing that such risk factors are associated with childhood pneumonia in resource-limited settings, including Egypt, 14 Brazil, 15 and India. 16 We also demonstrate that for those under 12 months of age, breast-feeding was associated with a lower risk of concurrent pneumonia.…”

Section: Discussionsupporting

confidence: 81%

Concurrent Pneumonia in Children Under 5 Years of Age Presenting to a Diarrheal Hospital in Dhaka, Bangladesh

Leung

Das

Malek

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Respiratory and gastrointestinal infections are the top killers of children worldwide, and their co-occurrence is reported but not well understood. Our aim was to determine the risk factors for concurrent presentation of diarrhea and pneumonia (DP) in a resource-limited setting in Bangladesh. We used data from the Diarrheal Disease Surveillance System of the icddr,b Dhaka Hospital to identify children < 60 months of age with diarrhea and concurrent pneumonia, defined as a history of cough, an abnormal lung examination, and tachypnea. For the years 1996-2007, out of total 14,628 diarrheal patients surveyed, there were 607 (4%) patients who satisfied criteria for pneumonia. Those with DP had a higher mortality rate (4% versus 0.05%, odds ratio [OR] = 86, 95% confidence interval [CI] = 26-286) and a longer hospital stay (mean 84 versus 26 hours, difference 58 hours, 95% CI = 52-64 hours) than those with diarrhea (D) only. In multivariable logistic regression comparing cases (N = 607) with controls matched for month and year of admission at a ratio of 1:3 (N = 1,808), we found that DP was associated with younger age, male gender, severe acute malnutrition (SAM), less maternal education, lower family income, and lack of current breast-feeding history.

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Section: Discussionsupporting

confidence: 81%

Concurrent Pneumonia in Children Under 5 Years of Age Presenting to a Diarrheal Hospital in Dhaka, Bangladesh

Leung

Das

Malek

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…Our isolated bacterial agents significantly differ from the common bacterial etiology of pneumonia in this age group of children [24,25]. High proportion of children with severe malnutrition (62%), a common co-morbidity of pneumonia and diarrhea in developing countries may be a factor that explains our observation- [26] -the etiology of pneumonia in under-five children is different in such children compared to those without severe malnutrition [9,27]. Our isolated bacterial agents are common in ventilation-associated pneumonia (VAP) or in nosocomial pneumonia [28,29]; however, we collected tracheal aspirates from children with community acquired pneumonia and we collected the sample immediately following their intubation and ventilation.…”

Section: Discussionmentioning

confidence: 51%

Bacterial Isolates from Tracheal Aspirates and their Anti-microbial Susceptibility in Mechanically-Ventilated Children with Pneumonia Admitted to an Urban Critical Care Ward

Shahunja

Salam

Ahmed

et al. 2015

Bangladesh Crit Care J

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Background and Aims: Data on Bacterial isolates from tracheal aspirates in children with severe pneumonia requiring intubation and mechanical ventilation especially in developing countries are very limited. We examined the microbial spectrum of bacteria isolated from tracheal aspirate of those children. The antibiotic susceptibility profiles of those bacteria were also examined.Methods: We evaluated the data of all mechanically ventilated children aged 0-59 months admitted to Intensive Care Unit (ICU) of Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between August 2009 and July 2013 having their tracheal aspirate culture done. Data were extracted from electronic medical records of the Dhaka Hospital.Results: Among 836 admitted pneumonia children in the ICU, we identified 35 children who fulfilled the inclusion criteria. Among them 34 (97%) had positive bacterial growths: Klebseilla species in 14 (40%), Escherichia coli in 11 (31%), Acinetobacter in 8 (23%) and Streptococcus species in 8 (23%). Additionally, Enterococcus, Staphylococcus aureus, Pseudominas and Proteus species were identified in 6 (17%), 4 (11%), and 2 (6%) of the children respectively. The susceptibility of the gram-negatives, except Klebseilla, to ampicillin, cotrimoxazole, gentamycin, ciprofloxacin, azithromycin, and ceftriaxone ranged from 0- 54%, while that for ceftazidime and amikacin ranged from 12-80%. The sensitivity of Klebseilla to these antibiotics ranged from 0-100%.Conclusions: Our data suggests that gram-negative bacteria, Klebseilla followed by Escherichia coli, and Acenetobacter are the predominant bacteria associated with severe pneumonia in ventilated children. The increased number of infections caused by Gram-negative bacteria is being accompanied by rising rates of multi-drug resistance which underscores the importance of aggressive antimicrobial therapy in the management of such children.Bangladesh Crit Care J September 2014; 2 (2): 60-64

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“…Several studies have examined the prevalence, health consequence, and clinical management of pneumonia however, inadequate number of literatures has reported the perception, especially of rural community mothers about pneumonia and its signs and symptoms [8–10]. A recent hospital based published data revealed that only 7% caregivers of pneumonic children had a good understanding and 51% had poor understanding about the clinical signs of pneumonia [11]. However, community based information is needed regarding mothers' ideas about causes of childhood pneumonia, and the healthcare seeking behaviors of mothers for their child's pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Mothers’ Perception and Healthcare Seeking Behavior of Pneumonia Children in Rural Bangladesh

Ferdous

Farzana

Ahmed

et al. 2014

ISRN Family Medicine

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We describe mothers' perception about signs and symptoms, causes of the illness, and healthcare seeking behaviors related to pneumonia and express the major modifiable barriers to seeking timely treatment when their under-5 children had pneumonia in rural Bangladesh. Using focus group discussion, we understood mothers' perception and healthcare seeking behavior of childhood pneumonia. Although mothers described pneumonia as a serious life threatening disease in young children but most of the mothers (n = 24) could not diagnose whether their child had pneumonia or not. Environmental factors such as dust particles, spread from coughing mother, and drinking cold water or playing with water were perceived as the causes for pneumonia. Three common barriers noted were as follows: illness was not perceived as serious enough or distance from healthcare facility or lack of money at household for seeking treatment outside. Most of the rural mothers did not have knowledge about severity of childhood pneumonia.

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Co-morbidity: exploring the clinical overlap between pneumonia and diarrhoea in a hospital in Dhaka, Bangladesh

Abstract: Increased public awareness of signs of pneumonia and severe sepsis in children under 5 is important to mitigate the risks of pneumonia and pneumonia-related deaths, and the importance of appropriate bedding for young children in reducing the risk of pneumonia needs to be addressed.

Cited by 42 publications

References 33 publications

Concurrent Pneumonia in Children Under 5 Years of Age Presenting to a Diarrheal Hospital in Dhaka, Bangladesh

Concurrent Pneumonia in Children Under 5 Years of Age Presenting to a Diarrheal Hospital in Dhaka, Bangladesh

Bacterial Isolates from Tracheal Aspirates and their Anti-microbial Susceptibility in Mechanically-Ventilated Children with Pneumonia Admitted to an Urban Critical Care Ward

Mothers’ Perception and Healthcare Seeking Behavior of Pneumonia Children in Rural Bangladesh

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