Pneumonia among young infants in rural Southeast Asia (Bohol Island, Philippines)

Abstract

Summaryobjective To develop a clinical algorithm that can be used to identify pneumonia deaths in young infants in developing countries and estimate the disease burden in this population.patients and methods Infants younger than 60 days hospitalized with signs of severe pneumonia who underwent clinical, microbiologic and radiological evaluation were the subjects. Stepwise logistic regression and subtractive iterative process were used to derive the algorithm.results Three-hundred and one infants had either clinical or radiographic pneumonia. The case fatality rate for 185 infants with radiographic pneumonia was 21% vs. 5% for clinical pneumonia. Age below 7 days was associated with an increased risk of dying. Among 7-to 59-day-old infants, poor feeding, cyanosis and absence of crackles were predictors of death from pneumonia. Using logistic regression, an algorithm consisting of any one of three clinical signs (cyanosis, poor feeding and abnormally sleepy) was developed in infants aged 7-59 days; 80% of deaths and 50% of those with radiographic pneumonia have at least one of these signs. It performed better than both the WHO case management algorithm and the IMCI algorithm.

Respiratory viruses from hospitalized children with severe pneumonia in the Philippines

“…Bacteremia was observed in 3.8% of our cases, and this rate is similar to our previous findings in the Philippines (2.9% and 5%) [20,22]. In addition to two major bacterial pathogens, S. pneumoniae (n = 4) and H. influenzae (n = 1), the most commonly isolated bacteria was B. cepacia group (n = 9).…”

“…"Others" included those who absconded or were transferred to another hospital. For data analysis, we combined "Discharged against medical advice-deteriorating" and "Died" as the fatal or life-threatening outcome group as we did in previous "Bohol study" in the Philippines [20][21][22].…”

The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study

“…Children aged <2 months with pneumonia present with a broader spectrum of clinical symptoms and signs than older children [22, 23]. For the purposes of PERCH, we extrapolated the WHO case definition, including the requirement for cough or difficulty breathing, to children aged 29–59 days.…”

Cost-effectiveness analysis of a physician deployment program to improve access to healthcare in rural and underserved areas in the Philippines

“…Province-specific pneumonia and diarrhoea incidence rates were estimated using FHSIS incidence rate ratios that we used to weigh the GBD incidence rates for pneumonia and diarrhoea (see online supplementary file l). Treatment effectiveness for diarrhoea and pneumonia was taken from a prospective analysis, systematic review and previous modelling studies, and we assume 100% compliance with treatment 43–46…”