Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2017 Feb 9;12(2):e0171687.
doi: 10.1371/journal.pone.0171687. eCollection 2017.

Etiology of severe pneumonia in Ecuadorian children

Sivani Jonnalagadda  1 , Oswaldo Rodríguez  2 , Bertha Estrella  2   3 , Lora L Sabin  1   4 , Fernando Sempértegui  2   3 , Davidson H Hamer  1   4   5   6
Affiliations
Observational Study

Etiology of severe pneumonia in Ecuadorian children

Sivani Jonnalagadda et al. PLoS One. .

Abstract

Background: In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador.

Methods: This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2-59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated.

Results: Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2%) samples and Mycoplasma pneumoniae in three (0.74%) samples. The yearly circulation pattern of RSV (P = 0.0003) overlapped with S. pneumoniae, (P = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01) and being underweight (aOR = 1.8, P = 0.04). Maternal education (aOR = 0.82, P = 0.003), pulse oximetry (aOR = 0.93, P = 0.005), and rales (aOR = 0.25, P = 0.007) were associated with influenza A. Younger age (aOR = 3.5, P = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03).

Conclusion: These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available.

Trial registration: ClinicalTrials.gov NCT 00513929.

Trial registration: ClinicalTrials.gov NCT00513929.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study profile and analysis of sample pathogens.
Fig 2
Fig 2. Seasonal distribution of viral pathogens among children with severe pneumonia between February 2008 and April 2010.
Fig 3
Fig 3. Seasonal distribution of bacterial pathogens among children with severe pneumonia between February 2008 and April 2010.
See this image and copyright information in PMC

References

    1. Cardinale F, Cappiello AR, Mastrototaro MF, Pignatelli M, Esposito S. Community-acquired pneumonia in children. Early Hum Dev. 2013;89(SUPPL3). - PMC - PubMed
    1. Nair H, Brooks WA, Katz M, Roca A, Berkley J a, Madhi S a, et al. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet. 2011;378(9807):1917–30. 10.1016/S0140-6736(11)61051-9 - DOI - PubMed
    1. Liu L, Johnson H, Cousens S. Global, regional, and national causes of child mortality in 2000–2010: an updated systematic analysis. Lancet. 2015;385(9966):430–40. 10.1016/S0140-6736(14)61698-6 - DOI - PubMed
    1. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Vol. 86, Bulletin of the World Health Organization. 2008. p. 408–16. 10.2471/BLT.07.048769 - DOI - PMC - PubMed
    1. Wardlaw T, Salama P, Johansson EW, Mason E. Pneumonia: the leading killer of children. Lancet. 2006;368(9541):1048–50. 10.1016/S0140-6736(06)69334-3 - DOI - PubMed

Publication types

MeSH terms

Associated data