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Review
. 2019 Nov:32:3-9.
doi: 10.1016/j.prrv.2019.06.001. Epub 2019 Jun 26.

Childhood pneumonia in low-and-middle-income countries: An update

Diana Marangu  1 , Heather J Zar  2
Affiliations
Review

Childhood pneumonia in low-and-middle-income countries: An update

Diana Marangu et al. Paediatr Respir Rev. 2019 Nov.

Abstract

Objectives: To review epidemiology, aetiology and management of childhood pneumonia in low-and-middle-income countries.

Design: Review of published English literature between 2013 and 2019.

Results: Pneumonia remains a major cause of morbidity and mortality. Risk factors include young age, malnutrition, immunosuppression, tobacco smoke or air pollution exposure. Better methods for specimen collection and molecular diagnostics have improved microbiological diagnosis, indicating that pneumonia results from several organisms interacting. Induced sputum increases microbiologic yield for Bordetella pertussis or Mycobacterium tuberculosis, which has been associated with pneumonia in high TB prevalence areas. The proportion of cases due to Streptococcus pneumoniae and Haemophilus influenzae b has declined with new conjugate vaccines; Staphylococcus aureus and H. influenzae non-type b are the commonest bacterial pathogens; viruses are the most common pathogens. Effective interventions comprise antibiotics, oxygen and non-invasive ventilation. New vaccines have reduced severity and incidence of disease, but disparities exist in uptake.

Conclusion: Morbidity and mortality from childhood pneumonia has decreased but a considerable preventable burden remains. Widespread implementation of available, effective interventions and development of novel strategies are needed.

Keywords: Aetiology; Epidemiology; Lower respiratory tract infection; Management; Prevention.

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Figures

Fig. 1
Fig. 1
Plain chest radiograph image of a young child with pneumonia who cultured M. tuberculosis on an induced sputum sample.
See this image and copyright information in PMC

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