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Mendes ADCL, De Souza AMG, Nunes ADDS, Jerez-Roig J, Barbosa IR. Frequency of Vitamin a Deficiency in Children Hospitalized for Pneumonia: An Integrative Review. Public Health Rev 2022; 43:1604500. [PMID: 36588988 PMCID: PMC9799238 DOI: 10.3389/phrs.2022.1604500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Objective: To identify the frequency of vitamin A deficiency in children aged 6 months to 5 years hospitalized for pneumonia. Methods: An integrative literature review was carried out, where searches were made by two independent researchers, with no language limits or publication time in the databases PubMed, LILACS, Web of Science, Scopus and CINAHL, and in the gray literature-OpenGrey, Proquest and Google Scholar. In the eligibility phase, the screened studies were read in full and those that did not answer the research question were excluded. Methodological quality was assessed using the Downs & Black (1998) checklist. Results: 1642 articles were identified, after all stages of screening and selection, 10 studies were included, of which 5 were longitudinal, 4 were intervention and 1 transversal. All studies identified subclinical vitamin A deficiency in children hospitalized with pneumonia; the highest frequency of subclinical vitamin A deficiency was 93.2%. All studies evaluated showed frequencies of subclinical vitamin A deficiency >20%. Conclusion: There is a high frequency of subclinical vitamin A deficiency in children with pneumonia; these data need to be further explored in terms of their associations. For this reason, new studies that evaluate this topic are of fundamental importance.
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Affiliation(s)
- Amanda De Conceição Leão Mendes
- Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil,*Correspondence: Amanda De Conceição Leão Mendes,
| | | | | | - Javier Jerez-Roig
- University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
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Ayeni OA, Walaza S, Tempia S, Groome M, Kahn K, Madhi SA, Cohen AL, Moyes J, Venter M, Pretorius M, Treurnicht F, Hellferscee O, von Gottberg A, Wolter N, Cohen C. Mortality in children aged <5 years with severe acute respiratory illness in a high HIV-prevalence urban and rural areas of South Africa, 2009-2013. PLoS One 2021; 16:e0255941. [PMID: 34383824 PMCID: PMC8360538 DOI: 10.1371/journal.pone.0255941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/27/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Severe acute respiratory illness (SARI) is an important cause of mortality in young children, especially in children living with HIV infection. Disparities in SARI death in children aged <5 years exist in urban and rural areas. OBJECTIVE To compare the factors associated with in-hospital death among children aged <5 years hospitalized with SARI in an urban vs. a rural setting in South Africa from 2009-2013. METHODS Data were collected from hospitalized children with SARI in one urban and two rural sentinel surveillance hospitals. Nasopharyngeal aspirates were tested for ten respiratory viruses and blood for pneumococcal DNA using polymerase chain reaction. We used multivariable logistic regression to identify patient and clinical characteristics associated with in-hospital death. RESULTS From 2009 through 2013, 5,297 children aged <5 years with SARI-associated hospital admission were enrolled; 3,811 (72%) in the urban and 1,486 (28%) in the rural hospitals. In-hospital case-fatality proportion (CFP) was higher in the rural hospitals (6.9%) than the urban hospital (1.3%, p<0.001), and among HIV-infected than the HIV-uninfected children (9.6% vs. 1.6%, p<0.001). In the urban hospital, HIV infection (odds ratio (OR):11.4, 95% confidence interval (CI):5.4-24.1) and presence of any other underlying illness (OR: 3.0, 95% CI: 1.0-9.2) were the only factors independently associated with death. In the rural hospitals, HIV infection (OR: 4.1, 95% CI: 2.3-7.1) and age <1 year (OR: 3.7, 95% CI: 1.9-7.2) were independently associated with death, whereas duration of hospitalization ≥5 days (OR: 0.5, 95% CI: 0.3-0.8) and any respiratory virus detection (OR: 0.4, 95% CI: 0.3-0.8) were negatively associated with death. CONCLUSION We found that the case-fatality proportion was substantially higher among children admitted to rural hospitals and HIV infected children with SARI in South Africa. While efforts to prevent and treat HIV infections in children may reduce SARI deaths, further efforts to address health care inequality in rural populations are needed.
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Affiliation(s)
- Oluwatosin A. Ayeni
- Faculty of Health Sciences, Division of Epidemiology and biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Sibongile Walaza
- Faculty of Health Sciences, Division of Epidemiology and biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
| | - Stefano Tempia
- Faculty of Health Sciences, Division of Epidemiology and biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Influenza Programme, Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa
- Mass Genics, Duluth, Georgia, Unites States of America
| | - Michelle Groome
- Faculty of Health Sciences, Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- Faculty of Health Sciences, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
- INDEPTH Network, Accra, Ghana
| | - Shabir A. Madhi
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
- Faculty of Health Sciences, Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Adam L. Cohen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Influenza Programme, Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa
| | - Jocelyn Moyes
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
| | - Marietjie Venter
- Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Marthi Pretorius
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
- Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Florette Treurnicht
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
| | - Orienka Hellferscee
- Faculty of Health Sciences, Division of Epidemiology and biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Anne von Gottberg
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
- School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Division of Infectious Diseases, Hubert Department of Global Health, Rollins School of Public Health, School of Medicine, Emory University, Atlanta, GA, United States of America
| | - Nicole Wolter
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
- School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Faculty of Health Sciences, Division of Epidemiology and biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
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