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Dembele BPP, Kamigaki T, Dapat C, Tamaki R, Saito M, Saito M, Okamoto M, Igoy MAU, Mercado ES, Mondoy M, Tallo VL, Lupisan SP, Egawa S, Oshitani H. Aetiology and risks factors associated with the fatal outcomes of childhood pneumonia among hospitalised children in the Philippines from 2008 to 2016: a case series study. BMJ Open 2019; 9:e026895. [PMID: 30928958 PMCID: PMC6475207 DOI: 10.1136/bmjopen-2018-026895] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Pneumonia remains the leading cause of hospitalisations and deaths among children aged <5 years. Diverse respiratory pathogens cause acute respiratory infections, including pneumonia. Here, we analysed viral and bacterial pathogens and risk factors associated with death of hospitalised children. DESIGN A 9-year case series study. SETTING Two secondary-care hospitals, one tertiary-care hospital and one research centre in the Philippines. PARTICIPANTS 5054 children aged <5 years hospitalised with severe pneumonia. METHODS Nasopharyngeal swabs for virus identification, and venous blood samples for bacterial culture were collected. Demographic, clinical data and laboratory findings were collected at admission time. Logistic regression analyses were performed to identify the factors associated with death. RESULTS Of the enrolled patients, 57% (2876/5054) were males. The case fatality rate was 4.7% (238/5054), showing a decreasing trend during the study period (p<0.001). 55.0% of the patients who died were either moderately or severely underweight. Viruses were detected in 61.0% of the patients, with respiratory syncytial virus (27.0%) and rhinovirus (23.0%) being the most commonly detected viruses. In children aged 2-59 months, the risk factors significantly associated with death included age of 2-5 months, sensorial changes, severe malnutrition, grunting, central cyanosis, decreased breath sounds, tachypnoea, fever (≥38.5°C), saturation of peripheral oxygen <90%, infiltration, consolidation and pleural effusion on chest radiograph.Among the pathogens, adenovirus type 7, seasonal influenza A (H1N1) and positive blood culture for bacteria were significantly associated with death. Similar patterns were observed between the death cases and the aforementioned factors in children aged <2 months. CONCLUSION Malnutrition was the most common factor associated with death and addressing this issue may decrease the case fatality rate. In addition, chest radiographic examination and oxygen saturation measurement should be promoted in all hospitalised patients with pneumonia as well as bacteria detection to identify patients who are at risk of death.
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Affiliation(s)
| | - Taro Kamigaki
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Clyde Dapat
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Raita Tamaki
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mariko Saito
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mayuko Saito
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Michiko Okamoto
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mary Ann U Igoy
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | | | - Melisa Mondoy
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Veronica L Tallo
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Socorro P Lupisan
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Shinichi Egawa
- Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Hitoshi Oshitani
- Virology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Sanogo M, Kone B, Diarra B, Maiga M, Baya B, Somboro AM, Sarro YS, Togo ACG, Dembele BPP, Goita D, Kone A, M'Baye O, Coulibaly N, Diabate S, Traore B, Diallo MH, Coulibaly YI, Saleeb P, Belson M, Orsega S, Siddiqui S, Polis MA, Dao S, Murphy RL, Diallo S. Performance of microscopic observation drug susceptibility for the rapid diagnosis of tuberculosis and detection of drug resistance in Bamako, Mali. Clin Microbiol Infect 2017; 23:408.e1-408.e6. [PMID: 28110049 DOI: 10.1016/j.cmi.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 11/08/2016] [Accepted: 01/04/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES In Mali early detection and treatment of multidrug-resistant tuberculosis (MDR-TB) are still challenging due to the cost, time and/or complexity associated with regular tests. Microscopic Observation Drug Susceptibility (MODS) is a low-cost assay validated by WHO in 2010. It is a liquid-culture-based assay to detect the 'cording' characteristic of Mycobacterium tuberculosis complex and to assess susceptibility to both isoniazid and rifampicin defining multidrug-resistant tuberculosis (MDR-TB). In this study we aimed to evaluate the performance of MODS as diagnostic tool compared with a validated method-Mycobacteria Growth Indicator Tube/Antimicrobial Susceptibility Testing/Streptomycin, Isoniazid, Rifampicin and Ethambutol (MGIT/AST/SIRE). METHODS AND RESULTS Between January 2010 and October 2015 we included 98 patients with suspected TB in an observational cohort study. The sensitivity and specificity of MODS assay for detecting TB were respectively 94.12% and 85.71% compared with the reference MGIT/7H11 culture, with a Cohen κ coefficient of 0.78 (95% CI 0.517-1.043). The median time to culture positivity for MODS assay and MGIT (plus interquartile range, IQR) was respectively 8 days (IQR 5-11) and 6 days (IQR 5-6). In detecting patients with MDR-TB, the sensitivity and specificity of MODS assay were respectively 100% and 95.92%. The positive predictive value and negative predictive value were, respectively, 66.7% and 100%. The median turnaround times for obtaining MDR-TB results using MODS assay and MGIT/AST/SIRE was respectively 9 days and 35 days. Hence, the MODS assay rapidly identifies MDR-TB in Mali compared with the MGIT/AST/SIRE. CONCLUSION As an easy, simple, fast and affordable method, the MODS assay could significantly improve the management of TB.
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Affiliation(s)
- M Sanogo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Diarra
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali; Institute of Tropical Medicine (ITM), Biomedical Department, Antwerp, Belgium.
| | - M Maiga
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali; Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, MD, USA
| | - B Baya
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A M Somboro
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B P P Dembele
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - D Goita
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O M'Baye
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - N Coulibaly
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Diabate
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Traore
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M H Diallo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y I Coulibaly
- Filariasis Unit of the Malaria Research and Training Centre (MRTC), USTTB, Bamako, Mali
| | - P Saleeb
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - M Belson
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Orsega
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Siddiqui
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - M A Polis
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Dao
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - R L Murphy
- Division of Infectious Diseases, Northwestern University, Chicago, IL, USA
| | - S Diallo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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Traore B, Diarra B, Dembele BPP, Somboro AM, Hammond AS, Siddiqui S, Maiga M, Kone B, Sarro YS, Washington J, Parta M, Coulibaly N, M'baye O, Diallo S, Koita O, Tounkara A, Polis MA. Molecular strain typing of Mycobacterium tuberculosis complex in Bamako, Mali. Int J Tuberc Lung Dis 2012; 16:911-6. [PMID: 22508197 DOI: 10.5588/ijtld.11.0397] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To identify strains of Mycobacterium tuberculosis complex (MTC) circulating in Bamako and to examine the relationship between the strains and their drug susceptibility profiles. METHODS Between 2006 and 2010, we conducted a cross-sectional study using spoligotyping to identify strains of MTC recovered from 126 tuberculosis (TB) patients under treatment in Bamako, Mali. RESULT Three members of the MTC were isolated: M. tuberculosis (71.4%), M. africanum (27.8%) and M. bovis (0.8%). Of these, three strains were found to be the most prevalent: M. tuberculosis T1 (MTB T1; 38.9%), M. africanum F2 (MAF2; 26.2%) and M. tuberculosis Latin American and Mediterranean 10 (MTB LAM 10; 10.3%). MAF2 and MTB LAM 10 strains have a lower risk of multidrug resistance (MDR) than MTB T1 (respectively OR 0.1, 95%CI 0.03-0.4 and OR 0.1, 95%CI 0.01-0.8). Age ≥ 32 years (OR 1.4, 95%CI 0.4-3.9), negative human immunodeficiency virus status (OR 0.4, 95%CI 0.1-2.5) and male sex (OR 4, 95%CI 0.9-16.5) were not associated with MDR. The prevalence of MDR among treatment and retreatment failure patients was respectively 25% and 81.8% compared to new patients (2.9%). CONCLUSION This study indicates a low level of primary drug resistance in Bamako, affirms the importance of using correct drug regimens, and suggests that the MTB T1 strain may be associated with the development of resistance.
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Affiliation(s)
- B Traore
- Project SEREFO-NIAID (Centre de Recherche et de Formation sur VIH/Sida et Tuberculose-Institut National des Maladies Infectieuses et Allergiques)/University of Bamako Research Collaboration on HIV-TB, Bamako, Mali
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