Outcome risk factors during respiratory infections in a paediatric ward in Antananarivo, Madagascar 2010-2012.
Outcome risk factors during respiratory infections in a paediatric ward in Antananarivo, Madagascar 2010-2012.
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DOI：
10.1371/journal.pone.0072839
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Richard V
中科院分区：
文献类型：
--
作者：
Rajatonirina S;Razanajatovo NH;Ratsima EH;Orelle A;Ratovoson R;Andrianirina ZZ;Andriatahina T;Ramparany L;Herindrainy P;Randrianirina F;Heraud JM;Richard V
急性呼吸道感染是全世界儿童，特别是发展中国家儿童与传染病相关的发病、住院和死亡的主要原因。在这些低收入国家，大多数急性呼吸道感染（ARI）患者，无论是轻度还是重度，仍然是凭经验治疗。该研究的目的是评估与5岁以下患者呼吸系统疾病演变和结局相关的风险因素。我们于2010年11月至2012年7月在塔那那利佛的儿科病房进行了一项前瞻性研究，纳入了5岁以下呼吸道感染患者。我们收集了人口统计学、社会经济学、临床和流行病学数据，以及用于实验室分析的样本。死亡、住院期间快速进展为呼吸窘迫和住院超过10天被视为重度结局。我们使用多变量分析来研究合并感染的影响。2010年11月至2012年7月，共入组290例患者。192例患者（70%）发现合并感染。合并感染在36个月以下的儿童中更常见，19-24个月组的差异有统计学意义（OR：8.0）。69%（230/290）的患者完全康复，住院期间无任何严重结局; 60名儿童的结局评分为严重，9名患者（3%）死亡。与住院期间病情恶化（严重结局）显著相关的风险因素为入院时年龄小于6个月（OR = 5.3）、合并症（OR = 4.6）和低家庭收入（OR = 4.1）。 合并症，低收入和年龄在6个月以下的儿童感染多种呼吸道病原体的严重后果的风险增加。这些结果突出表明，有必要实施有针对性的公共卫生政策，以减少呼吸道疾病对低收入国家儿童发病率和死亡率的影响。
Acute respiratory infections are a leading cause of infectious disease-related morbidity, hospitalisation and mortality among children worldwide, and particularly in developing countries. In these low-income countries, most patients with acute respiratory infection (ARI), whether it is mild or severe, are still treated empirically. The aim of the study was to evaluate the risk factors associated with the evolution and outcome of respiratory illnesses in patients aged under 5 years old. We conducted a prospective study in a paediatric ward in Antananarivo from November 2010 to July 2012 including patients under 5 years old suffering from respiratory infections. We collected demographic, socio-economic, clinical and epidemiological data, and samples for laboratory analysis. Deaths, rapid progression to respiratory distress during hospitalisation, and hospitalisation for more than 10 days were considered as severe outcomes. We used multivariate analysis to study the effects of co-infections. From November 2010 to July 2012, a total of 290 patients were enrolled. Co-infection was found in 192 patients (70%). Co-infections were more frequent in children under 36 months, with a significant difference for the 19–24 month-old group (OR: 8.0). Sixty-nine percent (230/290) of the patients recovered fully and without any severe outcome during hospitalisation; the outcome was scored as severe for 60 children and nine patients (3%) died. Risk factors significantly associated with worsening evolution during hospitalisation (severe outcome) were admission at age under 6 months (OR = 5.3), comorbidity (OR = 4.6) and low household income (OR = 4.1). Co-mordidity, low-income and age under 6 months increase the risk of severe outcome for children infected by numerous respiratory pathogens. These results highlight the need for implementation of targeted public health policy to reduce the contribution of respiratory diseases to childhood morbidity and mortality in low income countries.
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影响因子：
158.5
作者：
Klugman, KP;Madhi, SA;Pierce, N
通讯作者：
Pierce, N
影响因子：
3.7
作者：
Do AH;van Doorn HR;Nghiem MN;Bryant JE;Hoang TH;Do QH;Van TL;Tran TT;Wills B;Nguyen VC;Vo MH;Vo CK;Nguyen MD;Farrar J;Tran TH;de Jong MD
通讯作者：
de Jong MD
影响因子：
3.7
作者：
Randremanana, Rindra V.;Richard, Vincent;Bicout, Dominique J.
通讯作者：
Bicout, Dominique J.
DOI：
10.2471/blt.07.048512
发表时间：
2008-05-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Graham, Stephen M;English, Mike;Duke, Trevor
通讯作者：
Duke, Trevor
影响因子：
10
作者：
Lahti, E.;Peltola, V.;Ruuskanen, O.
通讯作者：
Ruuskanen, O.