Frequency of complications and the effects of pneumococcal vaccination in young children with acute respiratory tract infection |
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| Institution: | 1. Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Brazil;2. Department of Epidemiology, São Paulo University School of Public Health, São Paulo, Brazil;3. Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Salvador, Brazil;4. Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Brazil;5. Department of Pathology, Federal University of Bahia School of Medicine, Salvador, Brazil;1. Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy;2. Department of Biology and Biotechnology “Charles Darwin”, Sapienza University of Rome 00185 Rome, Italy;3. Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, USA;4. Division of Virology, Department of Microbiology and Immunology, and International Research Center for Infectious Diseases, Institute of Medical Science, University of Tokyo, Japan;5. Infection-Induced Host Responses Project, Exploratory Research for Advanced Technology, Saitama 332-0012, Japan;1. Unidad de Urgencias de Pediatría, Hospital Universitario Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain;2. Servicio de Microbiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain;3. Unidad de Enfermedades Infecciosas, Hospital Universitario Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain;1. Department of Clinical Laboratory, Children''s Hospital of Shanghai, Shanghai Jiaotong University, Shanghai, China;2. Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China;1. Department of Medical Microbiology, University Hospital RWTH Aachen, Aachen 52074, Germany;1. Department of ENT Head & Neck Surgery, Nordsjællands Hospital, Dyrehavevej 29, 4000 Hillerød, Denmark;2. Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;3. Department of Infectious Diseases, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark;4. Department of Pediatrics, Næstved Hospital, Ringstedgade 61, 4700 Næstved, Denmark;5. Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;6. Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, J.B. Winsløws Vej 9 B, 5000 Odense C, Denmark;7. Department of ENT Head & Neck Surgery, Zealand University Hospital, Lykkebækvej 1, 4600 Køge, Denmark |
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| Abstract: | BackgroundAcute respiratory infection (ARI) is the most frequent reason for children being seen by doctors worldwide. We aimed to estimate the frequency of complications in children aged 6–23 months during ARI episode and to evaluate risk factors present on recruitment associated with complications after the universal implementation of pneumococcal vaccine (PCV10) in our region.MethodsThis prospective cohort enrolled children who had shown ARI for up to 7 days and who were subsequently followed up 14–21 days after, in Salvador, Brazil. Data on recruitment were registered. The vaccine card was personally checked. Complication was defined when hospitalization, pneumonia or acute otitis media (AOM) were informed during the follow-up visit. Pneumonia and AOM were diagnosed by a doctor. Multiple logistic regression analysis was performed.ResultsOf 576 children, 422 (73%) returned and 79 (19%; 95%CI: 15–23%) had complications. The mean interval between admission and follow-up was 23 ± 13 days. Pneumonia (n = 47; 11%), hospitalization (n = 28; 7%), and AOM (n = 17; 4%) were reported. Most of the patients presented one complication (n = 66; 84%) followed by two (n = 13; 16%). Report of fever (92% versus 79%; OR 95%CI]: 2.90 1.18–7.14]), bird at home (24% versus 14%; OR 95%CI]: 2.13 1.07–4.26]), ronchi (48% versus 36%; OR 95%CI]: 2.06 1.16–3.67]) or crackles (17% versus 7%; OR 95%CI]: 2.36 1.04–5.38]) on auscultation were directly associated with complications whereas PCV10 (59% versus 75%; OR 95%CI]: 0.46 0.26–0.82]) was inversely associated. Bird at home (OR 95%CI]: 5.80 1.73–19.38]) and ronchi (OR 95%CI]: 6.39 1.96–20.85]) were associated with AOM; PCV10 was inversely associated with AOM (OR 95%CI]: 0.16 0.05–0.52]). Crackles were associated with pneumonia (OR 95%CI]: 2.55 1.01–6.40]).ConclusionsOne fifth of the children presented complications. PCV10 was independently associated with lower odds of development of AOM. Bird at home and ronchi are risk factors of otitis. Crackles are associated with pneumonia. |
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| Keywords: | Pneumococcal conjugate vaccine Children Common cold Viruses |
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