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Epidemiology of acute respiratory infections in children of developing countries
1Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262.
Insights
Acute respiratory infections kill 4.5 million children annually, primarily in developing nations. Pneumonia, often caused by bacteria like Streptococcus pneumoniae, is the leading cause of these preventable deaths.
Area of Science:
- Pediatrics
- Infectious Diseases
- Global Health
Background:
- Acute respiratory infections (ARIs) are a leading cause of child mortality worldwide, particularly in developing countries.
- Pneumonia accounts for the majority of ARI-related deaths, with significant contributions from measles, pertussis, and other viral and bacterial pathogens.
Purpose of the Study:
- To summarize the etiological agents responsible for childhood ARIs in developing countries.
- To identify key risk factors contributing to the incidence and severity of lower respiratory infections in vulnerable populations.
Main Methods:
- This study synthesizes existing data on the prevalence of various bacterial and viral pathogens causing ARIs in children.
- It reviews documented risk factors associated with increased ARI incidence and severity in developing regions.
Main Results:
- Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus are identified as primary bacterial culprits.
- Respiratory syncytial virus (RSV), parainfluenza viruses, influenza viruses, and adenoviruses are significant viral contributors.
- Risk factors include large family size, crowding, malnutrition, low birth weight, and lack of breastfeeding.
Conclusions:
- Effective interventions for prevention and medical management are critical to reduce child mortality from ARIs.
- Addressing malnutrition, improving vaccination rates, and promoting breastfeeding are crucial preventive strategies.
Abstract:
Acute respiratory infections cause four and a half million deaths among children every year, the overwhelming majority occurring in developing countries. Pneumonia unassociated with measles causes 70% of these deaths; post-measles pneumonia, 15%; pertussis, 10%; and bronchiolitis and croup syndromes, 5%. Both bacterial and viral pathogens are responsible for these deaths. The most important bacterial agents are Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. The data on bacterial etiology of pneumonia during the first 3 months of life are limited, and almost no information on the role of chlamydia and pertussis in this age period is available. The distribution of viral pathogens in developing countries can be summarized as follows: respiratory syncytial virus, 15%-20%; parainfluenza viruses, 7%-10%; and influenza A and B viruses and adenovirus, 2%-4%. Mixed viral and bacterial infections occur frequently. Risk factors that increase the incidence and severity of lower respiratory infection in developing countries include large family size, lateness in the birth order, crowding, low birth weight, malnutrition, vitamin A deficiency, lack of breast feeding, pollution, and young age. Effective interventions for prevention and medical case management are urgently needed to save the lives of many children predisposed to severe disease.