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2020 ; 95
(ä): 74-83
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English Wikipedia
Pneumonia in children admitted to the national referral hospital in Bhutan: A
prospective cohort study
#MMPMID32283281
Jullien S
; Pradhan D
; Tshering T
; Sharma R
; Dema K
; Garcia-Garcia S
; Ribó JL
; Muñoz-Almagro C
; Bassat Q
Int J Infect Dis
2020[Jun]; 95
(ä): 74-83
PMID32283281
show ga
OBJECTIVES: The study aim was to describe the etiological profile and clinical
characteristics of pneumonia among children hospitalized in Thimphu, Bhutan.
METHODS: This prospective study enrolled children aged 2-59 months admitted to
the Jigme Dorji Wangchuck National Referral Hospital with World Health
Organization (WHO)-defined clinical pneumonia. Demographic and
clinico-radiological data were collected through questionnaires, physical
examination, and chest radiography. Blood samples and nasopharyngeal washing were
collected for microbiological analysis including culture and molecular methods.
RESULTS: From July 2017 to June 2018, 189 children were enrolled, of which 53.4%
were infants. Pneumonia-related admissions were less frequent over the winter.
Chest radiographies were obtained in 149 children; endpoints included pneumonia
in 39 cases (26.2%), other infiltrates in 31 (20.8%), and were normal in 79
children (53.0%). Non-contaminated bacterial growth was detected in 8/152 (5.3%)
blood cultures, with only two cases of Streptococcus pneumoniae. Viral detection
in upper respiratory secretions was common, with at least one virus detected in
103/115 (89.6%). The three most-commonly isolated viruses were respiratory
syncytial virus (52/115; 45.2%), rhinovirus (42/115; 36.5%), and human
parainfluenza virus (19/115; 16.5%). A third of patients with viral infections
showed mixed infections. Case fatality rate was 3.2% (6/189). CONCLUSION:
Respiratory viral infections predominated among this cohort of WHO-defined
clinical pneumonia cases, whereas bacterial aetiologies were uncommon,
highlighting the epidemiologic transition that Bhutan seems to have reached.