Background
Methods/Design
Study objectives
Study sites and design
Study site characteristics | Country characteristics | Introduction into national immunization program a
| ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Hospital | Country | Town | Related research center | Population type | Climate | Country population, millions (year) a
| Population living in poverty, % (year) a
| Child mortality rate (‰) b
| Annual pneumonia cases c
| Deaths caused by pneumonia annually c
| PCV d
| Hib evaccine |
General Bonsucesso Hospital | Brazil | Rio de Janeiro | Fundaçao Oswaldo Cruz | Urban | Rain/Dry | 199 (2009) | 6.1 (2009) | 16 | 1,497,706 | 3,079 | 2010 | 1999 |
National Pediatric Hospital | Cambodia | Phnom Penh | Phnom Pehn Faculty of Pharmacy and University of Health Sciences | Urban | Rain/Dry | 14.9 (2012) | 18.6 (2009) | 43 | 373,583 | 2,101 | Not introduced | 2010 |
Beijing Children’s Hospital | China | Beijing | Chinese Academy of Medical Sciences | Urban | Four seasons | 1,351 (2012) | 11.8 (2009) | 15 | 6,488,544 | 43,089 | Not introduced | Not introduced |
Tent City Hospitalf
| Haïti | Port au Prince | GHESKIO Centers | Urban/rural | Rain/Dry | 10.2 (2012) | 61.7 (2001) | 70 | 345,081 | 4,090 | Not introduced | 2012 |
KEM Hospital Research Center Shirdi Sai Baba Rural Hospital | India | Pune/Vadu | KEM Hospital Research Center Sai Baba Rural Hospital | Urban/rural | Three seasons | 1,236.7 (2012) | 32.7 (2010) | 61 | 35,361,230 | 388,144 | Not introduced | 2011 |
Chatrapati Shahuji Maharaj University Hospital | India | Lucknow | Chatrapati Shahuji Maharaj University | Urban/rural | Rain/Dry | 1,236.7 (2012) | 32.7 (2010) | 61 | 35,361,230 | 388,144 | Not introduced | 2011 |
Hôpital Femme-Mere-Enfant | Madagascar | Antananarivo | Centre Charles Mérieux | Urban | Rain/Dry | 22.3 (2012) | 81.3 (2010) | 62 | 1,051,407 | 2,638 | 2011 | 2008 |
Gabriel Toure Hospital | Mali | Bamako | Centre Charles Mérieux | Urban/rural | Rain/Dry | 14.9 (2012) | 50.4 (2010) | 176 | 932,894 | 7,893 | 2008 | 2011 |
Bayanzurkh District General Hospital | Mongolia | Ulaanbaatar | Mongolian Academy of Medical Sciences | Urban | Four seasons | 2.8 (2012) | 27.4 (2012) | 31 | 60,292 | 332 | Not introduced | 2008 |
Pediatric General Hospital, Niños de Acosta Ñu | Paraguay | San Lorenzo | Research Institute of Health | Urban/rural | Rain/Dry | 6.7 (2009) | 7.2 (2012) | 22 | 139,661 | 368 | 2012 | 2002 |
Study participants
Definition of pneumonia
-
Cough and/or dyspnea, and
-
Tachypnea, as defined by the World Health Organization (WHO) (in children between 2 and 12 months of age: breathing rate ≥50 cycles per minute; in children between 12 months and 59 months of age: breathing rate ≥40 cycles per minute) [20], and
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Absence of wheezing at auscultation, and
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First symptoms appearing within the last 14 days, and
-
Radiological confirmation of pneumonia as per WHO guidelines [19].
Data sources and quality control
Category | Information | |
---|---|---|
General | Hospital | Country |
Demographic | Gender | Date of birth |
Underlying diseases | Heart disease | Lung disease |
Tuberculosis | Asthma | |
Pneumonia | HIV infection | |
Others | ||
Medical history | Contact with tuberculosis | Previous influenza |
Prior treatment with antibiotics | Prior treatment for fever | |
Date of first symptoms | ||
Clinical examination at enrollment | Weight | Height |
Arm circumference | Temperature | |
Blood pressure | Breathing rate | |
Arterial oxygen saturation | Cough | |
Dyspnea | Lower chest indrawing | |
Cyanosis | Pulmonary crackles | |
Dullness to percussion of the thorax | Rhonchi | |
Wheezing | Rasping | |
Diminished breathing sounds | Convulsions | |
Other pulmonary signs and symptoms | Rhinopharyngitis | |
Prostration or lethargy | Conjunctivitis | |
Otitis | Inability to drink | |
Skin rash | Diarrhea | |
Vomiting | Other signs | |
Radiological | Opacification | Abscess |
findings | Interstitial syndrome | Pneumothorax |
(cases only) | Alveolar infiltrate | Parenchymatous infiltrate |
Vaccination (dates, number of doses) | Pneumococcal conjugate vaccine Influenza vaccine | Diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type B vaccine |
During hospital stay | Antibiotics (dates, doses, duration) | Oxygen therapy |
Other drugs | Death | |
Acute complications | Cause of death | |
Recovery |
Biological samples
Samples | Population | Analyses |
---|---|---|
Nasal swab/aspirate | Cases and controls | Molecular detection of viruses and bacteria
S. pneumoniae typing |
Pleural effusion | Cases (if pleuritis) | Molecular detection of viruses and bacteria
S. pneumoniae typing |
Whole blood | Cases | Molecular detection of viruses and bacteria |
S. pneumoniae typing | ||
Blood culture | ||
Blood count | ||
Serum | Cases | C-reactive protein |
Procalcitonin | ||
Urine | Cases | Broad antibiotic detection |