Jamila Nambafu1, Mary Achakolong2, Fridah Mwendwa2, Jumaa Bwika1, Felix Riunga1, Samuel Gitau3, Hanika Patel3, Rodney D Adam4,5. 1. Department of Medicine, Aga Khan University, Third Parklands Rd, Nairobi, Kenya. 2. Department of Pathology, Aga Khan University, Third Parklands Rd, Nairobi, Kenya. 3. Department of Radiology, Aga Khan University, Nairobi, Kenya. 4. Department of Medicine, Aga Khan University, Third Parklands Rd, Nairobi, Kenya. rodney.adam@aku.edu. 5. Department of Pathology, Aga Khan University, Third Parklands Rd, Nairobi, Kenya. rodney.adam@aku.edu.
Abstract
BACKGROUND: Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infected patients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence. METHODS: We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. The patients were followed for etiology and clinical outcomes. Viral PCR testing was performed using the FTD respiratory pathogen-21 multiplex kit on nasopharyngeal or lower respiratory samples. Additional microbiologic workup was performed as determined by the treating physicians. RESULTS: A potential etiologic agent(s) was identified in 57% including 43% viral, 5% combined viral and bacterial, 5% bacterial and 4% Pneumocystis. The most common etiologic agent was Influenza A which was associated with severe clinical disease. The most common underlying conditions were cardiovascular disease, diabetes and lung disease, while HIV infection was identified in only 13% of patients. Critical care admission was required for 24, and 31% had acute kidney injury, sometimes in combination with acute respiratory distress or sepsis. CONCLUSION: Viruses, especially influenza, were commonly found in patients with CAP. In contrast to other studies from sub-Saharan Africa, the underlying conditions were similar to those reported in high resource areas and point to the growing concern of the double burden of infectious and noncommunicable diseases.
BACKGROUND: Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infectedpatients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence. METHODS: We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. The patients were followed for etiology and clinical outcomes. Viral PCR testing was performed using the FTD respiratory pathogen-21 multiplex kit on nasopharyngeal or lower respiratory samples. Additional microbiologic workup was performed as determined by the treating physicians. RESULTS: A potential etiologic agent(s) was identified in 57% including 43% viral, 5% combined viral and bacterial, 5% bacterial and 4% Pneumocystis. The most common etiologic agent was Influenza A which was associated with severe clinical disease. The most common underlying conditions were cardiovascular disease, diabetes and lung disease, while HIV infection was identified in only 13% of patients. Critical care admission was required for 24, and 31% had acute kidney injury, sometimes in combination with acute respiratory distress or sepsis. CONCLUSION: Viruses, especially influenza, were commonly found in patients with CAP. In contrast to other studies from sub-Saharan Africa, the underlying conditions were similar to those reported in high resource areas and point to the growing concern of the double burden of infectious and noncommunicable diseases.
Authors: Tom H Boyles; Adrian Brink; Greg L Calligaro; Cheryl Cohen; Keertan Dheda; Gary Maartens; Guy A Richards; Richard van Zyl Smit; Clifford Smith; Sean Wasserman; Andrew C Whitelaw; Charles Feldman Journal: J Thorac Dis Date: 2017-06 Impact factor: 2.895
Authors: Daniel R Feikin; M Kariuki Njenga; Godfrey Bigogo; Barrack Aura; George Aol; Allan Audi; Geoffrey Jagero; Peter Ochieng Muluare; Stella Gikunju; Leonard Nderitu; Amanda Balish; Jonas Winchell; Eileen Schneider; Dean Erdman; M Steven Oberste; Mark A Katz; Robert F Breiman Journal: PLoS One Date: 2012-08-24 Impact factor: 3.240
Authors: Laura Dwyer-Lindgren; Michael A Cork; Amber Sligar; Krista M Steuben; Kate F Wilson; Naomi R Provost; Benjamin K Mayala; John D VanderHeide; Michael L Collison; Jason B Hall; Molly H Biehl; Austin Carter; Tahvi Frank; Dirk Douwes-Schultz; Roy Burstein; Daniel C Casey; Aniruddha Deshpande; Lucas Earl; Charbel El Bcheraoui; Tamer H Farag; Nathaniel J Henry; Damaris Kinyoki; Laurie B Marczak; Molly R Nixon; Aaron Osgood-Zimmerman; David Pigott; Robert C Reiner; Jennifer M Ross; Lauren E Schaeffer; David L Smith; Nicole Davis Weaver; Kirsten E Wiens; Jeffrey W Eaton; Jessica E Justman; Alex Opio; Benn Sartorius; Frank Tanser; Njeri Wabiri; Peter Piot; Christopher J L Murray; Simon I Hay Journal: Nature Date: 2019-05-15 Impact factor: 49.962