A population-based study of hospital admission incidence rate and bacterial aetiology of acute lower respiratory infections in children aged less than five years in Bangladesh

Abdullah H. Baqui, Mahbubur Rahman, K. Zaman, Shams El Arifeen, Hafizur Rahman Chowdhury, Nazma Begum, Gaurav Bhattacharya, Rashid A. Chotani, Mohammad Yunus, Mathuram Santosham, Robert E. Black

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27 Scopus citations

Abstract

The research was carried out to study the rate of population-based hospital admissions due to acute lower respiratory infections (ALRIs) and bacterial aetiology of ALRIs in children aged less than five years in Bangladesh. A cohort of children aged less than five years in a rural surveillance population in Matlab, Bangladesh, was studied for two years. Cases were children admitted to the Matlab Hospital of ICDDR,B with a diagnosis of severe ALRIs. Bacterial aetiology was determined by blood culture. Antimicrobial resistance patterns of Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Spn) isolates were determined using the disc-diffusion method. In total, 18,983 children aged less than five years contributed to 24,902 child-years of observation (CYO). The incidence of ALRI-related hospital admissions was 50.2 per 1,000 CYO. The incidences of ALRI were 67% higher in males than in females and were higher in children aged less than two years than in older children. About 34% of the cases received antibiotics prior to hospitalization. Of 840 blood samples cultured, 39.4% grew a bacterial isolate; 11.3% were potential respiratory pathogens, and the rest were considered contaminants. The predominant isolates were Staphylococcus aureus (4.5%). Hib (0.4%) and Spn (0.8%) were rarely isolated; however, resistance of both these pathogens to trimethoprim-sulphamethoxazole was common. The rate of ALRI-related hospitalizations was high. The high rate of contamination, coupled with high background antibiotic use, might have contributed to an underestimation of the burden of Hib and Spn. Future studies should use more sensitive methods and more systematically look for resistance patterns of other pathogens in addition to Hib and Spn.

Original languageEnglish (US)
Pages (from-to)179-188
Number of pages10
JournalJournal of Health, Population and Nutrition
Volume25
Issue number2
StatePublished - Jun 2007

Keywords

  • Acute lower respiratory infections
  • Bangladesh
  • Child
  • Drug resistance
  • Haemophilus influenzae
  • Hospitalization
  • Infant
  • Microbial
  • Morbidity
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Food Science
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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