The epidemiology and aetiology of infections in children admitted with clinical severe pneumonia to a university hospital in Rabat, Morocco

Imane Jroundi, Chafiq Mahraoui, Rachid Benmessaoud, Cinta Moraleda, Houssain Tligui, Myriam Seffar, Selma Cherif Kettani, Badr Sououd Benjelloun, Saad Chaacho, Abderrahman Maaroufi, Edward B. Hayes, Míriam J. Álvarez-Martínez, Carmen Muñoz-Almagro, Joaquim Ruiz, Pedro L. Alonso, Quique Bassat

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Objectives: Scarce and limited epidemiological, clinical and microbiological data are available regarding paediatric respiratory tract infections in the Kingdom of Morocco, a middle-income country in northwestern Africa. The results of hospital-based surveillance aiming at describing the aetiology and epidemiology of respiratory distress among children <5 years of age are presented. Methods: Children admitted to the Hô pital d'Enfants de Rabat, Morocco, and meeting the World Health Organization clinical criteria for severe pneumonia were recruited over a period of 14 months and were thoroughly investigated to ascertain a definitive diagnosis. Results: In total, 700 children were recruited for the study. Most frequent clinical diagnoses included wheezing-related conditions (bronchitis/asthma, 46%; bronchiolitis, 15%), while typical bacterial pneumonia was infrequent (only 19% of the cases). Invasive bacterial disease detected by classical microbiology or molecular methods was also uncommon, affecting only 3.5% of the patients, and with an overall low detection of pneumococcal or Haemophilus influenzae type b disease. Conversely, coverage of respiratory viral detection in the nasopharynx was almost universal among cases (92%), with the three most frequent viruses detected being rhinovirus (53%), respiratory syncytial virus (18%) and adenovirus (17%). The overall case fatality rate (CFR) among recruited patients with a known outcome was 4.1% (28/690). Conclusions: In Morocco, the epidemiological profile of paediatric acute respiratory infections is markedly shifted towards wheezing-related diseases and thus resembles that of high-income countries. However, the high associated CFRs found in this study call for an improvement in preventive and clinical management strategies.

Original languageEnglish
Article numberfmu010
Pages (from-to)270-278
Number of pages9
JournalJournal of Tropical Pediatrics
Volume60
Issue number4
DOIs
StatePublished - Aug 2014

Keywords

  • Acute respiratory infections
  • Bacterial diseases
  • Diagnostics
  • Epidemiology
  • Paediatrics
  • Respiratory viruses

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