Prevalence, risk factors and outcome in Ugandan children infected with Mycoplasma pneumoniae: a prospective study
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Paediatrics and international child health
Abstract
Background:
A typical bacteria cause 10–40% of all childhood community-acquired pneumonia and severe disease in children under 5 years of age. Data on the burden of atypical pneumonia in sub-Saharan Africa are limited.
Aim:
To determine the prevalence, associated factors, and outcome of Mycoplasma pneumoniae infection in children presenting with respiratory symptoms at Mulago National Referral Hospital,
Kampala.
Methods:
Children aged 2 months to 12 years who presented with cough and/or difficult breathing and fast breathing were recruited. A clinical history and physical examination were undertaken. Blood samples were taken at enrolment (Day 0) and on Day 21 to determine the presence of Mycoplasma pneumoniae IgM antibodies, and induced sputum for DNA-PCR. Admitted participants were followed for a maximum of 7 days or until discharge or death, whichever came first.
Results:
A total of 385 children were enrolled, and, of these, 368 (95.6%) were <5 years of age and the other 17 (4.4%) 5–12 years. Overall, 60/385 (15.6%) participants tested positive for M. pneumoniae IgM and/or DNA-PCR. Of these, 56/60 (93.3%) were <5 years of age. Wheezing was present in 21/60 (35.0%) of the children with atypical pneumonia (Mycoplasma pneumonia) and in 128/325 (39.4%) of those with typical pneumonia. The factors associated with M. pneumonia were female sex (AOR 1.94, 95% CI 1.22–3.08, p<0.001), age ≥12 months (AOR 2.73, 95% CI 1.53–4.87, p=0.01) and a history of prematurity (AOR 2.07, 95% CI 1.23–3.49, p=0.01). The overall mortality was 17/352 (4.8%) and, of these, 4/17 (23.5%) had M. pneumonia
Conclusion:
In Uganda, M. pneumonia is common in children <5 years of age, especially females above 2 years, and in those with a history of prematurity. It presents with severe symptoms requiring hospitalisation. The results highlight the importance of considering atypical bacteria in under-5s who present with symptoms of pneumonia.
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Citation
Nantanda, R., Bwanga, F., Najjingo, I., Ndeezi, G., & Tumwine, J. K. (2021). Prevalence, risk factors and outcome in Ugandan children infected with Mycoplasma pneumoniae: a prospective study. Paediatrics and international child health, 41(3), 188. doi:10.1080/20469047.2021.1980698.