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-
1.
Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE, 2013. Global burden of childhood pneumonia and diarrhoea. Lancet 381: 1405–1416.
-
2.
Chisti MJ, Huq S, Das SK, Malek MA, Ahmed T, Faruque AS, Salam MA, 2008. Predictors of severe illness in children under age five with concomitant infection with pneumonia and diarrhea at a large hospital in Dhaka, Bangladesh. Southeast Asian J Trop Med Public Health 39: 719–727.
-
3.
Chisti MJ, Pietroni MA, Smith JH, Bardhan PK, Salam MA, 2011. Predictors of death in under-five children with diarrhoea admitted to a critical care ward in an urban hospital in Bangladesh. Acta Paediatr 100: e275–e279.
-
4.
Walker CL, Perin J, Katz J, Tielsch JM, Black RE, 2013. Diarrhea as a risk factor for acute lower respiratory tract infections among young children in low income settings. J Glob Health 3: 010402.
-
5.
Ashraf S, Huque MH, Kenah E, Agboatwalla M, Luby SP, 2013. Effect of recent diarrhoeal episodes on risk of pneumonia in children under the age of 5 years in Karachi, Pakistan. Int J Epidemiol 42: 194–200.
-
6.
Schmidt WP, Cairncross S, Barreto ML, Clasen T, Genser B, 2009. Recent diarrhoeal illness and risk of lower respiratory infections in children under the age of 5 years. Int J Epidemiol 38: 766–772.
-
7.
Ichinohe T, Pang IK, Kumamoto Y, Peaper DR, Ho JH, Murray TS, Iwasaki A, 2011. Microbiota regulates immune defense against respiratory tract influenza A virus infection. Proc Natl Acad Sci USA 108: 5354–5359.
-
8.
Sarker P, Ahmed S, Tiash S, Rekha RS, Stromberg R, Andersson J, Bergman P, Gudmundsson GH, Agerberth B, Raqib R, 2011. Phenylbutyrate counteracts Shigella mediated downregulation of cathelicidin in rabbit lung and intestinal epithelia: a potential therapeutic strategy. PLoS One 6: e20637.
-
9.
Stoll BJ, Glass RI, Huq MI, Khan MU, Holt JE, Banu H, 1982. Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh. BMJ 285: 1185–1188.
-
10.
World Health Organization, 1991. Technical Bases for the WHO Recommendations on the Management of Pneumonia in Children at First-Level Health Facilities. Programme of Acute Respiratory Infections. Geneva, Switzerland: World Health Organization.
-
11.
Gupta D, Mishra S, Chaturvedi P, 1996. Fast breathing in the diagnosis of pneumonia—a reassessment. J Trop Pediatr 42: 196–199.
-
12.
Chisti MJ, Graham SM, Duke T, Ahmed T, Faruque AS, Ashraf H, Bardhan PK, Shahid AS, Shahunja KM, Salam MA, 2014. Post-discharge mortality in children with severe malnutrition and pneumonia in Bangladesh. PLoS One 9: e107663.
-
13.
Chisti MJ, Duke T, Robertson CF, Ahmed T, Faruque AS, Bardhan PK, La Vincente S, Salam MA, 2011. Co-morbidity: exploring the clinical overlap between pneumonia and diarrhoea in a hospital in Dhaka, Bangladesh. Ann Trop Paediatr 31: 311–319.
-
14.
Azab SF, Sherief LM, Saleh SH, Elsaeed WF, Elshafie MA, Abdelsalam SM, 2014. Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study. Infect Dis Poverty 3: 14.
-
15.
Barsam FJ, Borges GS, Severino AB, de Mello LM, da Silva AS, Nunes AA, 2013. Factors associated with community-acquired pneumonia in hospitalised children and adolescents aged 6 months to 13 years old. Eur J Pediatr 172: 493–499.
-
16.
Bhat RY, Manjunath N, 2013. Correlates of acute lower respiratory tract infections in children under 5 years of age in India. Int J Tuberc Lung Dis 17: 418–422.
-
17.
Cesar JA, Victora CG, Barros FC, Santos IS, Flores JA, 1999. Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case–control study. BMJ 318: 1316–1320.
-
18.
Arifeen S, Black RE, Antelman G, Baqui A, Caulfield L, Becker S, 2001. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 108: E67.
-
19.
Chisti MJ, Tebruegge M, La Vincente S, Graham SM, Duke T, 2009. Pneumonia in severely malnourished children in developing countries—mortality risk, aetiology and validity of WHO clinical signs: a systematic review. Trop Med Int Health 14: 1173–1189.
-
20.
Ahmed T, Ali M, Ullah MM, Choudhury IA, Haque ME, Salam MA, Rabbani GH, Suskind RM, Fuchs GJ, 1999. Mortality in severely malnourished children with diarrhoea and use of a standardised management protocol. Lancet 353: 1919–1922.
-
21.
Zaman RU, Alamgir AS, Rahman M, Azziz-Baumgartner E, Gurley ES, Sharker MA, Brooks WA, Azim T, Fry AM, Lindstrom S, Gubareva LV, Xu X, Garten RJ, Hossain MJ, Khan SU, Faruque LI, Ameer SS, Klimov AI, Rahman M, Luby SP, 2009. Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007–2008. PLoS One 4: e8452.
-
22.
Watanakunakorn C, Bailey TA, 1997. Adult bacteremic pneumococcal pneumonia in a community teaching hospital, 1992–1996. A detailed analysis of 108 cases. Arch Intern Med 157: 1965–1971.
-
23.
Holm AM, Berild D, Ringertz SH, Haheim LL, Hoiby EA, 2002. Occurrence and clinical presentation of systemic pneumococcal infections in an unselected population in Oslo, Norway, between 1993 and 1997. Eur J Clin Microbiol Infect Dis 21: 465–467.
-
24.
Egger M, Mausezahl D, Odermatt P, Marti HP, Tanner M, 1990. Symptoms and transmission of intestinal cryptosporidiosis. Arch Dis Child 65: 445–447.
-
25.
Mor SM, Tumwine JK, Ndeezi G, Srinivasan MG, Kaddu-Mulindwa DH, Tzipori S, Griffiths GK, 2010. Respiratory cryptosporidiosis in HIV-seronegative children in Uganda: potential for respiratory transmission. Clin Infect Dis 50: 1366–1372.
-
26.
Ghenghesh KS, Ahmed SF, El-Khalek RA, Al-Gendy A, Klena J, 2008. Aeromonas-associated infections in developing countries. J Infect Dev Ctries 2: 81–98.
-
27.
Chisti MJ, Ahmed T, Ashraf H, Faruque ASG, Bardhan PK, Dey SK, Huq S, Das SK, Salam MA, 2012. Clinical predictors and outcome of metabolic acidosis in under-five children admitted to an urban hospital in Bangladesh with diarrhea and pneumonia. PLoS One 7: e39164.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 982 | 857 | 227 |
| Full Text Views | 336 | 3 | 0 |
| PDF Downloads | 130 | 2 | 0 |
Concurrent Pneumonia in Children Under 5 Years of Age Presenting to a Diarrheal Hospital in Dhaka, Bangladesh
Daniel T. Leung
Daniel T. Leung
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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Sumon K. Das
Sumon K. Das
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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M. A. Malek
M. A. Malek
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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Firdausi Qadri
Firdausi Qadri
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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A. S. G. Faruque
A. S. G. Faruque
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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Mohammod J. Chisti
Mohammod J. Chisti
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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Edward T. Ryan
Edward T. Ryan
Division of Infectious Diseases, Department of Medicine, and Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Public Health, The University of Queensland, Brisbane, Australia; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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Respiratory and gastrointestinal infections are the top killers of children worldwide, and their co-occurrence is reported but not well understood. Our aim was to determine the risk factors for concurrent presentation of diarrhea and pneumonia (DP) in a resource-limited setting in Bangladesh. We used data from the Diarrheal Disease Surveillance System of the icddr,b Dhaka Hospital to identify children < 60 months of age with diarrhea and concurrent pneumonia, defined as a history of cough, an abnormal lung examination, and tachypnea. For the years 1996–2007, out of total 14,628 diarrheal patients surveyed, there were 607 (4%) patients who satisfied criteria for pneumonia. Those with DP had a higher mortality rate (4% versus 0.05%, odds ratio [OR] = 86, 95% confidence interval [CI] = 26–286) and a longer hospital stay (mean 84 versus 26 hours, difference 58 hours, 95% CI = 52–64 hours) than those with diarrhea (D) only. In multivariable logistic regression comparing cases (N = 607) with controls matched for month and year of admission at a ratio of 1:3 (N = 1,808), we found that DP was associated with younger age, male gender, severe acute malnutrition (SAM), less maternal education, lower family income, and lack of current breast-feeding history.
Author Notes
Financial support: This study was supported by grants from the National Institutes of Health, including National Institute of Allergy and Infectious Diseases grants AI058935, AI100023, AI106878, AI077883 (to Edward T. Ryan), AI100923 (to Daniel T. Leung), a Thrasher Research Fund Early Career Award, and a Postdoctoral Fellowship in Tropical Infectious Diseases from the American Society of Tropical Medicine and Hygiene/Burroughs Wellcome Fund (both to Daniel T. Leung).
Authors' addresses: Daniel T. Leung, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, E-mail: daniel.leung@utah.edu. Sumon K. Das, M. A. Malek, and A. S. G. Faruque, Centre for Nutrition and Food Security (CNFS), icddr,b, Dhaka, Bangladesh, E-mails: sumon@icddrb.org, mamalek@icddrb.org, and gfaruque@icddrb.org. Firdausi Qadri, Centre for Vaccine Sciences, icddr,b, Dhaka, Bangladesh, E-mail: fqadri@icddrb.org. Mohammod J. Chisti, ICU and Respiratory Ward, Dhaka Hospital and CNFS, icddr,b, Dhaka, Bangladesh, E-mail: chisti@icddrb.org. Edward T. Ryan, Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, E-mail: etryan@partners.org.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE, 2013. Global burden of childhood pneumonia and diarrhoea. Lancet 381: 1405–1416.
-
2.
Chisti MJ, Huq S, Das SK, Malek MA, Ahmed T, Faruque AS, Salam MA, 2008. Predictors of severe illness in children under age five with concomitant infection with pneumonia and diarrhea at a large hospital in Dhaka, Bangladesh. Southeast Asian J Trop Med Public Health 39: 719–727.
-
3.
Chisti MJ, Pietroni MA, Smith JH, Bardhan PK, Salam MA, 2011. Predictors of death in under-five children with diarrhoea admitted to a critical care ward in an urban hospital in Bangladesh. Acta Paediatr 100: e275–e279.
-
4.
Walker CL, Perin J, Katz J, Tielsch JM, Black RE, 2013. Diarrhea as a risk factor for acute lower respiratory tract infections among young children in low income settings. J Glob Health 3: 010402.
-
5.
Ashraf S, Huque MH, Kenah E, Agboatwalla M, Luby SP, 2013. Effect of recent diarrhoeal episodes on risk of pneumonia in children under the age of 5 years in Karachi, Pakistan. Int J Epidemiol 42: 194–200.
-
6.
Schmidt WP, Cairncross S, Barreto ML, Clasen T, Genser B, 2009. Recent diarrhoeal illness and risk of lower respiratory infections in children under the age of 5 years. Int J Epidemiol 38: 766–772.
-
7.
Ichinohe T, Pang IK, Kumamoto Y, Peaper DR, Ho JH, Murray TS, Iwasaki A, 2011. Microbiota regulates immune defense against respiratory tract influenza A virus infection. Proc Natl Acad Sci USA 108: 5354–5359.
-
8.
Sarker P, Ahmed S, Tiash S, Rekha RS, Stromberg R, Andersson J, Bergman P, Gudmundsson GH, Agerberth B, Raqib R, 2011. Phenylbutyrate counteracts Shigella mediated downregulation of cathelicidin in rabbit lung and intestinal epithelia: a potential therapeutic strategy. PLoS One 6: e20637.
-
9.
Stoll BJ, Glass RI, Huq MI, Khan MU, Holt JE, Banu H, 1982. Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh. BMJ 285: 1185–1188.
-
10.
World Health Organization, 1991. Technical Bases for the WHO Recommendations on the Management of Pneumonia in Children at First-Level Health Facilities. Programme of Acute Respiratory Infections. Geneva, Switzerland: World Health Organization.
-
11.
Gupta D, Mishra S, Chaturvedi P, 1996. Fast breathing in the diagnosis of pneumonia—a reassessment. J Trop Pediatr 42: 196–199.
-
12.
Chisti MJ, Graham SM, Duke T, Ahmed T, Faruque AS, Ashraf H, Bardhan PK, Shahid AS, Shahunja KM, Salam MA, 2014. Post-discharge mortality in children with severe malnutrition and pneumonia in Bangladesh. PLoS One 9: e107663.
-
13.
Chisti MJ, Duke T, Robertson CF, Ahmed T, Faruque AS, Bardhan PK, La Vincente S, Salam MA, 2011. Co-morbidity: exploring the clinical overlap between pneumonia and diarrhoea in a hospital in Dhaka, Bangladesh. Ann Trop Paediatr 31: 311–319.
-
14.
Azab SF, Sherief LM, Saleh SH, Elsaeed WF, Elshafie MA, Abdelsalam SM, 2014. Impact of the socioeconomic status on the severity and outcome of community-acquired pneumonia among Egyptian children: a cohort study. Infect Dis Poverty 3: 14.
-
15.
Barsam FJ, Borges GS, Severino AB, de Mello LM, da Silva AS, Nunes AA, 2013. Factors associated with community-acquired pneumonia in hospitalised children and adolescents aged 6 months to 13 years old. Eur J Pediatr 172: 493–499.
-
16.
Bhat RY, Manjunath N, 2013. Correlates of acute lower respiratory tract infections in children under 5 years of age in India. Int J Tuberc Lung Dis 17: 418–422.
-
17.
Cesar JA, Victora CG, Barros FC, Santos IS, Flores JA, 1999. Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case–control study. BMJ 318: 1316–1320.
-
18.
Arifeen S, Black RE, Antelman G, Baqui A, Caulfield L, Becker S, 2001. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 108: E67.
-
19.
Chisti MJ, Tebruegge M, La Vincente S, Graham SM, Duke T, 2009. Pneumonia in severely malnourished children in developing countries—mortality risk, aetiology and validity of WHO clinical signs: a systematic review. Trop Med Int Health 14: 1173–1189.
-
20.
Ahmed T, Ali M, Ullah MM, Choudhury IA, Haque ME, Salam MA, Rabbani GH, Suskind RM, Fuchs GJ, 1999. Mortality in severely malnourished children with diarrhoea and use of a standardised management protocol. Lancet 353: 1919–1922.
-
21.
Zaman RU, Alamgir AS, Rahman M, Azziz-Baumgartner E, Gurley ES, Sharker MA, Brooks WA, Azim T, Fry AM, Lindstrom S, Gubareva LV, Xu X, Garten RJ, Hossain MJ, Khan SU, Faruque LI, Ameer SS, Klimov AI, Rahman M, Luby SP, 2009. Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007–2008. PLoS One 4: e8452.
-
22.
Watanakunakorn C, Bailey TA, 1997. Adult bacteremic pneumococcal pneumonia in a community teaching hospital, 1992–1996. A detailed analysis of 108 cases. Arch Intern Med 157: 1965–1971.
-
23.
Holm AM, Berild D, Ringertz SH, Haheim LL, Hoiby EA, 2002. Occurrence and clinical presentation of systemic pneumococcal infections in an unselected population in Oslo, Norway, between 1993 and 1997. Eur J Clin Microbiol Infect Dis 21: 465–467.
-
24.
Egger M, Mausezahl D, Odermatt P, Marti HP, Tanner M, 1990. Symptoms and transmission of intestinal cryptosporidiosis. Arch Dis Child 65: 445–447.
-
25.
Mor SM, Tumwine JK, Ndeezi G, Srinivasan MG, Kaddu-Mulindwa DH, Tzipori S, Griffiths GK, 2010. Respiratory cryptosporidiosis in HIV-seronegative children in Uganda: potential for respiratory transmission. Clin Infect Dis 50: 1366–1372.
-
26.
Ghenghesh KS, Ahmed SF, El-Khalek RA, Al-Gendy A, Klena J, 2008. Aeromonas-associated infections in developing countries. J Infect Dev Ctries 2: 81–98.
-
27.
Chisti MJ, Ahmed T, Ashraf H, Faruque ASG, Bardhan PK, Dey SK, Huq S, Das SK, Salam MA, 2012. Clinical predictors and outcome of metabolic acidosis in under-five children admitted to an urban hospital in Bangladesh with diarrhea and pneumonia. PLoS One 7: e39164.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 982 | 857 | 227 |
| Full Text Views | 336 | 3 | 0 |
| PDF Downloads | 130 | 2 | 0 |