ABSTRACT

Background

: Atypical bacteria cause 10–40% of all childhood pneumonia.. 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 with respiratory symptoms at Mulago National Referral Hospital, Kampala.

Methods

: Children aged 2 months to 12 years with cough and/or difficult breathing and fast breathing were recruited. A clinical history and physical examination were undertaken. Blood samples for Mycoplasma pneumoniae IgM antibodies were taken at enrolment and Day 21 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. 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 and in 128/325 (39.4%) 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). Mortality was 17/352 (4.8%) and, of these, 4/17 (23.5%) had M. pneumonia.

Conclusion

: M. pneumonia is common in young children , especially females above 2 years and those with history of prematurity. It presents with severe symptoms. The results of the study highlight the importance of considering atypical bacteria in under-5s with the symptoms of pneumonia.

中文翻译：

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乌干达儿童肺炎支原体感染的患病率、危险因素和结局：一项前瞻性研究

摘要

背景

：非典型细菌导致所有儿童肺炎的 10-40%。关于撒哈拉以南非洲非典型肺炎负担的数据有限。

目标

: 确定坎帕拉穆拉戈国家转诊医院有呼吸道症状的儿童肺炎支原体感染的患病率、相关因素和结果。

方法

：招募了 2 个月至 12 岁有咳嗽和/或呼吸困难和呼吸急促的儿童。进行了临床病史和体格检查。在入组时和第 21 天采集肺炎支原体IgM 抗体的血样，并诱导痰液进行 DNA-PCR。被录取的参与者最多被跟踪 7 天或直到出院或死亡，以先到者为准。

结果

：总共招收了 385 名儿童，其中 368 名 (95.6%) 年龄小于 5 岁。总体而言，60/385 (15.6%) 参与者的肺炎支原体IgM 和/或 DNA-PCR检测呈阳性。其中，56/60 (93.3%) 的年龄小于 5 岁。21/60 (35.0%) 的非典型肺炎患儿和 128/325 (39.4%) 的典型肺炎患儿出现喘息。与肺炎支原体相关的因素是女性 (AOR 1.94, 95% CI 1.22–3.08, p < 0.001)、年龄≥12 个月 (AOR 2.73, 95% CI 1.53–4.87, p = 0.01) 和早产史（AOR 2.07，95% CI 1.23–3.49，p = 0.01）。死亡率为 17/352 (4.8%)，其中 4/17 (23.5%) 患有肺炎支原体。

结论

:肺炎支原体多见于幼儿，尤其是2岁以上的女性和有早产史的。它表现出严重的症状。研究结果强调了在 5 岁以下有肺炎症状的儿童中考虑非典型细菌的重要性。