Data on burden of pneumonia in the country is limited
Download
1 / 21

Data on burden of pneumonia in the country is limited - PowerPoint PPT Presentation


  • 127 Views
  • Uploaded on

Data on burden of pneumonia in the country is limited. Top Killer of Children: Pneumonia. Maria Rosario Z. Capeding, M.D. Research Institute for Tropical Medicine. Pneumonia remains to be a major cause of morbidity and mortality among Filipino children. Pneumonia Morbidity Rate by Region

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Data on burden of pneumonia in the country is limited' - doctor


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Top killer of children pneumonia

Top Killer of Children: Pneumonia

Maria Rosario Z. Capeding, M.D.

Research Institute for Tropical Medicine


Pneumonia remains to be a major cause of morbidity and mortality among Filipino children.


Pneumonia Morbidity Rate by Region mortality among Filipino children.

Rate per 100,00 population

CAR: 1750

Region II: 600

Region I: 400

Region III: 250

Region V: 3200

NCR: 450

Region IV-A: 700

Region VIII: 1400

Region IV-B: 350

CARAGA: 450

Region VI: 900

Region X: 600

Region VII: 800

Region XII: 1200

Region IX: 650

Region XI: 1300

2008

ARMM:


Acute lower respiratory infection pneumonia cases
Acute Lower Respiratory Infection/ mortality among Filipino children.Pneumonia Cases

2009


Active hospital based surveillance study of ipd and pneumonia among urban children 2007 2009
Active Hospital-based Surveillance Study of IPD mortality among Filipino children.and Pneumonia Among Urban Children (2007-2009)

Bravo, Santos, Capeding et al

Submitted for Publication


Younger children bore the greatest burden of pneumonia
Younger Children Bore the Greatest Burden of Pneumonia mortality among Filipino children.

No. of cases

2008


Risk factors for pneumonia
Risk factors for Pneumonia: mortality among Filipino children.

Rudan et al. WHO Bulletin 2008 May 2008, vol 86 no 5; Pneumonia: The Forgotten Killer of Children Unicef/WHO 2006


Outcome of childhood pneumonia evrmc 2008 2011
Outcome of Childhood Pneumonia mortality among Filipino children. EVRMC 2008-2011

Lupisan et al Asia-Africa Congress on Emerging and Re-emerging Infections

Kobe, Japan January 2012


Etiology of pneumonia in 5 years old 1984 1986 ritm n 537
Etiology of Pneumonia in <5 Years Old mortality among Filipino children.1984-1986, RITM, N=537

Pre Hib/PCV Era

RSV

37%

Parainfluenza

17%

Adenov 13%

S. pneumo

15%

Mixed

Viral/bacterial

23%

H

influenzae

21%

Others

17%

S

typhi

14%

Lucero, et al. Reviews InfDis 1990


Etiology of Pneumonia in <5 Years Old mortality among Filipino children.1990-1992, RITM, N=332

Pre Hib/PCV Era

Bacterial Pathogens

S. aureus

K. pneumoniae

S. viridans

A. anitratum

Viral Pathogens

Parainfluenza

Influenza A and B

Capeding et al. Etiology of ALRI in Filipino Children under 5 years

Southeast Asian J Trop Med Public Health, Dec. 1994


Etiology of Pneumonia in <5 Years Old mortality among Filipino children.2008-2011, EVRMC N=1582

Hib/PCV Era

S. pneumoniae

H. influenzae

Others

S. aureus

MRSA

S. typhi

RSV 14%

Rhino-A 7%

Rhino-C 6%

hMPV* 3.3%

Others

Influenza A (H1N1)

Influenza A/B

Adenovirus

Parainfluenza

Lupisan et al Asia-Africa Congress on Emerging and Re-emerging Infections

Kobe, Japan January 2012


Determining bacterial etiology in childhood pneumonia is challenging
Determining Bacterial Etiology in Childhood Pneumonia is Challenging

  • Use of conventional bacterial culture considered as gold standard but with low sensitivity

  • Bacteria (S. pneumoniae, H. influenzae) are fastidious organisms

  • High percentage of antibiotic usage prior to hospitalization


Mortality rate by case definitions evrmc
Mortality Rate by Case Definitions Challenging EVRMC

Total number of cases = 108




Empiric antibiotic treatment
Empiric Antibiotic Challenging Treatment

  • PCAP A or B without previous antibiotic

    • Oral amoxicillin, drug of choice

  • PCAP C without previous antibiotic and complete Hib vaccination.

    • Penicillin G, drug of choice

  • PCAP C with incomplete Hib vaccination

    • Ampicillin IV

  • PCAP D

    • Refer to Specialist

  • CPG, In the Evaluation and Management of Pediatric Community Acquired Pneumonia


    Percent resistance of s pneumoniae jan dec 2010
    Percent Resistance of Challenging S. pneumoniaeJan-Dec 2010

    % RESISTANCE

    CHL=ChloramphenicolPEN=Penicillin SXT=Cotrimoxazole

    *%R(N)

    ARSP Report 2010


    Clinical management of viral etiology
    Clinical Management of Viral Etiology Challenging

    • In laboratory confirmed influenza A or B virus infection.

      • Influenza A: amantadine for 3-5 days, an option to discontinue within 24-48 hours after resolution of symptoms

      • Influenza A or B: oseltamivir for 5 days

  • Both drugs should be administered within 48 hours of onset of symptoms, ineffective against respiratory viruses other than influenza, not recommended for children below 1 year old

  • CPG, In the Evaluation and Management of Pediatric Community Acquired Pneumonia


    Burden of pneumonia over the past decades
    Burden of Pneumonia Over the Past Decades Challenging

    • Pneumonia is the most common presentation of IPD in children.

    • Most commonly affects the very young

    • S. pneumoniae, H. influenzaeand RSV consistently are the most frequently detected pathogens

    • Pneumonia is the top killer of Filipino children <5 years old, accounts for 34% of deaths

    the

    90’s


    ad