Results from Fondation Mérieux’s multicenter study on the causes of pneumonia in children under 5 in developing countries were presented at the ICAAC/ICC global meeting.
Presenting author Thomas Bénet, MD, MPH, gave a presentation on two different studies: a case-control pilot study, conducted with the Charles Mérieux Infectiology Center in Mali and clinicians from the Gabriel Touré Hospital, and the multicenter study which followed, conducted by research centers belonging to the GABRIEL* network in 8 developing countries representing the bulk of pneumonia burden in children worldwide (Mongolia, China, Cambodia, India (2 sites), Mali, Madagascar, Haiti and Paraguay).
The multicenter study, which started in 2011, was led by principal investigator, Dr. Glaucià Paranhos-Baccalà, at Fondation Mérieux’s Emerging Pathogens Laboratory (LPE) and conducted by international research centers collaborating through the GABRIEL scientific network. The LPE co-developed a diagnostic test used in the harmonized multicenter study. It is able to detect a wide range of 19 viruses and 5 bacteria that can potentially cause pneumonia, and can also be used for pneumococcus typing. Professor Philippe Vanhems’ team of epidemiologists from university hospitals and the Université Claude Bernard in Lyon analyzed the data.
The preliminary results show that almost half of pneumonia in children under five can be attributed to Streptococcus pneumoniae. The remaining pneumonia cases were caused by viruses, particularly the respiratory syncytial virus (RSV), rhinovirus, and human metapneumovirus. However, the study also showed great geographic variations of the different pathogens. In Mali, the pilot site, most pneumonia cases were caused by S. pneumoniae, RSV, human metapneumovirus and influenza A virus.
Dedicated to the fight against infectious diseases in developing countries, Fondation Mérieux designed and funded the study with the goal of contributing to the reduction of child mortality due to pneumonia. This severe respiratory tract infection is the number 1 cause of death in children under the age of five in developing countries, where the infection is compounded by malnutrition, poor sanitary conditions and limited access to healthcare, including diagnostics.
Little is known about the causes of pneumonia in developing countries. Many viruses and bacteria can be responsible and patients may also have co-infections. Antimicrobial treatment and preventive measures are different if the infection is bacterial or viral. In limited resource settings where access to laboratories and diagnostic testing can be lacking, doctors often rely on empiric treatment.
Knowing the prevalent causes of infection in a given region is therefore important and the multicenter study results could impact pneumonia treatment protocols and prevention in the developing world. The authors conclude that vaccinating against S. pneumoniae and developing a vaccine against respiratory syncytial virus could greatly reduce the burden of pneumonia in developing countries. The data will also help to determine the risk factors associated with disease severity and drive vaccination strategies.
ICAAC/ICC is the joint meeting of ASM’s Interscience Conference of Antimicrobial Agents and Chemotherapy and the International Society of Chemotherapy (ISC)’s International Congress of Chemotherapy and Infection.
*Global Approach to Biological Research, Infectious Diseases and Epidemics in Low-income Countries
About the studies
Thomas Bénet, MD, MPH, is a hospital practitioner and epidemiologist in the department of Infection Control, Epidemiology and Prevention at the Edouard Herriot University Hospital in Lyon, doing a doctoral thesis in epidemiology and public health under Dr. Glaucià Paranhos-Baccalà and Prof. Philippe Vanhems’ supervision.
He presented the preliminary study results during a slide session at ICAAC/ICC devoted to the Epidemiology of Lower Respiratory Tract and CNS Infections in Pediatric Patients Globally on Sunday, September 20th.
Etiology and Factors Associated with Severe Pneumonia Among Children Under 5 Years of Age in Mali: A Case-control Pilot Study
T. Bénet1, M. Sylla2, M. Messaoudi3, V. Sanchez Picot3, J-N. Telles3, A-A. Diakite4, F. Komurian-Prade3, H. Endtz3, S. Diallo5, G. Paranhos-Baccalà3, P. Vanhems1; 1Hosp. Edouard Herriot, Lyon, France,2Hosp. Gabriel Touré, Bamako, France, 3Fondation Mérieux, Ctr. Intl. de Recherche en Infectiologie, Lyon, France, 4Hosp. Gabriel Touré, Bamako, Mali, 5Ctr. d’Infectiologie Charles Mérieux, Bamako, Mali
Pneumonia Etiology in Children Under 5 Years of Age in Developing Countries: A Multicentric Case-control Study
T. Bénet1, M. Messaoudi2, J-N. Telles2, V. Sanchez Picot2, P. Vanhems1, G. Paranhos-Baccalà2, GABRIEL network; 1Hosp. Edouard Herriot, Lyon, France, 2Fondation Mérieux, Ctr. Intl. de Recherche en Infectiologie, Lyon, France
About the Emerging Pathogens Laboratory
Located next to Lyon’s BSL4 laboratory, the P4 Jean Mérieux-Inserm Laboratory, the Emerging Pathogens Laboratory (LPE) focuses on public health issues affecting developing countries, particularly respiratory infections, multi-drug-resistant tuberculosis, and fevers including typhoid. It coordinates the activities of the GABRIEL research network, whose members participated in the study, and belongs to a number of national and international scientific networks of excellence: in particular the CIRI (International Center for Infectiology Research - Inserm U1111), AVIESAN (French National Alliance for Life Sciences and Health) and ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium).
Its 3 main activities are:
Developing and transferring technologies for the diagnosis and epidemiological surveillance of infectious diseases;
Identifying and characterizing new biomarkers;
Training scientists in developing countries.
Tel.: +33 6 13 94 51 14