ArticleEpidemiology (Cambridge, Mass.)2010
Estimating the proportion of pneumonia attributable to pneumococcus in Kenyan adults: latent class analysis.
Article in Epidemiology (Cambridge, Mass.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques.PloS one · 2013Pooled it
- Pneumococcal community-acquired pneumonia in hospitalized adults in México 2018-2021: serotype distribution and clinical characteristics.Frontiers in public health · 2026Article
- Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns.Pneumonia (Nathan Qld.) · 2022Review
- Prevalence, Antimicrobial Resistance, and Associated Factors ofThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2022Article
- Methods to Account for Uncertainty in Latent Class Assignments When Using Latent Classes as Predictors in Regression Models, with Application to Acculturation Strategy Measures.Epidemiology (Cambridge, Mass.) · 2020Article
- Pneumococcal pneumonia prevalence among adults with severe acute respiratory illness in Thailand - comparison of Bayesian latent class modeling and conventional analysis.BMC infectious diseases · 2019Article
- Testing Pneumonia Vaccines in the Elderly: Determining a Case Definition for Pneumococcal Pneumonia in the Absence of a Gold Standard.American journal of epidemiology · 2018Article
- Accuracy of composite diagnostic standards for pneumococcal pneumonia in vaccine trials.Epidemiology and infection · 2018Review
- Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Review
- Evaluation of chest radiography, lytA real-time PCR, and other routine tests for diagnosis of community-acquired pneumonia and estimation of possible attributable fraction of pneumococcus in northern Togo.Epidemiology and infection · 2017Article
- Multiplex Urinary Antigen Detection for 13 Streptococcus pneumoniae Serotypes Improves Diagnosis of Pneumococcal Pneumonia in South African HIV-Infected Adults.Journal of clinical microbiology · 2017Article
- Bayesian latent class estimation of the incidence of chest radiograph-confirmed pneumonia in rural Thailand.Epidemiology and infection · 2016Article
- How recent advances in molecular tests could impact the diagnosis of pneumonia.Expert review of molecular diagnostics · 2016Review
- Effect of antimicrobial use on pneumococcal diagnostic tests in elderly patients with community-acquired pneumonia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Article
- Incidence of Hospitalized Pneumococcal Pneumonia among Adults in Guatemala, 2008-2012.PloS one · 2015Article
- Genomic load from sputum samples and nasopharyngeal swabs for diagnosis of pneumococcal pneumonia in HIV-infected adults.Journal of clinical microbiology · 2014Article
- Pneumococcal colonisation density: a new marker for disease severity in HIV-infected adults with pneumonia.BMJ open · 2014Article
- Antimicrobial susceptibility of Streptococcus pneumoniae in adult patients with pneumococcal pneumonia in an urban hospital in Mozambique.BMC research notes · 2014Article
- Use of a rapid test of pneumococcal colonization density to diagnose pneumococcal pneumonia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012Article
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2 authors.
Funding
Abstract
backgroundCommunity-acquired pneumonia is a common cause of hospitalization among African adults, and Streptococcus pneumoniae is assumed to be a frequent cause. Pneumococcal conjugate vaccine is currently being introduced into childhood immunization programs in Africa. The case for adult vaccination is dependent on the contribution of the pneumococcus to the hospital pneumonia burden.
methodsPneumococcal diagnosis is complex because there is no gold standard, and culture methods are invalidated by antibiotic use. We used latent class analysis to estimate the proportion of pneumonia episodes caused by pneumococcus. Furthermore, we extended this methodology to evaluate the effect of antimicrobial treatment on test accuracies and the prevalence of the disease. The study combined data from 5 validation studies of pneumococcal diagnostic tests performed on 281 Kenyan adults with pneumonia.
resultsThe proportion of pneumonia episodes attributable to pneumococcus was 0.46 (95% confidence interval = 0.36-0.57). Failure to account for the effect of antimicrobial exposure underestimates this proportion as 0.32. A history of antibiotic exposure was a poor predictor of antimicrobial activity in patients' urine. Blood culture sensitivity for pneumococcus was estimated at 0.24 among patients with antibiotic exposure, and 0.75 among those without.
conclusionsThe large contribution of pneumococcus to adult pneumonia provides a strong case for the investigation of pneumococcal vaccines in African adults.
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