ArticleBMJ open2019
Aetiology and risks factors associated with the fatal outcomes of childhood pneumonia among hospitalised children in the Philippines from 2008 to 2016: a case series study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 6 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 6 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- High case fatality rate of human adenovirus type 7 infections in children: a meta-analysis and phylogenetic study of HAdV-7 epidemics over the past seven decades.Emerging microbes & infections · 2025Pooled it
- Pooled it
- What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review.Journal of global health · 2023Pooled it
- Aetiology of childhood pneumonia in low- and middle-income countries in the era of vaccination: a systematic review.Journal of global health · 2022Pooled it
- Prevalence of hypoxaemia in children with pneumonia in low-income and middle-income countries: a systematic review and meta-analysis.The Lancet. Global health · 2022Pooled it
- The impact of childhood malnutrition on mortality from pneumonia: a systematic review and network meta-analysis.BMJ global health · 2021Pooled it
- Predicting the risk of mortality during hospitalization in sick severely malnourished children using daily evaluation of key clinical warning signs.BMC medicine · 2021Trial
- Prevalence, associated factors and treatment prescriptions for community-acquired pneumonia: a cross-sectional study at the largest children's hospital in the Ashanti Region, Ghana.BMC infectious diseases · 2026Article
- Risk factors associated with disease severity among children hospitalised with community-acquired pneumonia in Angola.Journal of global health · 2026Observational
- The Burden of Hospitalization Due toHealth science reports · 2025Review
- Treatment outcome of pneumonia and its associated factors among pediatric patients admitted to Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia.Frontiers in pediatrics · 2024Article
- Seroprevalence of four endemic human coronaviruses and, reactivity and neutralization capability against SARS-CoV-2 among children in the Philippines.Scientific reports · 2023Article
- The utility of chest x-ray and lung ultrasound in the management of infants and children presenting with severe pneumonia in low-and middle-income countries: A pragmatic scoping review.Journal of global health · 2022Article
- Comparison of Rhinovirus A-, B-, and C-Associated Respiratory Tract Illness Severity Based on the 5'-Untranslated Region Among Children Younger Than 5 Years.Open forum infectious diseases · 2022Article
- Incidence of lower respiratory tract infection and associated viruses in a birth cohort in the Philippines.BMC infectious diseases · 2022Article
- Chest radiography in children aged 2-59 months enrolled in the Innovative Treatments in Pneumonia (ITIP) project in Lilongwe Malawi: a secondary analysis.BMC pediatrics · 2022Article
- Severe pneumonia: Treatment outcome and its determinant factors among under-five patients, Jimma, Ethiopia.SAGE open medicine · 2022Article
- Incidence of Pneumonia and Predictors Among Human Immunodeficiency Virus Infected Children at Public Health Institutions in the Northwest Part of Ethiopia: Multicenter Retrospective Follow-Up Study.Pediatric health, medicine and therapeutics · 2022Article
- Near-Complete Genome Sequencing of Influenza C Virus in the Philippines between 2014 and 2019.Microbiology resource announcements · 2021Article
- Epidemiology and Seasonality of Childhood Respiratory Syncytial Virus Infections in the Tropics.Viruses · 2021Review
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePneumonia remains the leading cause of hospitalisations and deaths among children aged <5 years. Diverse respiratory pathogens cause acute respiratory infections, including pneumonia. Here, we analysed viral and bacterial pathogens and risk factors associated with death of hospitalised children.
designA 9-year case series study.
settingTwo secondary-care hospitals, one tertiary-care hospital and one research centre in the Philippines.
participants5054 children aged <5 years hospitalised with severe pneumonia.
methodsNasopharyngeal swabs for virus identification, and venous blood samples for bacterial culture were collected. Demographic, clinical data and laboratory findings were collected at admission time. Logistic regression analyses were performed to identify the factors associated with death.
resultsOf the enrolled patients, 57% (2876/5054) were males. The case fatality rate was 4.7% (238/5054), showing a decreasing trend during the study period (p<0.001). 55.0% of the patients who died were either moderately or severely underweight. Viruses were detected in 61.0% of the patients, with respiratory syncytial virus (27.0%) and rhinovirus (23.0%) being the most commonly detected viruses. In children aged 2-59 months, the risk factors significantly associated with death included age of 2-5 months, sensorial changes, severe malnutrition, grunting, central cyanosis, decreased breath sounds, tachypnoea, fever (≥38.5°C), saturation of peripheral oxygen <90%, infiltration, consolidation and pleural effusion on chest radiograph.Among the pathogens, adenovirus type 7, seasonal influenza A (H1N1) and positive blood culture for bacteria were significantly associated with death. Similar patterns were observed between the death cases and the aforementioned factors in children aged <2 months.
conclusionMalnutrition was the most common factor associated with death and addressing this issue may decrease the case fatality rate. In addition, chest radiographic examination and oxygen saturation measurement should be promoted in all hospitalised patients with pneumonia as well as bacteria detection to identify patients who are at risk of death.
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