ArticleThe Pediatric infectious disease journal2021
The Etiology of Pneumonia in HIV-uninfected South African Children: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study.
Article in The Pediatric infectious disease journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Tuberculosis in children who are HIV-exposed uninfected.AIDS (London, England) · 2026Pooled 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
- Infectious-cause hospitalisation in a province-wide cohort of children with antenatal HIV exposure compared to children without HIV exposure.AIDS (London, England) · 2026Article
- Maternal Inflammation Likely Drives Impaired Immune Responses to Respiratory Syncytial Virus in HIV-Exposed Uninfected Infants.The Journal of infectious diseases · 2026Article
- Chlamydia trachomatis-specific T Cell Immunity Reflects Widespread Exposure in South African Adolescents and Young Women.The Journal of infectious diseases · 2026Article
- Aetiological Fraction of Influenza, Respiratory Syncytial Virus and Other Respiratory Pathogens in Infants Aged < 1 Year Hospitalised With Respiratory and Non-Respiratory Medical Illness in South Africa, 2016-2018.Influenza and other respiratory viruses · 2025Article
- Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017.Frontiers in pediatrics · 2025Article
- Care of the Child Perinatally Exposed to Human Immunodeficiency Virus.Clinics in perinatology · 2024Review
- Pneumococcal colonization and coinfecting respiratory viruses in children under 5 years in Addis Ababa, Ethiopia: a prospective case-control study.Scientific reports · 2024Article
- Determining the aetiology of lower respiratory tract illness in children.African journal of thoracic and critical care medicine · 2024Article
- Burden of respiratory syncytial virus diseases among under 5 children in Sub-Saharan Africa:Heliyon · 2023Article
- Viral etiologies of lower respiratory tract infections in children < 5 years of age in Addis Ababa, Ethiopia: a prospective case-control study.Virology journal · 2023Article
- Study on the Application of the Concept of Childlike Interest with Refined Nursing Intervention in the Treatment of Children with Severe Pneumonia.Computational and mathematical methods in medicine · 2022Article
- The Etiology of Pneumonia in HIV-1-infected South African Children in the Era of Antiretroviral Treatment: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study.The Pediatric infectious disease journal · 2021Article
- Diagnosis and management of community-acquired pneumonia in children: South African Thoracic Society guidelines.African journal of thoracic and critical care medicine · 2020Article
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Authors and funding
17 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia is the major contributor to under 5 childhood mortality globally. We evaluated the etiology of pneumonia amongst HIV-uninfected South African children enrolled into the Pneumonia Etiology Research for Child Health case-control study.
methodsCases, 1-59 months of age hospitalized with World Health Organization clinically defined severe/very severe pneumonia, were frequency-matched by age and season to community controls. Nasopharyngeal-oropharyngeal swabs were analyzed using polymerase chain reaction for 33 respiratory pathogens, and whole blood was tested for pneumococcal autolysin. Cases were also tested for Mycobacterium tuberculosis. Population etiologic fractions (EF) of pneumonia with radiologic evidence of consolidation/infiltrate were derived for each pathogen through Bayesian analysis.
resultsOf the 805 HIV-uninfected cases enrolled based on clinical criteria, radiologically confirmed pneumonia was evident in 165 HIV-exposed, -uninfected, and 246 HIV-unexposed children. In HIV-exposed and HIV-unexposed children, respiratory syncytial virus was the most important pathogen with EFs of 31.6% [95% credible interval (CrI), 24.8%-38.8%] and 36.4% (95% CrI, 30.5%-43.1%), respectively. M. tuberculosis contributed EFs of 11.6% (95% CrI, 6.1%-18.8%) in HIV-exposed and 8.3% (95% CrI, 4.5%-13.8%) in HIV-unexposed children, including an EF of 16.3% (95% CrI, 6.1%-33.3%) in HIV-exposed children ≥12 months of age. Bacteremia (3.0% vs. 1.6%) and case fatality risk (3.6% vs. 3.7%) were similar in HIV-exposed and HIV-unexposed children.
conclusionsVaccination strategies targeting respiratory syncytial virus should be prioritized for prevention of pneumonia in children. Furthermore, interventions are required to address the high burden of tuberculosis in the pathogenesis of acute community-acquired pneumonia in settings such as ours.
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