| Titre : | Aetiology, outcome, and risk factors for mortality among adults with acute pneumonia in Kenya. (2000) |
| Auteurs : | J.A.G. SCOTT ; B. CHOHAN ; F. DROBNIEWSKI ; E. GETAMBU ; F. GLEESON ; A.J. HALL ; B. LOWE ; K. MANDALIYA ; K. MARSH ; C. MUYODI ; M. ROSS ; Coast Province General Hospital. Mombasa. KEN ; Infectious Disease Epidemlology Unit. London School of Hygiene and Tropical Medicine. London. GBR ; Kenya Medical Research Institute. Centre for Geographic Medicine Research-Coast. Kllifl. KEN |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 355, n° 9211, 2000) |
| Pagination : | 1225-1230 |
| Langues: | Anglais |
| Mots-clés : | Pneumonie ; Etiologie ; Mortalité ; Facteur risque ; Kenya ; Afrique ; Homme ; Appareil respiratoire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST LR0xNK30. Diffusion soumise à autorisation]. Background Despite a substantial disease burden, there is little descriptive epidemiology of acute pneumonia in sub-Saharan Africa. We did this study to define the aetiology of acute pneumonia, to estimate mortality at convalescence, and to analyse mortality risk-factors. Methods We studied 281 Kenyan adults who presented to two public hospitals (one urban and one rural) with acute radiologically confirmed pneumonia during 1994-96. We did blood and lung-aspirate cultures, mycobacterial cultures, serotype-specific pneumococcal antigen detection, and serology for viral and atypical agents. Findings Aetiology was defined in 182 (65%) patients. Streptococcus pneumoniae was the most common causative agent, being found in 129 (46%) cases ; Mycobacterium tuberculosis was found in 26 (9%). Of 255 patients followed up for at least 3 weeks, 25 (10%) died at a median age of 33 years. In multivariate analyses, risk or protective factors for mortality were age (odds ratio 1.51 per decade [95% Cl 1.04-2.19]), unemployment (4.42 [1.21-16.1]), visiting a traditional healer (5.26 [1.67-16.5]), visiting a pharmacy (0.30 [0.10-0.91]), heart rate (1.64 per 10 beats [1.24-2.16]), and herpes labialis (15.4 [2.22-107]). HIV-1 seropositivity, found in 52%, was not associated with mortality. (...) |
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