title: Percentage, bacterial etiology and antibiotic susceptibility of acute respiratory infection and pneumonia among children in rural Senegal.
abstract: Acute respiratory infections (ARI) are still a major health problem in most developing countries. So far no study has evaluated the importance of childhood ARI in rural Senegal. We prospectively studied ARI, the percentage of pneumonia and related mortality, as well as the bacterial composition of nasopharyngeal flora using nasopharyngeal aspirates in 114 children, aged 2-59 months, presenting at Ndioum's pediatric ward. Excluded from the trial were those children that had had antimicrobial therapy in the previous 2 weeks. The Kirby-Bauer method was used to determine antibiotic resistance throughout the study. The percentage of ARI and pneumonia among the population tested was 24 per cent and 11 per cent respectively. Streptococcus pneumonia was often resistant to cotrimoxazole (31 per cent) but only 9 per cent were resistant to chloramphenicol and 14 per cent to penicillin. Haemophilus influenzae (HI) was uniformly sensitive to ampicillin, and only 4 per cent were resistant to chloramphenicol and 11 per cent to cotrimoxazole. We conclude that SP and HI resistance to cotrimoxazole is important and warrants larger clinical trials using chloramphenicol. Information campaigns and intense management of comorbidities are desirable in this type of population. Comorbidities (tuberculosis, malaria, HIV-AIDS, severe malnutrition) are determinant variables in many ARI cases and carry a high negative prognosis value.
authors.affiliation: Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Pablo
authors.initials: P
authors.lastname: Echave
authors.forename: Jacques
authors.initials: J
authors.lastname: Bille
authors.forename: Chantal
authors.initials: C
authors.lastname: Audet
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Talla
authors.forename: Bernard
authors.initials: B
authors.lastname: Vaudaux
authors.forename: Mario
authors.initials: M
authors.lastname: Gehri
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D011014:Pneumonia / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D012423:Rural Health; D012675:Senegal / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity