title: Prevalence of Mycoplasma pneumoniae Infection in Malagasy Children.
abstract: Childhood community-acquired pneumonia is a leading cause of childhood morbidity in low-income countries. The etiologic agents are usually Staphylococcus aureus, Streptococcus pneumoniae and Mycoplasma pneumoniae. M. pneumoniae was recognized as a cofactor in asthmatic disease. High asthma prevalence was reported in Madagascar. Our aim was to clarify the prevalence of M. pneumoniae infection in this country and its relationship with asthma.
  
  
  
  A prospective study was conducted in 351 children (from 2 to 16 years of age) from January 2012 to December 2014. According to the clinical symptoms, children were enrolled in 3 groups: "control group" (CG, n = 106), "asthma group" (n = 129) and "pneumonia group" (n = 116). The IgG and IgM M. pneumoniae status was evaluated by an enzyme-linked immunosorbent assay. Clinical signs of infection, socioeconomic data and antimicrobial treatment were recorded.
  
  
  
  The overall prevalence of M. pneumoniae infection was 18.2%. The multivariate analysis demonstrated that M. pneumoniae infection was significantly more frequent in the CG [pneumonia group vs. CG: odds ratio = 0.45 (0.21-0.91), P = 0.037 and asthma group vs. CG: odds ratio = 0.39 (0.18-0.87), P = 0.021]. The C-reactive protein value was significantly higher in children with M. pneumonia-positive serology (85 vs. 61 mg/L, P = 0.03). Of note, 99 (41%) children received antibiotics before attending.
  
  
  
  We report a prevalence of 18.2% for M. pneumoniae infection in children in Madagascar. The prevalence of M. pneumoniae infection was higher in the control patients than in asthmatic ones.
authors.affiliation: From the *Service de Pédiatrie, Hôpital Ambohimiandra, Antananarivo, Madagascar; †URC, University Paris Descartes, Hôpital Cochin, Paris, France; ‡Service de Pédiatrie, Hôpital Befelatanana, §Service de Pédiatrie, Hôpital Soavinandriana, and ¶Service de Pédiatrie, Hôpital Tsaralanana, Antananarivo, Madagascar; ‖Service de Pédiatrie, Hôpital Be, Toamasina, Madagascar; **Service de Néonatologie, Befelatanana, Madasgascar; ††Bacteriology, University Paris Descartes, Hôpital Cochin, Paris, France; ‡‡Institut Pasteur, Antananarivo, Madagascar; §§Departement Recherche, Direction du service de santé des Armées, Hôspital Bégin, Paris, France; and ¶¶Association Jeremi Rhônes-Alpes, Jeremi, Rhônes-Alpes, France.
authors.forename: Lova
authors.initials: L
authors.lastname: Ravelomanana
authors.forename: Naim
authors.initials: N
authors.lastname: Bouazza
authors.forename: Mbola
authors.initials: M
authors.lastname: Rakotomahefa
authors.forename: André Zo
authors.initials: AZ
authors.lastname: Andrianirina
authors.forename: Annick Lalaina
authors.initials: AL
authors.lastname: Robinson
authors.forename: Honoré
authors.initials: H
authors.lastname: Raobidjaona
authors.forename: Rabezanahary
authors.initials: R
authors.lastname: Andriamihaja
authors.forename: Nadjet
authors.initials: N
authors.lastname: Benhaddou
authors.forename: Fréderique
authors.initials: F
authors.lastname: Randrianirina
authors.forename: Elisoa
authors.initials: E
authors.lastname: Ratsima
authors.forename: Patrick
authors.initials: P
authors.lastname: Imbert
authors.forename: Josette
authors.initials: J
authors.lastname: Raymond
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections; D003906:Developing Countries; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D009177:Mycoplasma pneumoniae / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D012923:Social Class
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D002097:C-Reactive Protein