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An investigation in the seasonal patterns of bacterial colonisation in childhood pneumonia
Globally, pneumonia is a leading cause of morbidity and mortality in children younger than the age of 5 years, especially in low- and middle-income countries. The aetiology of paediatric pneumonia is complex, and its definitive determination remains challenging. S. pneumoniae, H. influenzae, M. cata...
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| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2023
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| Summary: | Globally, pneumonia is a leading cause of morbidity and mortality in children younger than the age of 5 years, especially in low- and middle-income countries. The aetiology of paediatric pneumonia is complex, and its definitive determination remains challenging. S. pneumoniae, H. influenzae, M. catarrhalis, and S. aureus are among the most frequent bacterial causes of childhood pneumonia. Common to such recognised bacterial pathogens is the occurrence of asymptomatic bacterial colonisation or carriage of the nasopharynx, which in turn precedes disease development and progression. This study investigates the trends and patterns of bacterial carriage in the development of pneumonia in South African infants up to one year of life. It is hypothesised that respiratory bacterial carriage is considerably influenced by age and seasonality. Based on previously collected time-series data from the Drakenstein Child Health Study conducted in Paarl, South Africa, this study focuses on exploring the effects of season on nasopharyngeal carriage of pathogens occurring in the nasopharynx of young children with and without the occurrence of lower respiratory tract infection. Using logistic mixed effects models and taking into account the repeated measure structure of the data as well as seasonal components, we found that seasonal variations occur in the prevalence of nasopharyngeal carriage of respiratory pathogens in infants, with and without lower respiratory tract infection. With the inclusion of age-effects, these associations appeared to be highly complex. Understanding the factors that influence bacterial carriage, asymptomatic or not, is necessary to better understand the opportunities for and impact of intervention strategies against lower respiratory tract illness. |
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