PMID- 16798573
OWN - NLM
STAT- MEDLINE
DCOM- 20061031
LR  - 20091014
IS  - 1526-0542 (Print)
IS  - 1526-0542 (Linking)
VI  - 7 Suppl 1
DP  - 2006
TI  - Global paediatric pulmonology: out of Africa.
PG  - S226-8
AB  - Respiratory illness is the major cause of mortality and morbidity in African 
      children. The spectrum of disease includes acute and chronic respiratory illness. 
      As a result of the HIV epidemic currently occurring in sub-Saharan Africa, 
      HIV-associated acute and chronic respiratory disease has emerged as a major 
      factor in the epidemiology of childhood respiratory illness. Pneumonia is the 
      leading causes of childhood mortality responsible for approximately 21% of deaths 
      in African children under five years of age each year. The HIV pandemic has 
      increased the incidence, severity and pneumonia mortality in African children. 
      Pulmonary tuberculosis (TB) is an important cause of morbidity and death. 
      Globally, the highest TB incidence rates occur in sub-Saharan African countries; 
      many of these countries are also experiencing a dual HIV epidemic, resulting in 
      an exponential increase in TB cases. The burden of childhood respiratory illness 
      has necessitated novel and improved ways of diagnosis, treatment and prevention, 
      particularly in the context of limited resources. Improved diagnosis, treatment 
      and prevention of pneumonia have been a research focus, particularly in 
      HIV-infected children. African studies have provided information on the 
      epidemiology, aetiology and outcome from pneumonia in HIV-infected and uninfected 
      children. The efficacy of trimethoprim-sulphamethoxazole prophylaxis in reducing 
      mortality and morbidity in HIV-infected African children was shown in the only 
      randomized controlled trial. Two large studies have shown the efficacy of the 
      pneumococcal conjugate vaccine in an African context. Regarding TB, areas of 
      research include diagnostic studies and improved preventative strategies. 
      Promising diagnostic studies for childhood TB include the use of sputum 
      induction, PCR techniques and blood interferon assays. The immune reconstitution 
      inflammatory syndrome (IRIS) has emerged as a new clinical entity in HIV-infected 
      children with TB associated with use of antiretroviral therapy. New preventative 
      strategies for TB include novel vaccines and primary prophylaxis. Available, 
      effective interventions for prevention and treatment of childhood respiratory 
      disease exist; the challenge is to achieve widespread implementation and high 
      coverage rates in African countries. Greater access to newer vaccines and, in 
      HIV-infected children, to anti-retroviral therapy and prophylaxis is necessary to 
      further reduce the burden of childhood respiratory illness in Africa.
FAU - Zar, Heather J
AU  - Zar HJ
AD  - Department of Paediatric Pulmonology, School of Child and Adolescent Health, Red 
      Cross Childrens Hospital, University of Cape Town, South Africa. 
      hzar@ich.uct.ac.za
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20060605
PL  - England
TA  - Paediatr Respir Rev
JT  - Paediatric respiratory reviews
JID - 100898941
SB  - IM
MH  - Africa/epidemiology
MH  - Child
MH  - Humans
MH  - Incidence
MH  - Pulmonary Medicine/*methods
MH  - Respiratory Tract Diseases/*epidemiology/*prevention & control
RF  - 16
EDAT- 2006/06/27 09:00
MHDA- 2006/11/01 09:00
CRDT- 2006/06/27 09:00
PHST- 2006/06/27 09:00 [pubmed]
PHST- 2006/11/01 09:00 [medline]
PHST- 2006/06/27 09:00 [entrez]
AID - S1526-0542(06)00248-X [pii]
AID - 10.1016/j.prrv.2006.04.195 [doi]
PST - ppublish
SO  - Paediatr Respir Rev. 2006;7 Suppl 1:S226-8. doi: 10.1016/j.prrv.2006.04.195. Epub 
      2006 Jun 5.