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Title: Procalcitonin and C-Reactive Protein for invasive bacterial pneumonia diagnosis among children in Mozambique, a malaria-endemic area
Author: Díez-Padrisa, Núria
Bassat Orellana, Quique
Machevo, Sonia
Quintó, Llorenç
Morais, Luis
Nhampossa, Tacilta
O'Callaghan Gordo, Cristina
Torres Martí, Antoni
Alonso, Pedro
Roca i Aparicio, Anna
Keywords: Epidemiologia molecular
Molecular epidemiology
Issue Date: 14-Oct-2010
Publisher: PLoS
Abstract: Background: Pneumonia is the major cause of mortality and morbidity in children worldwide. Procalcitonin (PCT) and C-reactive protein (CRP) are used in developed countries to differentiate between viral and bacterial causes of pneumonia. Validity of these markers needs to be further explored in Africa. Methodology and Principal Findings: We assessed the utility of PCT and CRP to differentiate viral from invasive bacterial pneumonia in children <5 years hospitalized with clinical severe pneumonia (CSP) in rural Mozambique, a malaria-endemic area with high HIV prevalence. Prognostic capacity of these markers was also evaluated. Out of 835 children with CSP, 87 fulfilled definition of viral pneumonia and 89 of invasive bacterial pneumonia. In absence of malaria parasites, levels of PCT and CRP were lower in the viral group when compared to the invasive bacterial one (PCT: median = 0.21 versus 8.31 ng/ml, p<0.001; CRP: 18.3 vs. 185.35 mg/l, p<0.001). However, in presence of malaria parasites distribution between clinical groups overlapped (PCT: median = 23.1 vs. 21.75 ng/ml, p = 0.825; CRP: median = 96.8 vs. 217.4 mg/l, p = 0.052). None of the two markers could predict mortality. Conclusions: Presence of malaria parasites should be taken into consideration, either for clinical or epidemiological purposes, if using PCT or CRP to differentiate viral from invasive bacterial pneumonia in malaria-endemic areas.
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It is part of: PLoS ONE, 2010, 5(10), paper e13226
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (ISGlobal)

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