Enarson Penny M, Gie Robert P, Enarson Donald A, Mwansambo Charles, Graham Stephen M
Child Lung Health Division, International Union Against Tuberculosis and Lung Disease (The Union), 68 Boulevard St Michel, 75006 Paris, France.
Expert Rev Respir Med. 2010 Apr;4(2):211-20. doi: 10.1586/ers.10.14.
It is estimated that 2 million children under 5 years of age die from pneumonia each year and that half of these deaths occur in sub-Saharan Africa. Over 85% of the more than 2.3 million children living with HIV worldwide reside in sub-Saharan Africa. HIV infection is likely to have a major impact on current recommendations for the standard case management of pneumonia in children and is the rationale for undertaking this review of published studies. The studies identified indicate an overall sixfold (range 2.5-13.5-fold) increase in pneumonia-related fatality in HIV-infected compared with HIV-uninfected African infants and children. They are more likely to have disease due to mixed infection and from a wider range of pathogens including Pneumocystis pneumonia, TB and cytomegalovirus. Scaling-up of the implementation of strategies that prevent HIV and Pneumocystis pneumonia remains an important strategy to reduce the burden of HIV-related pneumonia in the region. Research is urgently required to address the most effective pneumonia case management strategy in HIV-infected infants and children.
据估计，每年有200万5岁以下儿童死于肺炎，其中一半死亡发生在撒哈拉以南非洲地区。全球超过230万感染艾滋病毒的儿童中，超过85%居住在撒哈拉以南非洲地区。艾滋病毒感染可能会对当前儿童肺炎标准病例管理的建议产生重大影响，这也是对已发表研究进行此次综述的理由。已确定的研究表明，与未感染艾滋病毒的非洲婴幼儿相比，感染艾滋病毒的婴幼儿肺炎相关死亡率总体增加了六倍（范围为2.5至13.5倍）。他们更有可能因混合感染以及包括肺孢子菌肺炎、结核病和巨细胞病毒在内的更广泛病原体而患病。扩大预防艾滋病毒和肺孢子菌肺炎战略的实施仍是减轻该地区艾滋病毒相关肺炎负担的一项重要战略。迫切需要开展研究，以确定针对感染艾滋病毒的婴幼儿最有效的肺炎病例管理策略。
