Ravelomanana Lova, Bouazza Naim, Rakotomahefa Mbola, Andrianirina André Zo, Robinson Annick Lalaina, Raobidjaona Honoré, Andriamihaja Rabezanahary, Benhaddou Nadjet, Randrianirina Fréderique, Ratsima Elisoa, Imbert Patrick, Raymond Josette
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.
Pediatr Infect Dis J. 2017 May;36(5):467-471. doi: 10.1097/INF.0000000000001471.
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.
在低收入国家，儿童社区获得性肺炎是儿童发病的主要原因。病原体通常是金黄色葡萄球菌、肺炎链球菌和肺炎支原体。肺炎支原体被认为是哮喘疾病的一个辅助因素。据报道，马达加斯加哮喘患病率很高。我们的目的是明确该国肺炎支原体感染的患病率及其与哮喘的关系。
2012年1月至2014年12月，对351名2至16岁儿童进行了一项前瞻性研究。根据临床症状，将儿童分为3组：“对照组”（CG，n = 106）、“哮喘组”（n = 129）和“肺炎组”（n = 116）。采用酶联免疫吸附试验评估肺炎支原体IgG和IgM状态。记录感染的临床体征、社会经济数据和抗菌治疗情况。
肺炎支原体感染的总体患病率为18.2%。多因素分析表明，肺炎支原体感染在对照组中更为常见[肺炎组与对照组：比值比 = 0.45（0.21 - 0.91），P = 0.037；哮喘组与对照组：比值比 = 0.39（0.18 - 0.87），P = 0.021]。肺炎支原体血清学阳性儿童的C反应蛋白值显著更高（85对61mg/L，P = 0.03）。值得注意的是，99名（41%）儿童在就诊前接受过抗生素治疗。
我们报告马达加斯加儿童肺炎支原体感染患病率为18.2%。对照组中肺炎支原体感染的患病率高于哮喘患者。
