Prevalence of Mycoplasma pneumoniae Infection in Malagasy Children.

Lova Ravelomanana Naim Bouazza Mbola Rakotomahefa André Zo Andrianirina Annick Lalaina Robinson Honoré Raobidjaona Rabezanahary Andriamihaja Nadjet Benhaddou Fréderique Randrianirina Elisoa Ratsima Patrick Imbert Josette Raymond

Pediatr Infect Dis J

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.

Published: May 2017

Childhood community-acquired pneumonia is a major health issue in low-income countries, with common pathogens including Staphylococcus aureus, Streptococcus pneumoniae, and Mycoplasma pneumoniae; the latter is linked to asthma patients particularly in Madagascar where asthma prevalence is high.
A study involving 351 children aged 2 to 16 years was conducted to assess the prevalence of M. pneumoniae infection, categorizing them into control, asthma, and pneumonia groups, and analyzing their IgG and IgM antibody levels.
The findings showed an overall M. pneumoniae infection prevalence of 18.2%, and surprisingly, the infection was more common in the control group than in the asthma

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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http://dx.doi.org/10.1097/INF.0000000000001471	DOI Listing

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