TABLE 1.
Demographic and Clinical Characteristics of HIV-uninfected Cases and Controls
| All Cases | CXR+ Cases | Controls | CXR+ Severe Cases | CXR+ Very Severe Cases | |
|---|---|---|---|---|---|
| All | 631 | 286 | 654 | 247 | 39 |
| Age | |||||
| Median age (mo) (IQR) | 8 (3, 18) | 9 (4, 17) | 11 (5, 22) | 8 (4, 18) | 10 (5, 16) |
| 1–5 mo | 253 (40.1) | 106 (37.1) | 199 (30.4) | 94 (38.1) | 12 (30.8) |
| 6–11 mo | 144 (22.8) | 71 (24.8) | 133 (20.3) | 60 (24.3) | 11 (28.2) |
| 12–23 mo | 136 (21.6) | 70 (24.5) | 181 (27.7) | 59 (23.9) | 11 (28.2) |
| 24–59 mo | 98 (15.5) | 39 (13.6) | 141 (21.6) | 34 (13.8) | 5 (12.8) |
| Ethnicity | |||||
| Wollof | 7 (1.1) | 3 (1.1) | 2 (0.3) | 3 (1.2) | 0 (0.0) |
| Mandinka | 179 (28.9) | 77 (27.3) | 165 (25.5) | 65 (26.6) | 12 (31.6) |
| Serahule | 286 (46.2) | 128 (45.4) | 258 (39.9) | 112 (45.9) | 16 (42.1) |
| Fula | 146 (23.6) | 74 (26.2) | 213 (33.0) | 64 (26.2) | 10 (26.3) |
| Other | 1 (0.2) | 0 (0.0) | 8 (1.2) | 0 (0.0) | 0 (0.0) |
| Female | 243 (38.5) | 108 (37.8) | 308 (47.1) | 90 (36.4) | 18 (46.2) |
| Season of enrollment | |||||
| Rainy (June–October) | 297 (47.1) | 140 (49) | 279 (42.7) | 125 (50.6) | 15 (38.5) |
| Dry (November–May) | 334 (52.9) | 146 (51.0) | 375 (57.3) | 122 (49.4) | 24 (61.5) |
| Respiratory tract illnessa | — | — | 159 (24.3) | — | — |
| Malaria slide positive | 11 (1.9) | 3 (1.2) | 7 (1.1) | 3 (1.3) | 0 (0.0) |
| Pentavalent fully vaccinated for ageb | |||||
| <1 y old | 213 (55.6) | 96 (56.1) | 218 (67.1) | 87 (58.4) | 9 (40.9) |
| ≥1 y old | 202 (93.1) | 97 (94.2) | 271 (92.8) | 83 (94.3) | 14 (93.3) |
| PCV fully vaccinated for ageb | |||||
| <1 y old | 211 (55.1) | 95 (55.6) | 214 (66.0) | 86 (57.7) | 9 (40.9) |
| ≥1 y old | 192 (88.9) | 94 (91.3) | 232 (80.0) | 81 (92.1) | 13 (86.7) |
| Measles fully vaccinatedc | 238 (90.8) | 119 (91.5) | 303 (89.9) | 103 (93.6) | 16 (80.0) |
| Weight-for-age (WHO) z scores | |||||
| >−2 z scores | 444 (70.4) | 188 (65.7) | 531 (81.8) | 170 (68.8) | 18 (46.2) |
| −3 ≤ z scores ≤ −2 | 121 (19.2) | 64 (22.4) | 83 (12.8) | 52 (21.1) | 12 (30.8) |
| <−3 z scores | 66 (10.5) | 34 (11.9) | 35 (5.4) | 25 (10.1) | 9 (23.1) |
| Weight-for-height (WHO) z scores | |||||
| >−2 z scores | 459 (73.0) | 201 (70.5) | 541 (84.3) | 179 (72.8) | 22 (56.4) |
| −3 ≤ z scores ≤ −2 | 114 (18.1) | 55 (19.3) | 73 (11.4) | 46 (18.7) | 9 (23.1) |
| <−3 z scores | 56 (8.9) | 29 (10.2) | 28 (4.4) | 21 (8.5) | 8 (20.5) |
| Height-for-age (WHO) z scores | |||||
| >−2 z scores | 515 (81.6) | 234 (81.8) | 538 (82.9) | 203 (82.2) | 31 (79.5) |
| −3 ≤ z scores ≤ −2 | 70 (11.1) | 34 (11.9) | 80 (12.3) | 29 (11.7) | 5 (12.8) |
| <−3 z scores | 46 (7.3) | 18 (6.3) | 31 (4.8) | 15 (6.1) | 3 (7.7) |
| Antibiotic pretreatment prior to specimen collectiond | 59 (9.5) | 30 (10.6) | 1 (0.2) | 24 (9.8) | 6 (15.4) |
| Serum antibiotic activity | 42 (7.3) | 20 (7.6) | 1 (0.2) | 16 (7.0) | 4 (11.4) |
| CXR result | |||||
| Any abnormality | 286 (45.3) | 286 (100) | — | 247 (100) | 39 (100) |
| Any consolidation | 101 (16.1) | 101 (35.3) | — | 80 (32.4) | 21 (53.8) |
| Other infiltrate only | 185 (29.4) | 185 (64.7) | — | 167 (67.6) | 18 (46.2) |
| Normal | 318 (50.6) | 0 (0.0) | — | 0 (0.0) | 0 (0.0) |
| Uninterpretable | 25 (4.0) | 0 (0.0) | — | 0 (0.0) | 0 (0.0) |
| Hypoxemiae | 49 (7.8) | 33 (11.5) | — | 23 (9.3) | 10 (25.6) |
| Tachypneaf | 547 (86.7) | 260 (90.9) | — | 227 (91.9) | 33 (84.6) |
| Tachycardiag | 342 (54.3) | 159 (55.8) | — | 138 (56.1) | 21 (53.8) |
| Very severe pneumoniah | 94 (14.9) | 39 (13.6) | — | 0 (0.0) | 39 (100) |
| Danger signs | |||||
| Head nodding | 28 (4.4) | 17 (5.9) | — | 0 (0.0) | 17 (43.6) |
| Central cyanosis | 4 (0.6) | 4 (1.4) | — | 0 (0.0) | 4 (10.3) |
| Convulsionsi | 29 (4.6) | 5 (1.7) | — | 0 (0.0) | 5 (12.8) |
| Lethargyj | 55 (8.7) | 23 (8) | — | 0 (0.0) | 23 (59.0) |
| Unable feed | 17 (2.7) | 6 (2.1) | — | 0 (0.0) | 6 (15.4) |
| Vomiting | 8 (1.3) | 2 (0.7) | — | 0 (0.0) | 2 (5.1) |
| Crackles | 486 (77.1) | 231 (81.1) | — | 200 (81.3) | 31 (79.5) |
| Wheeze on auscultation | 198 (31.5) | 84 (29.6) | — | 76 (31.0) | 8 (20.5) |
| Grunting | 50 (7.9) | 26 (9.1) | — | 16 (6.5) | 10 (25.6) |
| Nasal flaring | 332 (52.6) | 161 (56.3) | — | 133 (53.8) | 28 (71.8) |
| Elevated temperature (≥38°C) | 205 (32.5) | 117 (40.9) | — | 98 (39.7) | 19 (48.7) |
| Leukocytosisk | 196 (43.1) | 100 (49.8) | — | 81 (45.8) | 19 (79.2) |
| CRP ≥ 40 mg/L | 132 (34.5) | 86 (48.9) | — | 73 (47.7) | 13 (56.5) |
| Severe anemia (0–7.5 g/dL) | 33 (7.3) | 14 (7.0) | — | 9 (5.1) | 5 (20.8) |
| Duration of illnessl | |||||
| Median duration of illness (d)l (IQR) | 3 (2, 3) | 3 (2, 4) | — | 3 (2, 4) | 3 (2, 5) |
| 0–2 d | 256 (40.6) | 112 (39.2) | — | 98 (39.7) | 14 (35.9) |
| 3–5 d | 332 (52.6) | 149 (52.1) | — | 130 (52.6) | 19 (48.7) |
| >5 d | 43 (6.8) | 25 (8.7) | — | 19 (7.7) | 6 (15.4) |
| Median duration of hospitalization (d) (IQR) | 3 (2, 4) | 3 (2, 4) | — | 3 (2, 4) | 4 (2, 5) |
| Duration of hospitalization | |||||
| 0–2 d | 15 (2.4) | 9 (3.2) | — | 84 (34.3) | 10 (25.6) |
| 3–5 d | 554 (88.5) | 239 (84.2) | — | 134 (54.7) | 20 (51.3) |
| >5 d | 57 (9.1) | 36 (12.7) | — | 27 (11.0) | 9 (23.1) |
| Died in hospital or within 30 d of admission | 27 (4.3) | 16 (5.6) | — | 5 (2.0) | 11 (28.2) |
| Died in-hospital | 21 (3.3) | 12 (4.2) | — | 2 (0.8) | 10 (25.6) |
| Died postdischarge, within 30 d of admissionm | 6 (1.0) | 4 (1.5) | — | 3 (1.2) | 1 (3.5) |
| Missing 30-d vital statusm | 6 (1.0) | 2 (0.7) | — | 1 (0.4) | 1 (3.5) |
| IQR indicates interquartile range. | |||||
aControls were considered to have respiratory tract illness (RTI) if they had (1) cough (observed or reported) or runny nose (reported) or (2) one of the following: ear discharge (reported), wheeze (reported) or difficulty breathing (reported), in the presence of sore throat (reported) or fever (observed temperature ≥38.0°C or reported fever in the past 48 hours).
bFor children <1 year, defined as received at least one dose and up-to-date for age based on the child’s age at enrollment, doses received and country schedule (allowing 4-week window each for dose). For children > 1 year, defined as 3+ doses.
cAt least 1 dose, restricted to children >10 months.
dDefined as serum bioassay positive (cases and controls), antibiotics administered at the referral facility, or antibiotic administration prior to whole-blood specimen collection at the study facility (cases only).
eHypoxemia defined as oxygen saturation <92%, or on supplemental oxygen if a room air oxygen saturation reading was not available. A room air oxygen saturation reading was available from 616 (97.6%) of children.
fTachypnea defined as ≥60 breaths per minute (<2 months), ≥50 breaths per minute (2–11 months) and ≥40 breaths per minute (12–59 months).
gTachycardia defined as >160 beats per minute (bpm) (<11 months), >150 bpm (12–35 months) and >140 bpm (36–59 months).
hVery severe pneumonia defined as cough or difficulty breathing, and at least one of the following: central cyanosis, difficulty breast-feeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness or head nodding.
iMultiple or prolonged convulsions (≥15 min).
jLethargic or unresponsive (responds to voice or pain, unresponsive or pharmacologically sedated).
kLeukocytosis count defined as >15 × 109 cells/L for children 1–11 months and >13 × 109 cells/L for children 12–59 months.
lDefined as maximum days of reported symptoms for any of the following: cough, wheeze, fever or difficulty breathing.
mRestricted to those children discharged alive.