Update on community acquired pneumonia in African children

Abstract

Recent medical advances have led to a drop in the global incidence of pneumonia. Despite this global drop, pneumonia remains the number one cause of childhood mortality outside the neonatal period, especially in low-to-middle income countries. The purpose of this review is to give an update on the causes, diagnosis, management, and prevention of community acquired pneumonia (CAP) in African children.

Due to increased immunisation coverage, viruses have become the most common cause of CAP (respiratory syncytial virus being the most common virus), while staphylococcus aureus and non-typeable Haemophilus influenzae are the most common causes in fully immunised children.

Extensive investigations are not warranted in most cases, as a result, investigations to be carried out will be dependent upon the clinical condition and local protocol. In light of the COVID-19 pandemic all cases of CAP must be screened for COVID-19.

Antimicrobial treatment is determined by, clinical severity, local antibiotic resistance patterns, presence of complications, the causative organism, and local protocols. Broad-spectrum antibiotics such as amoxicillin-clavulanic acid or a 2^nd or 3^rd generation cephalosporin are normally sufficient. Special attention needs to be paid to immunocompromised children as well as those with sickle cell disease, as additional pharmacological cover is recommended.

Notwithstanding the significant burden posed by CAP in low-to-middle income countries, there remains a paucity of data on CAP from Africa, therefore, it is of paramount importance that further epidemiological data be collected from African countries to optimise the understanding, prevention and management of CAP in Africa.