Abstract
BackgroundThe pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion. Serum antioxidants and vitamin D with immunomodulatory properties therefore hold prospects in the prevention and management of pneumonia in children. This case–control study set out to compare the serum 25-hydroxyvitamin D (25-OHD) and total antioxidant capacity (TAC) in Nigerian children with CAP and age- and sex-matched controls and to relate these parameters with pneumonia severity and outcome—length of hospital stay (LOH).ResultsA total of 160 children (80 each for CAP and controls) were recruited. The median (IQR) age was 1.8 (0.6–4.0) years, male:female 1.7:1, 63 (78.8%) and 11 (13.8%) of CAP group had severe pneumonia and parapneumonic effusions, respectively. Serum 25-OHD (33.8 (18.3) ng/ml vs. 41.9 (12.3) ng/ml; p = 0.010) and TAC (6.1 (4.4–8.1) ng/dl vs. 7.2 (4.7–17.5) ng/dl; p = 0.023) were lower in children with CAP than controls. Lower serum 25-OHD was observed in severe than non-severe pneumonia (30.5(17.1) ng/ml vs. 46.3 (17.6) ng/ml; p = 0.001) but LOH did not correlate with serum 25-OHD and TAC.ConclusionChildren with CAP had lower serum vitamin D and antioxidants than controls, and severe pneumonia was significantly associated with suboptimal serum vitamin D. They however were not related to pneumonia outcome. Optimal serum vitamin D and antioxidants may play a role in reducing the incidence of childhood CAP in Nigerian children.
Highlights
The pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion
Epidemiological evidences revealed that significant progress had been made in this respect [3]; CAP still accounts for about 15% of global under-five mortality causing more than 800,000 deaths in children with over 90% of these deaths occurring in developing countries [1]
There was no significant difference in the age and sex distribution of the cases and controls; more proportions of the children with pneumonia were from low socio-economic class (SES) had undernutrition and inappropriate immunisation status (Table 1)
Summary
The pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion. Serum antioxidants and vitamin D with immunomodulatory properties hold prospects in the prevention and management of pneumonia in children. Community-acquired pneumonia (CAP) remains a leading cause of ill health and deaths in children from developing countries [1]. Failure to curtail the infection and inflammation may result in lung congestion, more free radical generation, cellular damages, consolidation and even parapneumonic effusions [4]. These pathologies impair gaseous exchange, increase dead space and cause intrapulmonary shunting and hypoxaemia [4, 5]
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