Volume 25, Number 4—April 2019
Research
Staphylococcus aureus Bacteremia in Children of Rural Areas of The Gambia, 2008–2015
, Christian Bottomley, Syed A. Zaman, Jodi Lindsay, Muhammed Shah, Ilias Hossain, Malick Ndiaye, Chidebere D.I. Osuorah, Yekini Olatunji, Henry Badji, Usman N.A. Ikumapayi, Ahmad Manjang, Rasheed Salaudeen, Lamin Ceesay, Momodou Jasseh, Richard A. Adegbola, Tumani Corrah, Philip C. Hill, Brian M. Greenwood, and Grant A. Mackenzie
Table 3
Sociodemographic and clinical parameters associated with death from Staphylococcus aureus bacteremia among children <5 years of age identified through 2 surveillance systems, The Gambia, 2008–2015*
| Parameter | Deaths/persons at risk (%) | Unadjusted OR (95% CI) | p value | Adjusted OR (95% CI)† | p value |
|---|---|---|---|---|---|
| Age, mo | |||||
| <1 | 13/84 (15.5) | Referent | Referent | ||
| 1–11 | 8/61 (13.1) | 0.8 (0.3–2.1) | 0.9 (0.4–2.6) | ||
| 12-23 | 4/33 (12.1) | 0.8 (0.2–2.5) | 1.3 (0.4–4.6) | ||
| 24-59 |
3/20 (15.0) |
1.0 (0.3–3.8) |
0.96‡ |
1.1 (0.3–4.6) |
0.96 |
| Sex | |||||
| M | 16/97 (16.5) | Referent | |||
| F |
12/101 (11.9) |
0.7 (0.3–1.5) |
0.35 |
||
| Severely stunted§ | |||||
| No | 20/150 (13.3) | Referent | |||
| Yes |
5/41 (12.2) |
0.9 (0.3–2.6) |
0.85 |
||
| Axillary temperature | |||||
| 36.5°C–37.5°C | 4/18 (22.2) | Referent | |||
| <36.5°C | 4/40 (10.0) | 0.4 (0.1–1.8) | |||
| >37.5°C |
20/140 (14.3) |
0.6 (0.2–2.0) |
0.48 |
||
| Pulse rate, beats/min¶ | |||||
| Within reference ranges | 13/114 (11.4) | Referent | |||
| Increased for age |
15/84 (17.9) |
1.7 (0.8–3.8) |
0.20 |
||
| Respiratory rate, breaths/min# | |||||
| Within reference ranges | 8/70 (11.4) | Referent | |||
| Increased for age |
20/128 (15.6) |
1.4 (0.6–3.5) |
0.41 |
||
| Need for oxygen supplementation | |||||
| No | 21/165 (12.7) | Referent | |||
| Yes |
7/33 (21.2) |
1.9 (0.7–4.8) |
0.22 |
||
| Season | |||||
| Dry | 18/101 (17.8) | Referent | |||
| Wet |
10/97 (10.3) |
0.5 (0.2–1.2) |
0.13 |
||
| Cough | |||||
| No | 13/95 (13.7) | Referent | |||
| Yes |
15/103 (14.6) |
1.1 (0.5–2.4) |
0.86 |
||
| Difficult breathing | |||||
| No | 14/108 (13.0) | Referent | |||
| Yes |
14/89 (15.7) |
1.3 (0.6–2.8) |
0.58 |
||
| Prostration | |||||
| No | 17/168 (10.1) | Referent | Referent | ||
| Yes |
11/29 (37.9) |
5.4 (2.2–13.4) |
0.0004 |
5.7 (2.2–14.8) |
0.01 |
| Admitted in previous 2 weeks | |||||
| No | 20/131 (15.3) | Referent | |||
| Yes | 2/31 (6.5) | 0.4 (0.1–1.7) | 0.16 |
*Surveillance data are from the Basse Health and Demographic Surveillance System and the Fuladu West Health and Demographic Surveillance System. OR, odds ratio.
†Adjusted for age only.
‡p value for trend.
§Defined as weight-for-height z-score <3 SDs from median weight-for-height for the corresponding age group. We calculated weight-for-height using z-scores from the 2006 World Health Organization child growth standards in Stata 14.0 (https://www.stata.com/stata14). Neonates were not included in weight-for-height measurements.
¶The reference ranges for pulse rates were 70–190 beats/min for children <1 month of age, 80–160 beats/min for children 1–11 months of age, 80–130 beats/min for children 1–2 years of age, 80–120 beats/min for children 3–4 years of age, 75–115 beats/min for children 5–6 years of age, 70–110 beats/min for children 7–9 years of age, and 60–100 beats/min for children >10 years of age.
#Increased respiratory rate was defined as >60 breaths/min for children <2 months of age, >50 breaths/min for children 2–12 months of age, >40 breaths/ min for children >1–5 years of age.