There are few epidemiologic data on invasive bacterial infections among children in sub-Saharan Africa.
Dr Berkley and colleagues undertook a large study of every acute pediatric admission to a rural district hospital in Kenya in order to examine the prevalence, incidence, types, and outcome of community-acquired bacteremia.
Between August 1998 and July 2002, the researchers cultured blood on admission from a total of 19,339 inpatients.
The investigators calculated the incidence of bacteremia on the basis of the population served by the hospital.
Of a total of 1783 infants who were under 60 days old, the researchers found that 13% had bacteremia, as did 6% of children who were 60 or more days of age.
The research team noted that among infants who were under 60 days old, Escherichia coli and group B streptococci predominated among a broad range of isolates (14% and 11% respectively).
|Of all in-hospital deaths, 26 % were in children with community-acquired bacteremia|
|New England Journal of Medicine|
Among infants who were 60 or more days of age, the researchers noted that Streptococcus pneumoniae, nontyphoidal salmonella species, Haemophilus influenzae, and E. coli accounted for more than 70 % of isolates.
The investigators estimated that the minimal annual incidence of community-acquired bacteremia was 1457 cases per 100,000 children among infants under a year old, 1080 among children under 2 years, and 505 among children under 5 years.
The team found that of all in-hospital deaths, 26 % were in children with community-acquired bacteremia.
Of 308 deaths in children with bacteremia, 33% occurred on the day of admission and 71% within two days.
Dr Berkley concluded, "Community-acquired bacteremia is a major cause of death among children at a rural sub-Saharan district hospital, a finding that highlights the need for prevention and for overcoming the political and financial barriers to widespread use of existing vaccines for bacterial diseases."