Findings from the decade-long global Pneumonia Etiology Research for Child Health (PERCH) study are published in the latest edition of the prestigious Lancet journal.
Professor David Murdoch of the University of Otago, Christchurch, is a renowned infectious disease expert who led establishment of laboratories in seven countries involved in the study.
The PERCH team – funded by the Bill and Melinda Gates Foundation – set up laboratories in seven countries in Asia and Africa. They did a wide range of tests on children hospitalised with severe pneumonia to pinpoint the specific viruses and bacteria involved.
The researchers found a wide range of bacteria and viruses across the seven countries, some of which were linked to worse outcomes for children. One virus was present in more than a quarter of all cases. The respiratory syncytial virus (RSV) is a major cause of respiratory illness in young children and efforts are under way to develop a vaccine against it.
Pneumonia kills more under-fives worldwide than any other disease. Almost 1 million children globally died from the disease in 2015.
Professor Murdoch says the PERCH study gives direction on where to put resources and scientific basis for vaccination programmes in countries with the greatest burden of childhood pneumonia.
“Before PERCH we were reliant on old data from the 1980s. The landscape has changed since then with the roll out of vaccines against some important causes of pneumonia, the AIDS epidemic, increased urbanisation, the development of antibiotic resistance, and availability of better diagnostic tests.”
Professor Murdoch says by understanding the range of viruses and bacteria causing the disease in each country, the research gives individual nations, and global agencies such as the World Health Organisation, a clear battle plan to combat pneumonia.
The PERCH study found more than 7% of children with severe pneumonia involved in the study died within a month of hospitalisation. In some countries, such as a Zambia, the death rate was much higher – with at least one in five children dying within a month of hospitalisation.
Professor Murdoch is also a senior staff member at the Canterbury District Health Board’s Canterbury Health Laboratories (CHL). CHL staff played a major role in the study. They helped train and mentor scientists in the overseas laboratories, established consistent quality protocols and did some of the more specialised tests required.
Professor Murdoch says there are few diagnostic laboratories, such as CHL, that have sufficient breadth of expertise to provide the support required for such a large and complex study. CHL has also been part of previous large pneumonia studies and this experience was crucial to the success of PERCH.
A major focus from now will be the development of effective vaccines and treatments against the important causes of childhood pneumonia identified by the PERCH study.