Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: a case–control study protocol

Bhuiyan, Mejbah Uddin; Snelling, Thomas L; West, Rachel; Lang, Jurissa; Rahman, Tasmina; Borland, Meredith L; Thornton, Ruth; Kirkham, Lea-Ann; Sikazwe, Chisha; Martin, Andrew C; Richmond, Peter C; Smith, David W; Jaffe, Adam; Blyth, Christopher C

• Specimens to detect respiratory viruses and bacteria will be collected from the upper respiratory tract (nasopharynx) instead of the actual site of infection, i.e. lower respiratory tract. Pathogens detected in nasopharyngeal swab do not necessarily confirms presence of the same pathogens in the lower respiratory tract, however, evidence of these pathogens in nasopharynx have been found to be associated with lower respiratory tract infection in children in previous epidemiological studies occur each year with nearly 1 million deaths among children aged <5 years; most deaths occur in low resource settings [1, 2] . The burden of childhood CAP in developed countries is lower (approximately 50 cases per 1000 children-years), however, CAP remains an important public health concern with increasing antibacterial resistance, evidence of replacement disease with non-vaccine strains, and emergence of new respiratory pathogens [3] [4] [5] . In Australia, CAP is an important cause of hospitalization of children with 2-8 hospitalisations per 1000 child-years for children < 5 years old [6, 7] . In Western Australia, the incidence is especially high for Aboriginal children who have been observed to be at 14 times higher risk of hospitalisation for CAP than non-Aboriginal children [8] .