Clinical response to antibiotics in indigenous versus non-indigenous children under 5 years old with community-acquired pneumonia in Otavalo, Ecuador

Matute, Susana Eulalia Dueñas; Donadi, Eduardo Antônio; Nunes, Altacílio Aparecido; Martinez, Edson Zangiacomi

doi:10.1590/0037-8682-0038-2020

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Short Communication • Rev. Soc. Bras. Med. Trop. 53 • 2020 • https://doi.org/10.1590/0037-8682-0038-2020 copy

Clinical response to antibiotics in indigenous versus non-indigenous children under 5 years old with community-acquired pneumonia in Otavalo, Ecuador

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION:

Community-acquired pneumonia (CAP) is an important cause of morbidity and mortality worldwide. This study compares the clinical response to antimicrobials between indigenous and non-indigenous Kichwa children under 5 years old with CAP in Otavalo, Ecuador.

METHODS:

All children with CAP who met the inclusion criteria and were admitted at the San Luis de Otavalo Hospital between March 2017 and June 2018 were evaluated.

RESULTS:

No significant differences were observed in clinical responses between indigenous and non-indigenous children.

CONCLUSIONS:

The improved healthcare access of the Otavalo’s Kichwa population may have contributed to the observed clinical response to CAP treatment.

Keywords:
Antibiotics; Cultural characteristics; Ecuador; Indigenous people; Parturition; Pneumonia

	Indigenous		Non-indigenous		Total		P value
	(n = 72)		(n = 34)		(N = 106)
	n	%	n	%	n	%	(a)

Sex							0.20
Male	48	66.7	18	52.9	66	62.3
Female	24	33.3	16	47.1	40	37.7
Age							0.63
Infant	43	59.7	17	50.0	60	56.6
Toddler	21	29.2	12	35.3	33	31.1
Preschool	8	11.1	5	14.7	13	12.3
Birth weight							0.50
Adequate	63	87.5	32	94.1	95	89.6
Inadequate	9	12.5	2	5.9	13	10.4
Birthplace							0.05
Hospital	64	88.9	34	100.0	98	92.5
House	8	11.1	0	0.0	8	7.5
Residence
Rural	52	72.2	13	38.2	65	61.3
Urban	20	27.8	21	61.8	41	38.7
Breastfeeding duration							0.51
6 months	27	37.5	9	26.5	36	34.0
12 months	27	37.5	16	47.1	43	40.6
24 months	18	25.0	9	26.5	27	25.0
Vaccinations							1.00
Complete	56	77.8	27	79.4	83	78.3
Incomplete	16	22.2	7	20.6	23	21.7
Water supply							1.00
No	4	5.6	2	5.9	6	5.7
Yes	68	94.4	32	94.1	100	94.3
Sewerage system							<0.01
No	30	41.7	24	70.6	54	50.9
Yes	42	58.3	10	29.4	52	49.1

	Indigenous		Non-indigenous		Total		P value
	(n = 72)		(n = 34)		(N = 106)
	n	%	n	%	n	%	(a)

Status at discharge							1.00
Alive	71	98.6	34	100.0	105	99.1
Dead	1	1.4	0	0.0	1	0.9
Antibiotic type							0.26
None	1	1.4	0	0.0	1	0.9
First-generation (b)	24	33.3	12	35.3	37	34.9
Second-generation (c)	12	16.7	11	32.4	22	20.8
Third-generation (d)	11	15.3	4	11.8	16	15.1
Double combination	13	18.1	6	17.6	24	22.6
Triple combination	11	15.3	1	2.9	6	5.7
Length of hospital stay							0.60
≤6 days	57	79.2	29	85.3	86	81.1
>6 days	15	20.8	5	14.7	20	18.9
Nonpharmacological therapy							0.03
Yes	29	40.3	12	35.3	41	38.7
No	35	48.6	11	32.4	46	43.4
Unknown	8	11.1	11	32.4	19	17.9

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[1] Corresponding author: Edson Zangiacomi Martinez. e-mail:edson@fmrp.usp.br