In developing countries, two bacteria, pneumococcus and Hib, are the dominant causes of severe pneumonia in children.
The introduction of vaccines against these diseases could reduce the global burden of severe pneumonia by about half. In this week's PLoS Medicine, J. Anthony G. Scott and Mike English—researchers at the Kenya Medical Research Institute–Wellcome Trust Collaborative Research Programme, Kenya—argue that the present classification and management guidelines for childhood pneumonia are founded on the dominance of these two organisms and will rapidly become obsolete as these vaccines are introduced.
The remaining cases of pneumonia, they say, will have a wide variety of causes and will include many cases of TB and noninfectious respiratory disease. This diversity of causes will make the diagnosis, classification, and management of pneumonia much more complex and expensive in the future.
"To be relevant to future policy,” say the authors, “research in the areas of pneumonia diagnosis, classification, prevention, or management should begin to anticipate this scenario now.”
Citation: Scott JAG, English M (2008) What are the implications for childhood pneumonia of successfully introducing Hib and pneumococcal vaccines in developing countries? PLoS Med 5(4): e86.