Streptococcus pneumoniae Acquisition and Carriage in Vaccine Naïve Indian Children with HIV and their Parents: A Longitudinal Household Study.

OBJECTIVES: To investigate the difference in pneumococcal carriage, acquisition, antibiotic resistance profiles and serotype distribution, in human immunodeficiency virus (HIV) affected and unaffected families. METHODS: A prospective cohort study was conducted in children with and without HIV in West Bengal from March 2012 through August 2014, prior to 13-valent pneumococcal conjugate vaccine (PCV-13) immunization. One thousand four hundred forty one nasopharyngeal swabs were collected and cultured at five-time points from children and their parents for pneumococcal culture, and serotyping by Quellung method. RESULTS: One hundred twenty five HIV infected children and their parents, and 47 HIV uninfected children and their parents participated. Two hundred forty pneumococcal isolates were found. In children under 6 y, the point prevalence of colonization was 31% in children living with HIV (CLH) and 32% in HIV uninfected children (HUC), p = 0.6. The most common vaccine type (VT) serotypes were 6A, 6B and 19A. All isolates from parents and 71% from children in the HIV uninfected cohort were PCV-13 representative, compared to 33% of isolates from CLH and their parents. Acquisition rate in children was 1.77 times that of parents (OR = 1.77, 95%CI: 1.18-2.65). The HIV status of child or parent did not affect acquisition. Isolates from CLH were more frequently resistant to multiple antibiotics (p = 0.02). CONCLUSIONS: While the rate of pneumococcal carriage and acquisition did not differ between CLH and HUC, HIV affected families had exposure to a wider range of serotypes including non-vaccine type serotypes and antibiotic resistant serotypes, than HIV unaffected families.

Lung Consolidation Detection through Analysis of Vocal Resonance Signals.

Consolidation of the lung is a common pathology which is sometimes life threatening. One of the primary causes is the infection of lung tissue (pneumonia). Vocal resonance and vocal fremitus are part of the routine clinical examination of the respiratory system by physicians, which although time consuming, helps in the diagnosis of consolidation of the lung. In this paper, we suggest a possible automatic lung consolidation detection system that can be used by health workers with basic training. Analysis is performed on the vocal resonance sound signals recorded using an electronic stethoscope from the chest walls of normal subjects and patients. We show that for the detection system, use of signal loudness, which is generally considered by physicians, would be infeasible and propose that signal power spectral density computed using our system be considered. Certain frequency regions in the power spectral density (periodogram) are proved to be significant indicators of lung consolidation using t-tests. These findings are then applied to design the detection system using Gaussian naive Bayes classifiers.