A Prospective Study of Agents Associated With Acute Respiratory Infection Among Young American Indian Children

Abstract

Background Native American children have higher rates of morbidity associated with acute respiratory infection than children in the general United States population, yet detailed information is lacking regarding their principal clinical presentations and infectious etiologies. Methods We pursued a comprehensive molecular survey of bacteria and viruses in nasal wash specimens from children with acute respiratory disease collected prospectively over one year (January 1 through December 31, 2009) from 915 Navajo and White Mountain Apache children in their second or third year of life who had been enrolled in an efficacy study of an RSV monoclonal antibody in the first year of life. Results During the surveillance period, 1476 episodes of disease were detected in 669 children. Rates of outpatient and inpatient lower respiratory tract illness were 391 and 79 per 1000 child-years, respectively, and were most commonly diagnosed as pneumonia. Potential pathogens were detected in 88% of specimens. Viruses most commonly detected were respiratory syncytial virus (RSV) and human rhinovirus (HRV); 2009 pandemic influenza A (H1N1) illnesses primarily occurred in the fall. Streptococcus pneumoniae was detected in 60% of subjects; only HRV was significantly associated with S. pneumoniae carriage. The presence of influenza virus, HRV, or S. pneumoniae was not associated with increased risk for lower respiratory tract involvement or hospitalization. Conclusions Acute lower respiratory illnesses occur at disproportionately high rates among young American Indian children, and are associated with a range of common pathogens. This study provides critical evidence to support reducing the disproportionate burden of acute respiratory disease among young Native Americans.

The use of a multiplex real-time PCR assay for diagnosing acute respiratory viral infections in children attending an emergency unit

“…A very high percentage of the samples were positive giving a virus signature in nearly 90% of cases, and all the viruses in the test panel were detected. These results are similar to those for young children and infants obtained by others (88-92%) [6][7][8], whereas the rate of detection in adults was lower (43%) [9]. RV, RSV, and IV were the three most prominent pathogens detected, while ADV, CoV, MPV and PiV were less frequent (<10% of cases).…”

Molecular Diagnosis of Pneumonia Using Multiplex Real-Time PCR Assay RespiFinder® SMART 22 FAST in a Group of Moroccan Infants

“…ey found Respiratory viruses in 64% of the Tracheal secretion (TS) samples [12]. is high positivity is similar to other studies in which molecular methods were performed [2,[22][23][24].…”

Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom

“…While our overall detection rate of at least one organism in >90% of subjects was substantially higher than some studies reporting on upper airways organisms in association with disease, our high detection rate is similar to other studies. A community-acquired pneumonia study [21] and an American Indian child cohort of ARI [5] described detection rates of 97% in the former [21] and 88% in the latter [5]. The seasonal distribution of most organisms correlated with the patterns of childhood ARI in subtropical climates, particularly over autumn and winter months, although all organisms were identified year round.…”

“…Studies that have examined both viruses and bacteria during an ARI have typically been limited in their scope, including short duration (e.g. 1 year during the 2009 influenza A/H1N1 pandemic [5]), linkage to specific diagnostic criteria [6] and small sample sizes [7].…”