Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

Abstract

BackgroundAcute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years.MethodNasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques.ResultsOut of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant.ConclusionThe study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

Risk factors of prolonged hospital stay in children with viral severe acute respiratory infections

“…These results are in concordance with previous studies from Ghana [17] and Saudi Arabia [19], in which adenovirus was the second most frequently detected virus following RSV infection. However, other studies carried out in Saudi Arabia [18,20] showed that parainfluenza was the second most frequently detected virus following RSV.…”

“…Viral infections occurred mostly in children one year of age and younger (88.9%), followed by children between one and five years of age (7.9%) and children over five years of age (3.2%). This is consistent with the age distribution of viral ALRI reported in developing countries [15][16][17][40][41][42][43] and Middle Eastern countries [18,20,24]. However, we did not identify a significant association between PLOS and the type of virus or seasonality.…”

“…RSV was the most predominant respiratory virus with a prevalence of 22.9%. The overall incidence is comparable to previous studies conducted in other developing countries [15][16][17] and to studies conducted in Middle Eastern countries [18][19][20]. The predominance of RSV is in concordance with the assertion that this virus is the single most frequently identified lower respiratory tract pathogen in hospitalized infants and young children worldwide [21][22][23][24].…”

“…A similar low prevalence of influenza viruses has been previously reported among hospitalized children in Ghana and Thailand [17,28]. The low prevalence of influenza in this study may be explained by the fact that only patients with SARI needing admission were included in our study.…”

Review of immunological and virological aspects as contributory factors in Sudden Unexpected Death in Infancy (SUDI)

“…Many respiratory viruses show definite seasonal variation, such as RSV [18], HMPV, influenza [19] and PIV, with peaks during winter [20]. A rise in SIDS cases has been documented in certain populations where infections are frequent, including during colder climates and annual influenza outbreaks [21,22,23].…”