Viral and bacterial etiology of severe acute respiratory illness among children < 5 years of age without influenza in Niger

Abstract

BackgroundGlobally, pneumonia is the leading cause of morbidity and mortality in children, with the highest burden experienced in sub-Saharan Africa and Asia. However, there is a dearth of information on the etiology of severe acute respiratory illness (SARI) in Africa, including Niger.MethodsWe implemented a retrospective study as part of national influenza sentinel surveillance in Niger. We randomly selected a sample of nasopharyngeal specimens collected from children <5 years of age hospitalized with SARI from January 2010 through December 2012 in Niger. The samples were selected from individuals that tested negative by real-time reverse transcription polymerase chain reaction (rRT-PCR) for influenza A and B virus. The samples were analyzed using the Fast Track Diagnostic Respiratory Pathogens 21plus Kit (BioMérieux, Luxemburg), which detects 23 respiratory pathogens including 18 viral and 5 bacterial agents.ResultsAmong the 160 samples tested, 138 (86 %) tested positive for at least one viral or bacterial pathogen; in 22 (16 %) sample, only one pathogen was detected. We detected at least one respiratory virus in 126 (78 %) samples and at least one bacterium in 102 (64 %) samples. Respiratory syncytial virus (56/160; 35 %), rhinovirus (47/160; 29 %) and parainfluenza virus (39/160; 24 %) were the most common viral pathogens detected. Among bacterial pathogens, Streptococcus pneumoniae (90/160; 56 %) and Haemophilus influenzae type b (20/160; 12 %) predominated.ConclusionsThe high prevalence of certain viral and bacterial pathogens among children <5 years of age with SARI highlights the need for continued and expanded surveillance in Niger.

Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital‐based observational study in Niamey, Niger

“…At least one respiratory virus or bacteria was found in 77.7% of samples tested. This proportion was similar to that reported in a previous study on the etiology of ARI in children aged younger than 5 years in Niger (78%), although on a limited number of samples . This finding was also consistent with those of other similar studies conducted in Africa (range 55%‐70%) and Asia (range 45%‐65%) …”

“…As reported in other studies, RSV, INF, and HMPV were mostly detected as single viral infections . RSV, HRV, and HPIV were also the most predominant viruses detected in children aged younger than 5 years in a previous study conducted in Niger . RSV is considered to be a major cause of ARI in children aged younger than 5 years, and it was the most commonly detected virus also in this study (149/638; 23.3%).…”

“…In the absence of laboratory diagnosis, it is difficult to clinically differentiate between ARI‐related causative pathogens, due to similarities of symptoms . The main causative agents of ARI are viruses and bacteria .…”

Prevalence of human respiratory syncytial virus infection in people with acute respiratory tract infections in Africa: A systematic review and meta‐analysis

“…The inter‐rater agreement for study selection was high ( κ = 0.81). Finally, 66 full texts including 67 studies were included (one paper included two studies) …”

Comparison of FTD® respiratory pathogens 33 and a singleplex CDC assay for the detection of respiratory viruses: A study from Cameroon

“…Viral culture, for example, can be time consuming, labor intensive and requires substantial technical expertise to maintain and evaluate cell culture monolayers (Leland and Ginocchio, 2007). Currently, nucleic acid amplification is the method of choice for the diagnosis of respiratory infections (Bierbaum et al, 2014;Driscoll et al, 2014;Kenmoe et al, 2016;Lagare et al, 2015;Malhotra et al, 2016). Molecular tests are widely recognized to contribute to a better efficiency, sensitivity and speed compared to traditional methods for the diagnosis of respiratory infections.…”