title: Viral acute respiratory infections among infants visited in a rural hospital of southern Mozambique.
abstract: OBJECTIVE
  To determine the epidemiology and clinical presentation of virus-associated acute respiratory infections (ARI) in Mozambican infants.
  
  
  METHODS
  A systematic selection of nasopharyngeal aspirates (n = 333), collected from infants younger than 12 months who visited Manhiça District Hospital (southern Mozambique) with ARI during a 12 months respiratory syncitial virus surveillance, were tested for other common respiratory viruses. Four different polymerase chain reactions were used to diagnose rhinovirus (RV), influenza (Flu; A and B), adenovirus (ADV), human metapneumovirus (hMPV), parainfluenza (PIV; 1, 2, 3 and 4AB) and enterovirus (EV).
  
  
  RESULTS
  At least one study virus was identified in more than half of the samples tested (185/333). Overall, 231 viruses were detected among 185 infants, listed in the order of prevalence: RV (26%), Flu (15%), ADV (14%), hMPV (7%), PIV (5%) and EV (3%). Acute respiratory infections (ARI) cases and viral episodes were seasonal and concentrate during the warm and the rainy season. Clinical features were similar among all study children regardless of the detection of virus, with the exception of ear discharge, which was more frequent among viral cases [6% (11/183) vs. 1% (2/144); P = 0.034]. Children with multiple viral infections had higher odds of severity such as nasal flaring and indrawing (OR = 2.7, P = 0.028 and OR = 3.8, P = 0.007, respectively) and higher odds of hospitalisation (OR = 4.42, P = 0.001, adjusted by age and sex).
  
  
  CONCLUSIONS
  Viral ARI are frequent among infants visited in MHD. Strategies to prevent mild respiratory infections, and specially their complications, might alleviate health systems of source-limited settings.
authors.affiliation: Barcelona Centre for International Health Research, Hospital Clínic/Institut d'Investigacions Biomedicas August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: O'Callaghan-Gordo
authors.forename: Núria
authors.initials: N
authors.lastname: Díez-Padrisa
authors.forename: Fatima
authors.initials: F
authors.lastname: Abacassamo
authors.forename: Pilar
authors.initials: P
authors.lastname: Pérez-Breña
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Casas
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.forename: Anna
authors.initials: A
authors.lastname: Roca
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000175:diagnosis / Q000453:epidemiology; D007231:Infant, Newborn; D007297:Inpatients; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D012423:Rural Health / Q000706:statistics & numerical data; D012621:Seasons; D018571:Sentinel Surveillance; D014777:Virus Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology