Etiology and seasonality of viral respiratory infections in rural Honduran children.
BACKGROUND
Limited data are available in Honduras that describe the etiology and seasonality of respiratory infections, especially in rural outpatient settings. Better data may lead to improved therapeutic and preventive strategies. The goal of our study was to determine the viral etiology and seasonality of acute respiratory infections in a rural Honduran population of children.


METHODS
Prospective clinic surveillance was conducted to identify children < 5 years of age presenting with respiratory symptoms of < 5 days duration. We obtained data on age, sex, medical history, breastfeeding history, symptoms, risk factors, household setting, temperature, respiratory rate and chest examination findings. To assess the association between specific viruses and weather, regional meteorological data were collected. Nasopharyngeal samples were tested for 16 respiratory viruses using a multiplex polymerase chain reaction panel.


RESULTS
From February 2010 through June 2011, 345 children < 5 years of age were enrolled; 17%, 23%, 30% and 31% were <6, 6-11, 12-23 and 24-60 months old, respectively. Including all clinics in the region, 44.5% of patients < 5 years of age with documented respiratory diagnoses were enrolled. At least 1 virus was identified in 75.4% children, of which 7.5% were coinfections; 13.3% were positive for parainfluenza, 11.9% for influenza, 8.1% for human metapneumovirus and 7.5% for respiratory syncytial virus. Rainfall correlated with parainfluenza (P < 0.0001), influenza (P < 0.0001), human metapneumovirus (P = 0.0182) and respiratory syncytial virus (P < 0.0001).


CONCLUSIONS
These results suggest that the spectrum of viruses in ill, rural, Honduran children is similar to that in North and Central America, although the seasonality is typical of some tropical regions.
Global Health Center, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH 45229, USA. elizabeth.schlaudecker@cchmc.org
Elizabeth P
EP
Schlaudecker
Joan P
JP
Heck
Elizabeth T
ET
Macintyre
Ruben
R
Martinez
Caitlin N
CN
Dodd
Monica M
MM
McNeal
Mary A
MA
Staat
Jeffery E
JE
Heck
Mark C
MC
Steinhoff
D002675:Child, Preschool; D060085:Coinfection; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000821:virology*; D012424:Rural Population; D012621:Seasons; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology; D014780:Viruses / Q000145:classification / Q000302:isolation & purification