title: Epidemiology of adenovirus respiratory infections among hospitalized children in Seremban, Malaysia.
abstract: BACKGROUND
  There is scarcity of data regarding epidemiology and clinical aspects of human adenovirus acute respiratory infection (ARI) among children in developing countries.
  
  
  METHODS
  Retrospective data on demographics, clinical presentation, outcomes and laboratory findings of 116 children admitted into Tuanku Jaafar Hospital in Seremban, Malaysia from 2012 to 2013 with documented diagnosis of community-acquired adenovirus ARI were collected and analyzed.
  
  
  RESULTS
  Male to female ratio was 1.70. Median age was 14 (1-107) months. The commonest symptoms were fever (94.8%; 110/116), cough (82.8%, 96), rhinorrhea (63.8%; 74), interrupted feeding (66.4%; 77), diarrhea (33.6%; 39) and conjunctivitis (21.6%; 25). Mean temperature on admission was 38.4°C±0.9°C. Among all 116 subjects, 20.7% (24) needed oxygen supplementation, 57.8% (67) required intravenous hydration, 11.2% (13) were admitted into the pediatric intensive care unit and 6.9% (8) required mechanical ventilation. Only 1% (1/87) had positive blood culture (Streptococcus pneumoniae) among 87 who received antibiotic treatment. Case fatality rate was 2.6% (3/116) and 1.7% (2/116) developed bronchiolitis obliterans. Median length of hospital stay was 4 (1-50) days.
  
  
  CONCLUSIONS
  Adenovirus ARI caused significant morbidity and substantial resource utilization among hospitalized Malaysian children. It should be considered in the differential diagnosis of infants below two years presenting with ARI associated with high fever. Antibiotics should not be prescribed as secondary bacterial infections are uncommon.
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, 70300 Seremban, Malaysia nfkhuen2@yahoo.com.
authors.forename: Khuen
authors.initials: K
authors.lastname: Foong Ng
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, 70300 Seremban, Malaysia.
authors.forename: Kah
authors.initials: K
authors.lastname: Kee Tan
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, 70300 Seremban, Malaysia.
authors.forename: Boon
authors.initials: B
authors.lastname: Hong Ng
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, 70300 Seremban, Malaysia.
authors.forename: Pritiss
authors.initials: P
authors.lastname: Nair
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43300 Serdang, Malaysia.
authors.forename: Wan
authors.initials: W
authors.lastname: Ying Gan
mesh_terms: D000208:Acute Disease; D000257:Adenoviridae Infections / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001989:Bronchiolitis Obliterans / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology* / Q000628:therapy / Q000821:virology*; D012189:Retrospective Studies; D017678:Sex Distribution
chemical_list: D000900:Anti-Bacterial Agents
keywords: Adenovirus; Children; Epidemiology; Malaysia; Respiratory viral infection