title: A comparison of human metapneumovirus and respiratory syncytial virus WHO-defined severe pneumonia in Moroccan children.
abstract: Acute respiratory infections remain the principal cause of morbidity and mortality in Moroccan children. Besides bacterial infections, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are prominent among other viruses due to their high prevalence and association with severe clinical episodes. We aimed to describe and compare RSV- and hMPV-associated cases of WHO-defined severe pneumonia in a paediatric population admitted to Morocco's reference hospital. Children aged 2-59 months admitted to the Hôpital d'Enfants de Rabat, Morocco meeting WHO-defined severe pneumonia criteria were recruited during 14 months and thoroughly investigated to ascertain a definitive diagnosis. Viral prevalence of RSV, hMPV and other viruses causing respiratory symptoms was investigated in nasopharyngeal aspirate samples through the use of molecular methods. Of the 683 children recruited and included in the final analysis, 61/683 (8·9%) and 124/683 (18·2%) were infected with hMPV and RSV, respectively. Besides a borderline significant tendency for higher age in hMPV cases, patients infected with either of the viruses behaved similarly in terms of demographics, patient history, past morbidity and comorbidity, vaccination history, socioeconomic background and family environment. Clinical presentation on arrival was also similar for both viruses, but hMPV cases were associated with more severity than RSV cases, had a higher risk of intensive care need, and received antibiotic treatment more frequently. RSV and hMPV are common and potentially life-threatening causes of WHO-defined pneumonia in Moroccan children. Both viruses show indistinctive clinical symptomatology, but in Moroccan children, hMPV was associated with a more severe evolution.
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: I
authors.initials: I
authors.lastname: Jroundi
authors.affiliation: Hôpital d'Enfants de Rabat (HER),Centre Hospitalier Universitaire Ibn Sina,Rabat,Morocco.
authors.forename: C
authors.initials: C
authors.lastname: Mahraoui
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: R
authors.initials: R
authors.lastname: Benmessaoud
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: C
authors.initials: C
authors.lastname: Moraleda
authors.affiliation: Hôpital d'Enfants de Rabat (HER),Centre Hospitalier Universitaire Ibn Sina,Rabat,Morocco.
authors.forename: H
authors.initials: H
authors.lastname: Tligui
authors.affiliation: Hôpital d'Enfants de Rabat (HER),Centre Hospitalier Universitaire Ibn Sina,Rabat,Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Seffar
authors.affiliation: Hôpital d'Enfants de Rabat (HER),Centre Hospitalier Universitaire Ibn Sina,Rabat,Morocco.
authors.forename: S E C
authors.initials: SE
authors.lastname: El Kettani
authors.affiliation: Hôpital d'Enfants de Rabat (HER),Centre Hospitalier Universitaire Ibn Sina,Rabat,Morocco.
authors.forename: B S
authors.initials: BS
authors.lastname: Benjelloun
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: S
authors.initials: S
authors.lastname: Chaacho
authors.affiliation: University Hospital Sant Joan de Déu,Esplugues,Barcelona,Spain.
authors.forename: C
authors.initials: C
authors.lastname: Muñoz-Almagro
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: P L
authors.initials: PL
authors.lastname: Alonso
authors.affiliation: ISGlobal,Barcelona Centre for International Health Research (CRESIB),Hospital Clínic - Universitat de Barcelona,Barcelona,Spain.
authors.forename: Q
authors.initials: Q
authors.lastname: Bassat
mesh_terms: D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D029121:Metapneumovirus / Q000235:genetics / Q000302:isolation & purification*; D009018:Morocco / Q000453:epidemiology; D009305:Nasopharynx / Q000821:virology; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000302:isolation & purification*; D012621:Seasons; D012720:Severity of Illness Index; D014944:World Health Organization
chemical_list: D004279:DNA, Viral
keywords: Human metapneumovirus; Morocco; children; pneumonia; respiratory syncytial virus