Respiratory viruses associated with severe pneumonia in children under 2 years old in a rural community in Pakistan.
The objective of this study was to determine the incidence of respiratory viruses associated with severe pneumonia among children less than 2 years of age in the rural district of Matiari in Sindh, Pakistan. This study was a community-based prospective cohort active surveillance of infants enrolled at birth and followed for 2 years. Cases were identified using the World Health Organization's Integrated Management of Childhood Illnesses' definition of severe pneumonia. Nasopharyngeal swabs were obtained for assessment by multiplex RT-PCR for eight viruses and their subtypes, including RSV, influenza virus, human metapneumovirus, enterovirus/rhinovirus, coronavirus, parainfluenza virus, adenovirus, and human bocavirus. Blood cultures were collected from febrile participants. A total of 817 newborns were enrolled and followed with fortnightly surveillance for 2 years, accounting for a total of 1,501 child-years of follow-up. Of the nasopharyngeal swabs collected, 77.8% (179/230) were positive for one or more of the above mentioned respiratory viruses. The incidence of laboratory confirmed viral-associated pneumonia was 11.9 per 100 child-years of follow-up. Enterovirus/rhinovirus was detected in 51.7% patients, followed by parainfluenza virus type III (8.3%), and RSV (5.7%). Of the uncontaminated blood cultures, 1.4% (5/356) were positive. Respiratory viruses are frequently detected during acute respiratory infection episodes in children under 2 years old in a rural community in Pakistan. However, causal association is yet to be established and the concomitant role of bacteria as a co-infection or super-infection needs further investigation. J. Med. Virol. 88:1882-1890, 2016. © 2016 Wiley Periodicals, Inc.
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Asad
A
Ali
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Tauseef
T
Akhund
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Gohar Javed
GJ
Warraich
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Fatima
F
Aziz
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Najeeb
N
Rahman
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Fayyaz Ahmed
FA
Umrani
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Shahida
S
Qureshi
Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.
William A
WA
Petri
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Zulfiqar
Z
Bhutta
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Anita K M
AK
Zaidi
Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.
Molly A
MA
Hughes
D000257:Adenoviridae Infections / Q000453:epidemiology / Q000821:virology; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D018352:Coronavirus Infections / Q000453:epidemiology / Q000821:virology; D062665:Epidemiological Monitoring; D005260:Female; D056661:Human bocavirus; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D060885:Multiplex Polymerase Chain Reaction; D009305:Nasopharynx / Q000821:virology; D010154:Pakistan / Q000453:epidemiology; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000821:virology*; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000097:blood / Q000453:epidemiology / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000302:isolation & purification; D012424:Rural Population; D012720:Severity of Illness Index; D014780:Viruses / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
PCR; Pakistan; multiplex; pneumonia; viral