title: Incidence and etiology of hospitalized acute respiratory infections in the Egyptian Delta.
abstract: Acute Respiratory Infections (ARI) are responsible for nearly two million childhood deaths worldwide. A limited number of studies have been published on the epidemiology of viral respiratory pathogens in Egypt.
  
  
  
  A total of 6113 hospitalized patients >1 month of age with suspected ARI were enrolled between June 23, 2009 and December 31, 2013. Naso- and oropharyngeal specimens were collected and tested for influenza A and B, respiratory syncytial virus, human metapneumovirus, adenovirus, and parainfluenza viruses 1-3. Blood specimens from children 1-11 months were cultured and bacterial growth was identified by polymerase chain reaction. Results from a healthcare utilization survey on the proportion of persons seeking care for ARI was used to calculate adjusted ARI incidence rates in the surveillance population.
  
  
  
  The proportion of patients with a viral pathogen detected decreased with age from 67% in patients age 1-11 months to 19% in patients ≥65 years of age. Influenza was the dominant viral pathogen detected in patients ≥1 year of age (13.9%). The highest incidence rates for hospitalized ARI were observed in children 1-11 months (1757.9-5537.5/100 000 population) and RSV was the most commonly detected pathogen in this age group.
  
  
  
  In this study population, influenza is the largest viral contributor to hospitalized ARIs and children 1-11 months of age experience a high rate of ARI hospitalizations. This study highlights a need for surveillance of additional viral pathogens and alternative detection methods for bacterial pathogens, which may reveal a substantial proportion of as yet unidentified etiologies in adults.
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Emily
authors.initials: E
authors.lastname: Rowlinson
authors.affiliation: US Centers for Disease Control & Prevention, Atlanta, GA, USA.|US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Erica
authors.initials: E
authors.lastname: Dueger
authors.affiliation: US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Mansour
authors.affiliation: Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
authors.forename: Nahed
authors.initials: N
authors.lastname: Azzazy
authors.affiliation: US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Hoda
authors.initials: H
authors.lastname: Mansour
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Lisa
authors.initials: L
authors.lastname: Peters
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Summer
authors.initials: S
authors.lastname: Rosenstock
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hamid
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Mayar M
authors.initials: MM
authors.lastname: Said
authors.affiliation: Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Geneidy
authors.affiliation: Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
authors.forename: Monier
authors.initials: M
authors.lastname: Abd Allah
authors.affiliation: Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Kandeel
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology / Q000821:virology; D008297:Male; D029121:Metapneumovirus / Q000472:pathogenicity; D008875:Middle Aged; D009960:Oropharynx / Q000821:virology; D009975:Orthomyxoviridae / Q000472:pathogenicity; D011159:Population Surveillance; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000472:pathogenicity; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology* / Q000821:virology; D012621:Seasons; D055815:Young Adult
keywords: acute respiratory infections; hospitalization; influenza; population surveillance; respiratory syncytial viruses; viral respiratory pathogens