Viral Acute Lower Respiratory Tract Infections (ALRI) in Rural Bangladeshi Children Prior to the COVID‐19 Pandemic
ABSTRACT Background Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh. Methods We e...
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| Veröffentlicht in: | Influenza and other respiratory viruses Jg. 18; H. 12; S. e70062 - n/a |
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England
John Wiley & Sons, Inc
01.12.2024
John Wiley and Sons Inc |
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| Abstract | ABSTRACT
Background
Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh.
Methods
We enrolled 3‐ to 23‐month‐old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel.
Results
Between August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty‐seven percent presented during autumn (mid‐June to mid‐October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year‐round; RSV was detected during August–November and hMPV during December–March.
Conclusions
Respiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy. |
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| AbstractList | Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh.BACKGROUNDAcute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh.We enrolled 3- to 23-month-old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel.METHODSWe enrolled 3- to 23-month-old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel.Between August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty-seven percent presented during autumn (mid-June to mid-October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year-round; RSV was detected during August-November and hMPV during December-March.RESULTSBetween August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty-seven percent presented during autumn (mid-June to mid-October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year-round; RSV was detected during August-November and hMPV during December-March.Respiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy.CONCLUSIONSRespiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy. Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh. We enrolled 3- to 23-month-old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel. Between August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty-seven percent presented during autumn (mid-June to mid-October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year-round; RSV was detected during August-November and hMPV during December-March. Respiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy. ABSTRACT Background Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh. Methods We enrolled 3‐ to 23‐month‐old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel. Results Between August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty‐seven percent presented during autumn (mid‐June to mid‐October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year‐round; RSV was detected during August–November and hMPV during December–March. Conclusions Respiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy. ABSTRACT Background Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh. Methods We enrolled 3‐ to 23‐month‐old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel. Results Between August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty‐seven percent presented during autumn (mid‐June to mid‐October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year‐round; RSV was detected during August–November and hMPV during December–March. Conclusions Respiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy. |
| Author | Mehta, Kayur Ahmed, Salahuddin Santosham, Mathuram McCollum, Eric D. Chowdhury, Nabidul Haque Anderson, Jack Saha, Samir Reller, Megan E. Roy, Arunangshu D. Baqui, Abdullah H. Moulton, Lawrence H. |
| AuthorAffiliation | 6 Projahnmo Research Foundation Dhaka Bangladesh 5 Global Program in Respiratory Sciences, Department of Pediatrics, Eudowood Division of Pediatric Respiratory Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA 7 Child Health Research Foundation Dhaka Bangladesh 1 Department of Medicine Duke University School of Medicine Durham North Carolina USA 4 Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA 2 Duke Global Health Institute Durham North Carolina USA 3 Durham Veterans Affairs Medical Center Durham North Carolina USA |
| AuthorAffiliation_xml | – name: 7 Child Health Research Foundation Dhaka Bangladesh – name: 3 Durham Veterans Affairs Medical Center Durham North Carolina USA – name: 4 Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA – name: 5 Global Program in Respiratory Sciences, Department of Pediatrics, Eudowood Division of Pediatric Respiratory Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA – name: 6 Projahnmo Research Foundation Dhaka Bangladesh – name: 1 Department of Medicine Duke University School of Medicine Durham North Carolina USA – name: 2 Duke Global Health Institute Durham North Carolina USA |
| Author_xml | – sequence: 1 givenname: Megan E. surname: Reller fullname: Reller, Megan E. organization: Durham Veterans Affairs Medical Center – sequence: 2 givenname: Kayur surname: Mehta fullname: Mehta, Kayur email: kmehta6@jhu.edu organization: Johns Hopkins Bloomberg School of Public Health – sequence: 3 givenname: Eric D. surname: McCollum fullname: McCollum, Eric D. organization: Johns Hopkins University School of Medicine – sequence: 4 givenname: Salahuddin surname: Ahmed fullname: Ahmed, Salahuddin organization: Projahnmo Research Foundation – sequence: 5 givenname: Jack surname: Anderson fullname: Anderson, Jack organization: Durham Veterans Affairs Medical Center – sequence: 6 givenname: Arunangshu D. surname: Roy fullname: Roy, Arunangshu D. organization: Projahnmo Research Foundation – sequence: 7 givenname: Nabidul Haque surname: Chowdhury fullname: Chowdhury, Nabidul Haque organization: Projahnmo Research Foundation – sequence: 8 givenname: Samir surname: Saha fullname: Saha, Samir organization: Child Health Research Foundation – sequence: 9 givenname: Lawrence H. surname: Moulton fullname: Moulton, Lawrence H. organization: Johns Hopkins Bloomberg School of Public Health – sequence: 10 givenname: Mathuram surname: Santosham fullname: Santosham, Mathuram organization: Johns Hopkins Bloomberg School of Public Health – sequence: 11 givenname: Abdullah H. surname: Baqui fullname: Baqui, Abdullah H. organization: Johns Hopkins Bloomberg School of Public Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39701824$$D View this record in MEDLINE/PubMed |
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| Notes | This study was funded by the Bill and Melinda Gates Foundation to A Baqui (OPP1084286, OPP1117483) and Thrasher Research Fund to ME Reller (14193). The funders had no role in data collection or analysis or preparation of the manuscript or decision to publish. The content is solely the responsibility of the authors and does not represent the official views of the Bill & Melinda Gates Foundation or Thrasher Research Fund. Funding ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Funding: This study was funded by the Bill and Melinda Gates Foundation to A Baqui (OPP1084286, OPP1117483) and Thrasher Research Fund to ME Reller (14193). The funders had no role in data collection or analysis or preparation of the manuscript or decision to publish. The content is solely the responsibility of the authors and does not represent the official views of the Bill & Melinda Gates Foundation or Thrasher Research Fund. |
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Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses... Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large... ABSTRACT Background Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses... |
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| SubjectTerms | Acute Disease - epidemiology Age ALRI Alveoli Autumn Bangladesh Bangladesh - epidemiology child Children Children & youth Coronaviruses Cough COVID-19 COVID-19 - epidemiology COVID-19 - virology Demographics Disease transmission Education Epidemiology Female Hospitals Humans Infant Infections Influenza Male Metapneumovirus - genetics Metapneumovirus - isolation & purification Mortality Nasopharynx - virology Original Pandemics Pathogens Pediatrics Physicians Population Respiratory diseases Respiratory syncytial virus Respiratory tract Respiratory tract infection Respiratory Tract Infections - epidemiology Respiratory Tract Infections - virology Rural Population - statistics & numerical data SARS-CoV-2 - genetics SARS-CoV-2 - isolation & purification Seasons Vaccines viral Viral infections Viruses Viruses - classification Viruses - genetics Viruses - isolation & purification |
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| Title | Viral Acute Lower Respiratory Tract Infections (ALRI) in Rural Bangladeshi Children Prior to the COVID‐19 Pandemic |
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