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Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital-based observational study in Niamey, Niger

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  • Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital-based observational study in Niamey, Niger


    Health Sci Rep. 2019 Oct 11;2(11):e137. doi: 10.1002/hsr2.137. eCollection 2019 Oct. Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital-based observational study in Niamey, Niger.

    Lagare A1, Ousmane S1, Dano ID1, Issaka B1, Issa I1, Mainassara HB1, Testa J1, Tempia S2,3,4, Mamadou S5.
    Author information

    1 Bacteriology-Virology Unit Centre de Recherche Médicale et Sanitaire (CERMES) Niamey Niger. 2 Influenza Division Centers for Disease Control and Prevention Atlanta Georgia. 3 Influenza Program Centers for Disease Control and Prevention Pretoria South Africa. 4 MassGenics Duluth Duluth Georgia. 5 Faculté des Sciences de la Santé Université Abdou Moumouni Niamey Niger.

    Abstract

    Background and Aims:

    In Niger, acute respiratory infections (ARIs) are the second most common cause of death in children aged younger than 5 years. However, the etiology of ARI is poorly understood in the country. This study aims to describe viral and bacterial infections among children aged younger than 5 years hospitalized with febrile ARI at two hospitals in Niamey, Niger's capital city, and the reported clinical procedures.
    Methods:

    We conducted a prospective study among children aged younger than 5 years hospitalized with febrile ARI at two national hospitals in Niamey between January and December 2015. Clinical presentation and procedures during admission were documented using a standardized case investigation form. Nasopharyngeal specimens collected from each patient were tested for a panel of respiratory viruses and bacteria using the Fast Track Diagnostic 21 Plus kit.
    Results:

    We enrolled and tested 638 children aged younger than 5 years, of whom 411 (64.4%) were aged younger than 1 year, and 15 (2.4%) died during the study period. Overall, 496/638 (77.7%) specimens tested positive for at least one respiratory virus or bacterium; of these, 195 (39.3%) tested positive for respiratory viruses, 126 (25.4%) tested positive for respiratory bacteria, and 175 (35.3%) tested positive for both respiratory viruses and bacteria. The predominant viruses detected were respiratory syncytial virus (RSV) (149/638; 23.3%), human parainfluenza virus (HPIV) types 1 to 4 (78/638; 12.2%), human rhinovirus (HRV) (62/638; 9.4%), human adenovirus (HAV) (60/638; 9.4%), and influenza virus (INF) (52/638; 8.1%). Streptococcus pneumoniae (249/638; 39.0%) was the most frequently detected bacterium, followed by Staphylococcus aureus (112/638; 12.2%) and Haemophilus influenzae type B (16/638; 2.5%). Chest X-rays were performed at the discretion of the attending physician on 301 (47.2%) case patients. Of these patients, 231 (76.7%) had abnormal radiological findings. A total of 135/638 (21.2%) and 572/638 (89.7%) children received antibiotic treatment prior to admission and during admission, respectively.
    Conclusion:

    A high proportion of respiratory viruses was detected among children aged younger than 5 years with febrile ARI, raising concerns about excessive use of antibiotics in Niger.
    © 2019 The Authors. Health Science Reports published by Wiley Periodicals, Inc.


    KEYWORDS:

    Niger; bacteria; children; febrile acute respiratory infection; viruses

    PMID: 31768420 PMCID: PMC6869554 DOI: 10.1002/hsr2.137

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