Prevalence and risk factors of acute respiratory infection by human respiratory syncytial virus in children at Provincial General Hospital of Bukavu, Democratic Republic of the Congo
Date
2017-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT : Human Respiratory Syncytial Virus (HRSV) is the major cause of acute respiratory
infection in children (ARI) and it is responsible for substantial morbidity and mortality,
especially in younger children. The present study had two main objectives. The first
one was to determine the prevalence of HRSV and non-HRSV ARI in children under
the age of 5 years at the Provincial General Hospital of Bukavu (PGHB). The second
objective was to analyse factors associated with the risk of ARI to be diagnosed as
lower respiratory tract infection (LRTI).
A total of 146 children under 5 years visiting the PGHB for ARI between August and
December 2016 were recruited. A clinical examination was made and a
questionnaire was completed by the parent or the guardian after which a
nasopharyngeal swab was performed to collect respiratory fluid. The sample was
analysed by a multiplex reverse transcriptase polymerase chain reaction for the
detection of 15 different viruses, among which HRSV A and B, Influenza A and B,
human Rhinovirus (HRV) A/B/C, Parainfluenza (PIV) viruses 1, 2, 3 and 4,
Adenovirus (ADV), Bocavirus, Coronavirus OC43 and 229E/NL63, Enterovirus and
human Metapneumovirus.
Of 146 samples collected, 84 (57.5%) displayed a positive result of at least one of the
15 viruses. The overall prevalence of HRSV was 21.2%. HRSV A (30, 20.5%) was
the virus the most detected, followed by HRV (24, 16.4%), PIV3 (20, 16.6) and ADV
(7, 4.79%). The other viruses were detected in three or less cases. There were only
11 (7.5%) of co-infection. In bivariate analyses, HRSV infection, malnutrition, younger
age, rural settings, low income and mother illiteracy were associated with the risk of
ARI to be diagnosed as LRTI. However, in multivariate analyses, only HRSV infection
and younger age predicted LRTI. Children with HRSV infection had 6.45 times higher
odds to exhibit LRTI when compared to children without HRSV infection. Older
children (by one month) had 6% lower odds of LRTI than younger children (adjusted
odds ratio = 0.94, 95% CI: 0.90 – 0.97, p-value = 0.004).
AFRIKAANSE OPSOMMING : Respiratoriese sinsitiale virus (RSV) is die hoofoorsaak van akute respiratoriese infeksie (ARI) by kinders en dit is verantwoordelik vir erge morbiditeit en mortaliteit, veral by jonger kinders. Die huidige studie het twee hoofdoelwitte gehad. Die eerste een was om die voorkoms van RSV en nie-RSV ARI in kinders onder die ouderdom van 5 jaar by die Provinsiale Algemene Hospitaal van Bukavu (PGHB) te bepaal. Die tweede doel was om faktore te analiseer wat verband hou met die risiko dat ARI gediagnoseer word as lae lugweginfeksie. 'n Totaal van 146 kinders onder 5 jaar wat die PGHB vir ARI besoek het tussen Augustus en Desember 2016 is gewerf vir die studie. 'n Kliniese ondersoek is gedoen en 'n vraelys is deur die ouer of voog voltooi, waarna respiratoriese vloeistof met behulp van 'n nasofaringeale depper versamel is. Die monster is geanaliseer met behulp van 'n multiplex-omgekeerde transkriptase-polimerase kettingreaksie vir die opsporing van 15 verskillende virusse, waaronder RSV A en B, Influenza A en B, menslike Rhinovirus (HRV) A / B / C, Parainfluenza virus (PIV) 2, 3 en 4, Adenovirus (ADV), Bocavirus, Coronavirus OC43 en 229E / NL63, Enterovirus en menslike Metapneumovirus. Van 146 monsters wat versamel is, is minstens een van die 15 virusse bevestig in 84 (57.5%) gevalle. Die algehele voorkoms van RSV was 21.2%. RSV A (30, 20.5%) was die virus wat die meeste bespeur is, gevolg deur HRV (24, 16.4%), PIV3 (20,16.6) en ADV (7, 4.79%). Die ander virusse is slegs in drie of minder gevalle bevestig. Daar was slegs 11 (7.5%) ko-infeksie. In ʼn twee-veranderlike analise is RSV-infeksie, wanvoeding, jonger ouderdom, landelike woongebiede, lae inkomste en ongeletterdheid in moeders geassosieer met die risiko dat ARI gediagnoseer word as lae lugweginfeksie. In ʼn meer-veranderlike analise het slegs RSV-infeksie en jonger ouderdom lae lugweginfeksie voorspel. Kinders met RSV-infeksie het ʼn 6.45 keer hoër kans gehad om lae lugweginfeksie te vertoon in vergelyking met kinders sonder RSV-infeksie. Ouer kinders (met een maand) het ʼn 6% laer kans gehad op lae lugweginfeksie as jonger kinders (aangepaste kansverhouding = 0.94, 95% CI: 0.90 – 0.97, p-waarde = 0.004).
AFRIKAANSE OPSOMMING : Respiratoriese sinsitiale virus (RSV) is die hoofoorsaak van akute respiratoriese infeksie (ARI) by kinders en dit is verantwoordelik vir erge morbiditeit en mortaliteit, veral by jonger kinders. Die huidige studie het twee hoofdoelwitte gehad. Die eerste een was om die voorkoms van RSV en nie-RSV ARI in kinders onder die ouderdom van 5 jaar by die Provinsiale Algemene Hospitaal van Bukavu (PGHB) te bepaal. Die tweede doel was om faktore te analiseer wat verband hou met die risiko dat ARI gediagnoseer word as lae lugweginfeksie. 'n Totaal van 146 kinders onder 5 jaar wat die PGHB vir ARI besoek het tussen Augustus en Desember 2016 is gewerf vir die studie. 'n Kliniese ondersoek is gedoen en 'n vraelys is deur die ouer of voog voltooi, waarna respiratoriese vloeistof met behulp van 'n nasofaringeale depper versamel is. Die monster is geanaliseer met behulp van 'n multiplex-omgekeerde transkriptase-polimerase kettingreaksie vir die opsporing van 15 verskillende virusse, waaronder RSV A en B, Influenza A en B, menslike Rhinovirus (HRV) A / B / C, Parainfluenza virus (PIV) 2, 3 en 4, Adenovirus (ADV), Bocavirus, Coronavirus OC43 en 229E / NL63, Enterovirus en menslike Metapneumovirus. Van 146 monsters wat versamel is, is minstens een van die 15 virusse bevestig in 84 (57.5%) gevalle. Die algehele voorkoms van RSV was 21.2%. RSV A (30, 20.5%) was die virus wat die meeste bespeur is, gevolg deur HRV (24, 16.4%), PIV3 (20,16.6) en ADV (7, 4.79%). Die ander virusse is slegs in drie of minder gevalle bevestig. Daar was slegs 11 (7.5%) ko-infeksie. In ʼn twee-veranderlike analise is RSV-infeksie, wanvoeding, jonger ouderdom, landelike woongebiede, lae inkomste en ongeletterdheid in moeders geassosieer met die risiko dat ARI gediagnoseer word as lae lugweginfeksie. In ʼn meer-veranderlike analise het slegs RSV-infeksie en jonger ouderdom lae lugweginfeksie voorspel. Kinders met RSV-infeksie het ʼn 6.45 keer hoër kans gehad om lae lugweginfeksie te vertoon in vergelyking met kinders sonder RSV-infeksie. Ouer kinders (met een maand) het ʼn 6% laer kans gehad op lae lugweginfeksie as jonger kinders (aangepaste kansverhouding = 0.94, 95% CI: 0.90 – 0.97, p-waarde = 0.004).
Description
Thesis (MMedSc)--Stellenbosch University, 2017.
Keywords
Medical virology -- Research, Respiratory infections in children -- Congo (Democratic Republic), Human respiratory syncytial virus, Acute respiratory infection, Lungs -- Diseases -- Congo (Democratic Republic), UCTD