Abstract

Respiratory tract infections (RTIs) are a major public health concern. This study aims to investigate the profiles and epidemiological characteristics of acute RTIs and respiratory pathogens in Palestinian hospitalized patients. Clinical samples from hospitalized patients with symptoms of acute RTIs admitted between January 2011 and December 2016 were referred to the Palestinian Central Public Health Laboratory (PHCL) to identify the causative pathogen. Patients' demographic information and the results of the molecular identification were retrieved from the electronic database at the PHCL. A total of 15413 patients with acute RTIs were hospitalized during the study period. The causal agent was identified only in 28.7% of the patients. Overall, influenza viruses were the most common cause of RTIs among hospitalized Palestinian patients in the West Bank. Children and elderlies were the most affected with RTIs. The elderly population (≥60 years old) had the highest rates. After influenza A virus, respiratory syncytial virus (RSV), and Bordetella pertussis (B. pertussis) were the most common causes of acute RTIs among hospitalized Palestinian patients. Children showed the highest hospitalization rates for RSV, B. pertussis, adenovirus, enterovirus, and Streptococcus pneumoniae. On the other hand, elderlies had the highest rates of influenza. Outbreaks of RTIs occurred mainly during winter (between December and March). The resurgence of B. pertussis in spite of vaccination is alarming and requires further investigation.

Highlights

  • Respiratory tract infections (RTIs) are considered to be the most common infectious diseases worldwide and the second leading cause of death among children under five years old [1, 2]

  • Identification of the causative agent of respiratory diseases based on signs and symptoms alone is not reliable [6]. erefore, understanding the epidemiology of RTIs and identification of the patterns and etiologies are critical for successful treatment and prevention programs [7]. is is very important as 14.9% of the Palestinian population are children

  • Samples of hospitalized patients with symptoms of acute RTIs are transferred from all Ministry of Health (MOH) hospitals in the West Bank and delivered to the PHCL for testing by polymerase chain reaction (PCR). ese samples include nasopharyngeal aspirates, nasopharyngeal swabs, oropharyngeal swabs, sputum, blood, and bronchoalveolar lavage fluid and are collected routinely by qualified medical personnel in the hospitals and sent to PHCL to confirm clinical diagnosis. e samples are tested for the suspected pathogen

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Summary

Introduction

Respiratory tract infections (RTIs) are considered to be the most common infectious diseases worldwide and the second leading cause of death among children under five years old [1, 2]. In Palestine, infectious diseases cause less than 10% of all deaths; respiratory diseases (ICD10 code: J00–J99.9) cause 70% of those deaths with a mortality rate of 17.0 per 100,000 population during 2016, being the sixth most common cause of death [3]. Identification of the causative agent of respiratory diseases based on signs and symptoms alone is not reliable [6]. Infectious diseases continue to be a major cause of morbidity and mortality among Palestinians, especially children under 5 years old [3]. Canadian Journal of Infectious Diseases and Medical Microbiology

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