Aetiology of Acute Lower Respiratory Infections among Children Under Five Years in Accra, Ghana.

Theophilus Adiku,Andrew Adjei,Eric Donkor,Bamenla Goka,Richard Asmah,Evangeline Obodai,Onike Rodrigues,George Armah

doi:10.3390/pathogens4010022

Abstract

The study aimed to investigate the aetiological agents and clinical presentations associated with acute lower respiratory infections (ALRI) among children under five years old at the Korle-Bu Teaching Hospital in Ghana. This was a cross-sectional study carried from February to December 2001. Nasopharyngeal aspirates and venous blood specimens obtained from 108 children with features suggestive of ALRI, were cultured and the isolated bacterial organisms were identified biochemically. Nasopharyngeal aspirates were also tested for Respiratory Syncitial Virus (RSV) antigen using a commercial kit (Becton Dickinson Directigen RSV test kit). A multiplex reverse transcription-PCR (RT-PCR) was also used to detect and characterize RSV using extracted RNA. Socio-demographic and clinical data were also obtained from the study subjects. Bronchopneumonia (55.5%), bronchiolitis (25%), lobar pneumonia (10.2), non-specific ALRI (4.6%), TB, bronchitis and respiratory distress (0.67%) were diagnosed. The prevalence of septicaemia was 10% and bacteria isolated were Staphylococcus aureus, Streptococcus pneumoniae and enteric bacteria, including Salmonella spp., Enterobacter spp and Klebsiella spp, were isolated. Out of the 108 cases, 18% tested positive for RSV, with two cases having RSV as the only aetiological pathogen detected. The subtyping analysis of RSV strains by a multiplex RT-PCR showed that subgroups A and B circulated in the season of analysis.

Highlights

In developing countries acute respiratory infections (ARI), diarrhoeal diseases, malaria and malnutrition are major causes of death among young children [1]
A wide range of bacterial agents are implicated in ARLI and include Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, Escherichia coli, Salmonella species Mycoplasma pneumoniae, and Chlamydia pneumoniae [6,7,8]
We investigated the aetiology of acute lower respiratory infections (ALRI)

Summary

Introduction

In developing countries acute respiratory infections (ARI), diarrhoeal diseases, malaria and malnutrition are major causes of death among young children [1]. It is estimated that 18% of all deaths in children less than five years old are attributable to ARI as an underlying or contributory cause, indicating. Several agents have aetiologically been associated with severe ALRI (acute lower respiratory infections). These include viral agents, such as RSV, adenoviruses, influenza virus, human metapneumovirus and para-influenza virus [4,5]. Respiratory syncytial virus (RSV) has been identified as causing proportionately more ALRI than the others during the first year of life [9,10]. RSV is responsible for approximately 85% of cases of bronchiolitis and 20% of cases of childhood pneumonia [9,10]

Methods

Results

Conclusion