Epidemiology of the Rhinovirus (RV) in African and Southeast Asian Children: A Case-Control Pneumonia Etiology Study.

Vicky L Baillie,Ruth A Karron,Maria Deloria Knoll,Samba O Sow,Pongpun Sawatwong,Henry C Baggett,Stephen R C Howie,Katherine L O’Brien,Karen L Kotloff,Daniel R Feikin,Christine Prosperi,Daniel E Park,Azwifarwi Mathunjwa,Shabir A Madhi,Abdullah Brooks,Juliet O Awori,Orin S Levine,Milagritos D Tapia,Melissa M Higdon,David R Murdoch,Amanda J Driscoll,Laura L Hammitt,Donald M Thea,David P Moore,Somwe Wa Somwe,Mustafizur Rahman,Mohammed Ziaur Rahman,Anthony Scott ,Eric A F Simões ,Susan Morpeth ,Justin Mulindwa ,Rasheed Salaudeen ,Martín Antonio ,Nicholas Fancourt

doi:10.3390/v13071249

Abstract

Rhinovirus (RV) is commonly detected in asymptomatic children; hence, its pathogenicity during childhood pneumonia remains controversial. We evaluated RV epidemiology in HIV-uninfected children hospitalized with clinical pneumonia and among community controls. PERCH was a case-control study that enrolled children (1–59 months) hospitalized with severe and very severe pneumonia per World Health Organization clinical criteria and age-frequency-matched community controls in seven countries. Nasopharyngeal/oropharyngeal swabs were collected for all participants, combined, and tested for RV and 18 other respiratory viruses using the Fast Track multiplex real-time PCR assay. RV detection was more common among cases (24%) than controls (21%) (aOR = 1.5, 95%CI:1.3–1.6). This association was driven by the children aged 12–59 months, where 28% of cases vs. 18% of controls were RV-positive (aOR = 2.1, 95%CI:1.8–2.5). Wheezing was 1.8-fold (aOR 95%CI:1.4–2.2) more prevalent among pneumonia cases who were RV-positive vs. RV-negative. Of the RV-positive cases, 13% had a higher probability (>75%) that RV was the cause of their pneumonia based on the PERCH integrated etiology analysis; 99% of these cases occurred in children over 12 months in Bangladesh. RV was commonly identified in both cases and controls and was significantly associated with severe pneumonia status among children over 12 months of age, particularly those in Bangladesh. RV-positive pneumonia was associated with wheezing.

Highlights

Rhinovirus (RV) was first discovered in 1956 in individuals with mild respiratory tract infection [1]
RV was detected in 21% of community controls and was more likely to be detected in controls with acute respiratory infections (ARI) (25%) than non-ARI children (20%; adjusted odds ratio (aOR) = 1.6, 95%confidence interval (CI): 1.3–1.8), regardless of age group
There was a similar prevalence in the detection of respiratory syncytial virus (RSV), human metapneumovirus (HMPV), and parainfluenza viruses (PIV) between RV-positive and RV-negative controls, while the prevalence of co-infection with influenza virus was lower among RV-positive controls (Table 1)

Summary

Introduction

Rhinovirus (RV) was first discovered in 1956 in individuals with mild respiratory tract infection [1]. Several studies have examined RV prevalence in hospitalized children and healthy controls to determine the clinical significance of RV detection in both diseased and healthy individuals. In the majority of these studies, cases had a significantly higher prevalence of RV detected than controls [15,16,17,18,19]. These studies were not designed to address the clinical epidemiology of RV and viral or bacterial coinfections in relation to disease severity [15,17,20]. Understanding the importance of HRV infection is critical when it comes to determining future strategies for disease treatment and prevention

Methods

Results

Discussion

Conclusion