Evidence of non-influenza respiratory viruses among children under five years hospitalized with pneumonia, Greater Accra, 2013-2017

Abstract

Introduction : acute respiratory illness contributes significantly to hospitalizations. It causes morbidity and mortality in younger children throughout the world, especially in developing countries. Pneumonia is a lower respiratory infection which causes inflammation of the lung parenchyma and leads to reduced oxygenation, shortness of breath and death. It is caused by a number of infectious agents which includes; viruses, bacteria and fungi. In 2015, pneumonia accounted for about 15% of deaths among children below five years, killing 920,136 children globally. Greater Accra records an estimated 16300 cases of pneumonia annually of which 40% are children under five years. Viral etiological agents responsible for pneumonia are not investigated, with treatment mostly focused on antibiotics. Against this introduction, this study sought to determine the contribution of non-influenza respiratory viruses (Respiratory syncytial virus, human para-influenza and adenovirus) in children under five years hospitalized with pneumonia in the Greater Accra region. Methods : a laboratory-based cross sectional study was conducted where nasopharyngeal (NP) and oropharyngeal (OP) specimen were obtained from children under five years hospitalized with pneumonia in two three health facilities. Specimen were tested via reverse transcription polymerase chain reaction (RT PCR). Data were entered into a Microsoft visual basic interface linked to SQL database. Analysis was performed using STATA v13 and data presented in proportions and charts. Results : a total of 238 nasopharyngeal and oropharyngeal swabs were obtained children under five years hospitalized with pneumonia from February 2013 through to April 2017. The mean age of the participants was 14 months (+/-13months), ranging from 2 to 58months, with 51.3% (122) males being the majority. A total of 60 (25.2%) tested positive for at least one of respiratory syncytial virus, adenovirus, human para-influenza virus 1 and 3. Relatively 39 (16.4%) were positive for RSV, 11 (4.6%) for adenovirus, 8 (3.4%) HPIV-3 and 5 (2.1%) HPIV-1. Conclusion : the study demonstrated the presence of non-influenza respiratory virus namely; RSV, HPIV-1, HPIV-3 and Adenoviruses among children under five years hospitalized with pneumonia in Greater Accra. Hence, non-investigation of these viruses before treatment with antibiotics could lead to a gap in proper patient management.