Abstract
Upper-respiratory tract infections (URTI) are the leading causes of childhood morbidities. This study investigated etiologies and patterns of URTI among children in Mwanza, Tanzania. A cross-sectional study involving 339 children was conducted between October-2017 and February-2018. Children with features suggestive of URTI such as nasal congestion, dry cough, painful swallowing and nasal discharge with/without fever were enrolled. Pathogens were detected from nasopharyngeal and ear-swabs by multiplex-PCR and culture respectively. Full blood count and C-reactive protein analysis were also done. The median age was 16 (IQR: 8–34) months. Majority (82.3%) had fever and nasal-congestion (65.5%). Rhinitis (55.9%) was the commonest diagnosis followed by pharyngitis (19.5%). Viruses were isolated in 46% of children, the commonest being Rhinoviruses (23.9%). Nineteen percent of children had more than 2 viruses; Rhinovirus and Enterovirus being the commonest combination. The commonest bacteria isolated from ears were Staphylococcus aureus and Pseudomonas aeruginosa. Children with viral pathogens had significantly right shift of lymphocytes (73%—sensitivity). Majority (257/339) of children were symptoms free on eighth day. Viruses are the commonest cause of URTI with Rhinitis being the common diagnosis. Rapid diagnostic assays for URTI pathogens are urgently needed in low-income countries to reduce unnecessary antibiotic prescriptions which is associated with antibiotic resistance.
Highlights
Upper-respiratory tract infections (URTI) are the leading causes of childhood morbidities
Common viral agents which have been linked to Respiratory tract infections (RTIs) include Rhinoviruses which accounts for 30%, Respiratory syncytial virus, influenza virus, Parainfluenza viruses, Human metapneumovirus and Adenoviruses accounting for 35% of RTI with about 10% being due to C oronaviruses[8]
These data are relevant to clinicians in developing countries and policy makers in order to invest on the improved diagnostic facilities and reduce antibiotic prescriptions for URTIs
Summary
Upper-respiratory tract infections (URTI) are the leading causes of childhood morbidities. Viruses are the commonest cause of URTI with Rhinitis being the common diagnosis. Up to 25% of children under 1 year of age and up to 18% of children aged 1 to 4 years develop RTIs4,5 These illnesses range from mild to severe and life-threatening illness accounting for over two million childhood deaths annually w orldwide[2,6,7]. Respiratory tract infections involving just the upper respiratory tract usually are self-limited disease requiring only supportive management Despite it being a less severe illness, it has emerged to be a major cause of childhood morbidity with a high cost to the society, and occasionally associated with serious sequelae.
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