Abstract
BackgroundAcute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG). However, comprehensive studies of the viral aetiology of ALRI have not been conducted in PNG for almost 30 years. ObjectivesTo determine the viruses associated with ALRI among children living in the PNG highlands using sensitive molecular detection techniques. Study designPernasal swabs were collected routinely between 1 week and 18 months of age and also during episodes of ALRI, as part of a neonatal pneumococcal conjugate vaccine trial. A tandem multiplex real-time PCR assay was used to test for a comprehensive range of respiratory viruses in samples collected from 221 young children. Picornavirus typing was supported by DNA sequence analysis. ResultsRecognized pathogenic respiratory viruses were detected in 198/273 (73%) samples collected from children with no evidence of ALRI and 69/80 (86%) samples collected during ALRI episodes. Human rhinoviruses (HRV) species A, B and C were detected in 152 (56%) samples from non-ALRI children and 50 (63%) samples collected during ALRI episodes. Partial structural region sequences for two new species C rhinoviruses were added to the GenBank database. ALRI was associated with detection of adenovirus species B (p<0.01) or C (p<0.05), influenza A (p<0.0001) or respiratory syncytial virus (p<0.0001). Multiple viruses were detected more often during ALRI episodes (49%) than when children displayed no symptoms of ALRI (18%) (p<0.0001). ConclusionsThe burden of infection with respiratory viruses remains significant in young children living in the PNG highlands.
Highlights
Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG)
We undertook a PCR-based study to identify and characterize respiratory viruses associated with ALRI in young PNG children
A randomized trial of neonatal 7-valent pneumococcal conjugate vaccine (PCV) was conducted in the Asaro Valley, Eastern Highlands Province, PNG between May 2005 and March 2009.16 As part of this trial, pernasal swabs were collected routinely at 1, 2, 3, 4 weeks and 3, 9 and 18 months of age, and when children presented with symptoms of ALRI
Summary
Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG). Acute lower respiratory infections (ALRI) are the leading cause of death in children, accounting for approximately two million deaths worldwide annually.[1] Currently there is limited information on the role of many of the respiratory viruses in lower respiratory tract infections in children. Children in the highlands of Papua New Guinea (PNG) suffer an average of 4.3 ALRIs by the age of 18 months.[2] Previous studies of respiratory viral infection in young children in PNG relied on the detection of viral antigens by immunofluorescence and traditional cell culture techniques.[3,4] Compared with nucleic acid detection tests, such techniques lack sensitivity for the detection
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