Abstract
The present study was done to identify the viral diversity, seasonality and burden associated with childhood acute respiratory tract infection (ARTI) in Sri Lanka. Nasopharyngeal aspirates (NPA) of hospitalized children (1 month—5 years) with ARTI were collected in 2 centers (wet and dry zones) from March 2013 to August 2014. Respiratory viral antigen detection by immunofluorescence assay (IFA) was used to identify the infecting viruses. IFA negative 100 NPA samples were tested for human metapeumovirus (hMPV), human bocavirus and corona viruses by polymerase chain reaction. Of the 443 and 418 NPAs, 37.2% and 39.4% were positive for any of the 8 different respiratory viruses tested from two centers studied. Viral co-infection was detected with respiratory syncytial virus (RSV) in both centers. Peak viral detection was noted in the wet zone from May-July 2013 and 2014 and in the dry zone from December-January 2014 suggesting a local seasonality for viral ARTI. RSV showed a clear seasonality with a direct correlation of monthly RSV infections with rainy days in the wet zone and an inverse correlation with temperature in both centers. The case fatality rate was 2.7% for RSV associated ARTI. The overall disability adjusted life years was 335.9 and for RSV associated ARTI it was 241.8. RSV was the commonly detected respiratory virus with an annual seasonality and distribution in rainy seasons in the dry and wet zones of Sri Lanka. Identifying the virus and seasonality will contribute to employ preventive measures and reduce the empirical use of antibiotics in resource limited settings.
Highlights
Acute respiratory tract infection (ARTI) represents one of the most common acute illnesses in childhood
38.33% of the hospitalized children had virus identified ARTI based on antigen detection by immunofluorescence assay (IFA)
The level of viral detection was similar in both study samples representing dry and wet zones of Sri Lanka
Summary
Acute respiratory tract infection (ARTI) represents one of the most common acute illnesses in childhood. Viral burden and diversity in acute respiratory tract infections in hospitalized children. Viral ARTI lead to secondary bacterial infections in healthy children by lowering the immunity in the respiratory tract allowing the invasion of bacteria [5, 6]. Most respiratory viruses cause lower respiratory tract infection (LRTI) of different severity with a wide range of respiratory manifestations including severe pneumonia and bronchiolitis. The viral detection in ARTI depends on many factors, such as sample processing and testing, disease severity, diagnostic methods, and the seasonal trends with the local climate [15].
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