Viral pathogens and clinical manifestations associated with acute lower respiratory tract infections in children of the Sudan

Abstract

Background: Incomplete knowledge regarding the viral agents causing respiratory infections in children living in developing countries impedes diagnosis and management of patients. Objectives: To assess the role of viral pathogens in Sudanese children presenting with acute lower respiratory tract infections (ALRI). Study design: The study population consisted of patients presenting with ALRI at the Children's Emergency Hospital in Khartoum during 2 periods (December 1987 to April 1988 and September 1990 to March 1991). Identification of viral infections was based an antigen detection by immunofluorescence and enzyme-linked immunosorbent assay (ELISA) on nasopharyngeal secretions and/or serology. Results: After exclusion of children with measles, 102 and 111 children, respectively, were prospectively enrolled in the study during the 2 periods. Their ages ranged between one mouth and 14 years (mean 2.0 years). Radiologic pulmonary infiltrations were detected in 135 (66%) of the 206 patients who had chest radiographs, whereas 7 (3%) showed lobar pneumonia. The case fatality rate was 2.3%. Of 83 virus infections detected, 79 were in children < years and consisted mainly of respiratory syncytial virus (RSV, 28%), followed by parainfluenza (7%), adenovirus (5%) and influenza A (2%). Infiltrates on radiographs were significantly less often found in virus-infected cases than in ALRI-cases with negative virus tests. Conclusions: RSV predominantly infected young infants (≤ 3 months) compared with those who were 5 years or older (28% and 13%, respectively). A tendency for respiratory viruses to be more prevalent was seen during the cooler months (January and February). There were no significant differences in clinical features between virus-positive cases and others. The panorama of viral infections proved to be the sme as in other developing countries.