Clinical features of parainfluenza infections among young children hospitalized for acute respiratory illness in Amman, Jordan

Abstract

Background Parainfluenza virus (PIV) is a leading cause of acute respiratory illness (ARI) in children. However, few studies have characterized the clinical features and outcomes associated with PIV infections among young children in the Middle East. Methods We conducted hospital-based surveillance for ARI among children < 2 years of age in a large referral hospital in Amman, Jordan. We systematically collected clinical data and respiratory specimens for pathogen detection using reverse transcription polymerase chain reaction. We compared clinical features of PIV-associated ARI among individual serotypes 1, 2, 3, and 4 and among PIV infections compared with other viral ARI and ARI with no virus detected. We also compared the odds of supplemental oxygen use using logistic regression. Results PIV was detected in 221/3168 (7.0%) children hospitalized with ARI. PIV-3 was the most commonly detected serotype (125/221; 57%). Individual clinical features of PIV infections varied little by individual serotype, although admission diagnosis of ‘croup’ was only associated with PIV-1 and PIV-2. Children with PIV-associated ARI had lower frequency of cough (71% vs 83%; p < 0.001) and wheezing (53% vs 60% p < 0.001) than children with ARI associated with other viruses. We did not find a significant difference in supplemental oxygen use between children with PIV-associated infections (adjusted odds ratio [aOR] 1.12, 95% CI 0.66–1.89, p = 0.68) and infections in which no virus was detected. Conclusions PIV is frequently associated with ARI requiring hospitalization in young Jordanian children. Substantial overlap in clinical features may preclude distinguishing PIV infections from other viral infections at presentation.

Virological Surveillance and Molecular Characterization of Human Parainfluenzavirus Infection in Children with Acute Respiratory Illness: Germany, 2015–2019

“…HPIV-4 has been considered rare in the past, in part due to underdiagnosis because it was more difficult to isolate and type-specific molecular methods were lacking [ 22 , 54 , 64 ]. Others have found HPIV-4 to represent between 8% and 22% of HPIV-positive samples and given that the frequency of detection for each type is subject to annual fluctuations, the frequencies determined for our study population match these findings well [ 23 , 53 , 55 , 63 ].…”

“…Our findings are consistent with those of Frost et al [ 20 ], who described year-round PIV-4 prevalence with peaks in the fall of odd-numbered years. Peaks in the fall have been described for this HPIV type previously [ 2 , 13 , 23 , 63 , 64 ], and one group of investigators also commented on the biennial circulation pattern of HPIV-4 [ 64 ]. Given that HPIV-4 has not been detected in many studies, our investigations help to address the paucity of seasonality data on this HPIV type.…”

“…These results are not entirely unexpected. HPIV-3 has been identified as the most common HPIV type in multiple investigations performed to date [ 22 , 54 , 55 , 61 , 62 , 63 ], and HPIV-1 has frequently been found to be the second most common HPIV type [ 22 , 54 , 55 , 62 ]. HPIV-2 is often considered the least frequent HPIV type [ 22 , 63 ].…”

“…HPIV-3 has been identified as the most common HPIV type in multiple investigations performed to date [ 22 , 54 , 55 , 61 , 62 , 63 ], and HPIV-1 has frequently been found to be the second most common HPIV type [ 22 , 54 , 55 , 62 ]. HPIV-2 is often considered the least frequent HPIV type [ 22 , 63 ]. HPIV-4 has been considered rare in the past, in part due to underdiagnosis because it was more difficult to isolate and type-specific molecular methods were lacking [ 22 , 54 , 64 ].…”

Prevalence of viral pathogens in a sample of hospitalized Egyptian children with acute lower respiratory tract infections: a two-year prospective study

“…On the other hand, PIV-3 showed a higher prevalence, as it was detected in 33% of cases, most of them under five years old. This is consistent with data that; PIV is identified as a substantial causative agent of pneumonia in children (Howard et al 2021 ). However, a recent Egyptian study reported a lower prevalence rate of PIV-3 (7%).…”