Patterns of viral pathogens causing upper respiratory tract infections among symptomatic children in Mwanza, Tanzania

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.

Seasonal Coronaviruses and Other Neglected Respiratory Viruses: A Global Perspective and a Local Snapshot

“…Rhinoviruses are the most common cause of ARI in all age groups (36)(37)(38)(39), which poses a significant burden for the health care system, as well as a substantial economic loss caused by absenteeism (40). Although they lead in the aetiology of ARI, they have been neglected for years for a number of reasons: (i) they were seen as rare (or improbable) causative agents of lower respiratory tract infections (LRTIs) since their replication is difficult at temperatures above 33 • C; (ii) because they cause self-limiting upper respiratory tract infections (URTIs) in healthy individuals, do not cause hospitalization and, consequently, do not burden the hospital system; (iii) until the development of molecular detection methods the laboratory diagnosis of these viruses was relatively slow, therefore clinically irrelevant and expensive, and; (iv) to date there is no commercially available effective specific antiviral therapy or vaccine specifically targeting rhinovirus (41).…”

“…Rhinoviruses are estimated to cause more than half of URTIs usually presenting as common cold syndrome; however, during the last two decades, numerous studies have revealed their role as leading causes of LRTIs ( 38 , 39 , 43 , 44 ). A recent prospective study conducted in 11 European countries has shown that in adults presenting to primary care with LRTI, the most common viral pathogens detected were human rhinoviruses (20.1%) ( 45 ).…”

Rhinovirus remains prevalent in school teenagers during fight against COVID‐19 pandemic

“…An investigation of 452 children with acute respiratory infection reported that acute respiratory infection in children was mainly infected by HRV (11.28%), and most of the HRV infection occurred was in winter 7 . Respiratory virus surveillance studies showed that the positive rate of HRV was 16.4%–35.1% 8–13 . During the COVID‐19 pandemic, the government had taken all possible means to stop the pandemic, and successfully stopped the COVID‐19 pandemic in Guangzhou, and the common respiratory infectious diseases, such as influenza and pneumonia as well 3 .…”

Bacterial Gut Microbiota and Infections During Early Childhood

“…ARIs are the most frequent type of infection during the first 3 years of life, with a median of 10 episodes per child (with up to 90% corresponding to AURIs) ( Vissing et al, 2018 ). Viruses are the primary cause of both AURIs and ALRIs in children, with rhinovirus the most common cause of AURI ( Kwiyolecha et al, 2020 ) and respiratory syncytial virus the most common cause of ALRI ( O’Brien et al, 2019 ; Li et al, 2021 ). Influenza virus causes seasonal global epidemics, representing an important cause of ALRIs associated with hospitalization and severe outcomes in children aged <5 years as compared to older children and adults ( Ruf and Knuf, 2014 ; Wang et al, 2020 ).…”