Prevalence of respiratory viruses among paediatric patients in acute respiratory illnesses in Malaysia

Abstract

Objectives Acute respiratory infections (ARIs) are one of the leading causes of childhood morbidity and mortality worldwide. However, there is limited surveillance data on the epidemiological burden of respiratory pathogens in tropical countries like Malaysia. This study aims to estimate the prevalence of respiratory pathogens causing ARIs among children aged <18 years old in Malaysia and their epidemiological characteristics. Methods Nasopharyngeal swab specimens received at 12 laboratories located in different states of Malaysia from 2015–2019 were studied. Detection of 18 respiratory pathogens were performed using multiplex PCR. Results Data from a total of 23,306 paediatric patients who presented with ARI over a five-year period was studied. Of these, 18538 (79.5%) were tested positive. The most prevalent respiratory pathogens detected in this study were enterovirus/ rhinovirus (6837/ 23000; 29.7%), influenza virus (5176/ 23000; 22.5%) and respiratory syncytial virus (RSV) (3652/ 23000; 15.9%). Throughout the study period, RSV demonstrated the most pronounce seasonality; peak infection occurred during July to September. Whereas the influenza virus was detected year-round in Malaysia. No seasonal variation was noted in other respiratory pathogens. The risk of RSV hospitalisation was found to be significantly higher in children aged less than two years old, whereas hospitalisation rates for the influenza virus peaked at children aged between 3–6 years old. Conclusion This study provides insight into the epidemiology and the seasonality of the causative pathogens of ARI among the paediatric population in Malaysia. Knowledge of seasonal respiratory pathogens epidemiological dynamics will facilitate the identification of a target window for vaccination.

Determining the Relationship of Meteorological Factors and Severe Pediatric Respiratory Syncytial Virus (RSV) Infection in Central Peninsular Malaysia

“…Thus, a larger sample size is required for future studies to comparatively demonstrate the effect of COVID-19 on RSV seasonality. Nevertheless, we agree with the findings from our local colleagues Low et al who also reported an increase of 517.4% in RSV cases from 2015 to 2019 [13].…”

“…According to a health report by the Malaysian Ministry of Health in 2020, disease in the respiratory system was ranked as one of the top three major causes of hospitalization, with 9.01% and 11.55% of admissions in public and private hospitals, respectively [19]. Similarly to many other studies, our result also highlighted that children younger than two years are more susceptible to RSV infection, and the positive detection rate decreased tremendously as the age of children increased [12,13]. This can be partly explained by the diminishing role of natural passive maternal immunity within months after birth, posing a higher risk to infants aged younger than six months.…”

“…Subsequently, in 2013, another local epidemiological study by Rahman et al reported an opposite result, whereby the peak of RSV activity was observed from May to June [12]. This result is further supported by another 5-year-long study in Kuala Lumpur, according whereto peak infection occurred from July to September [13]. This was also true for Singapore and Lombok, Indonesia, where the peak of RSV cases also did not coincide with their rainiest season, with most RSV cases recorded from March to August [14,15].…”

“…RSV infections are indeed a common infection among children, with nearly all children being infected with RSV at least once during the first two years of life, with about two-thirds being affected by the end of their first year [5]. Thus, immunological protection is eventually acquired through early infections or vaccination, resulting in a decline of positive cases among older children [5,7,13]. We also hypothesized that the rate of positive detection of RSV increased gradually every year, from 9% to 20.2% within the five years of study.…”

Influenza and Influenza-Like Virus Infection in Children Under 14 Years of Age: An Investigation of 725 Cases in the 2021/2022 Influenza Epidemic Season in Poland

“…The World Health Organization (WHO) global influenza surveillance standards define the surveillance case definitions for influenza-like illness (ILI) as an acute respiratory infection with fever ³38°C and cough, with onset within the last 10 days (WHO). The most commonly diagnosed flu-like viruses include: parainfluenza 1-4 (PIV-1, PIV-2, PIV-3, PIV-4), human respiratory syncytial virus (RSV), human corona virus (HCoV), human rhinovirus (RV), human adenovirus (ADV), and human metapneumovirus (hMPV) [5,[11][12][13][14].…”