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1. Perceptions of the impact of individual allergic rhinitis symptoms: A survey of ARIA clinical experts

Author

Sara Gil-Mata, MD, Tatiana Teixeira, MD, Anna Bedbrook, BSc, Jean Bousquet, PhD, Bernardo Sousa-Pinto, PhD, Rafael José Vieira, MD, Julijana Asllani, Habib Douagui, Estrella Asayag, Castro Maria Elizabeth, Carlos D. Crisci, René Maximiliano Gomez, Juan Carlos Ivancevich, Edgardo Jares, Jorge Fernando Máspero, Pablo Moreno, Hugo Eduardo Neffen, Mario Emilio Zernotti, Sinthia Bosnic-Anticevich, Kristin Chahhoud Carson, Biljana Cvetkovski, Janet M. Davies, Vicky Kritikos, Robyn O'Hehir, Brian Oliver, House Rachel Tan, Jessica Tattersall, Celia Zubrinich, Werner Aberer, Verena Niederberger-Leppin, Isabella Pali-Schöll, Virginie Doyen, Didier Ebo, Renaud Louis, Philippe Rombaux, Sophie Scheire, Kazi Bennoor, Bruno A. Barreto, Paulo Camargos, Herberto Jose Chong-Neto, Alvaro A. Cruz, Jane da Silva, Guidacci Marta, José Angelo Rizzo, Nelson Rosario Filho, Sarquis Serpa Faradiba, Dirceu Solé, Marilyn Urrutia-Pereira, George Christoff, Mandazhieva-Pepelanova Mariana, Odjakova Cvetanka, Todor A. Popov, Dilyana Vicheva, do Ceu Teixeira Maria, Jacques Bouchard, Jan Brozek, Derek K. Chu, Judah Denburg, Thomas Eiwegger, Paul K. Keith, Teresa To, Susan Waserman, Nancy Abusada, Emilio Alvarez Cuesta, Mario A. Calvo-Gil, Maria Antonieta Guzmán, Tamara Pérez Gomez, Wing Kin Wong Gary, Luo Zhang, Luis Caraballo, Alfonso Cepeda Sarabia, Dieudonné Nyembue, Manuel Soto-Martinez, Neven Miculinic, Davor Plavec, Constantinos Pitsios, Panayiotis Yiallouros, Petr Panzner, Milan Sova, Martina Vachova, Carsten Bindslev-Jensen, Ronald Dahl, Hans-Jorgen Malling, Lars Münter, Lars K. Poulsen, Suppli Ulrik Charlotte, Line Kring Tannert, Bassam Mahboub, Laila Salameh, Ivan Cherrez-Ojeda, de Guevara Karla Robles, Rasha Hassan El-Owaidy, Zeinab A. El-Sayed, Shereen Saad El-Sayed, Elham Hossny, Badr Eldin Mostafa, Kaja Julge, Nils Eric Billo, Patrik Eklund, Marina Erhola, Tari Haahtela, Jussi Karjalainen, Mika Makela, Sanna Toppila-Salmi, Erkka Valovirta, Tuula Vasankari, Isabella Annesi-Maesano, Isabelle Bossé, Melisande Bourgoin-Heck, Denis Charpin, André Coste, Frédéric de Blay, Philippe Devillier, Alain Didier, Anh Tuan Dinh-Xuan, Jean-François Fontaine, Jocelyne Just, Rachel Nadif, Nhân Pham-Thi, Bernard Pigearias, Nicolas Roche, Van Ganse Eric, Ekaterine Chkhartishvili, Amiran Gamkrelidze, Maia Gotua, Sven Becker, Karl-Christian Bergmann, Thomas Bieber, Randolf Brehler, Roland Buhl, Adam M. Chaker, Ulf Darsow, Eckard Hamelmann, Joachim Heinrich, Thomas Keil, Ludger Klimek, Pavel Kolkhir, Susanne Lau, Marcus Maurer, Ralph Mösges, Angelos Neou, Oliver Pfaar, Johannes Ring, Martin Wagenmann, Torsten Zuberbier, Aiste Ramanauskaite, Anja Lingnau, Demetrios Christou, Sophia Neisinger, Xenophon Aggelidis, Jannis Constantinidis, Maria Dimou, Christos Grigoreas, Trisevgeni Kapsali, Michael Katotomichelakis, Stelios Loukides, Michael Makris, Emmanouil Manousakis, Nikolaos Mikos, Aris Pagkalos, Nikolaos G. Papadopoulos, Vasileios Papanikolaou, Giannis Paraskevopoulos, Konstantina Piskou, Emmanuel Prokopakis, Fotios Psarros, Konstantinos Samitas, Sofia Stamataki, Evangelia Stefanaki Lina, Ekaterini Syrigou, Ioanna Tsiligianni, Mina Vallianatou, Dimitrios Vourdas, Paraskevi Xepapadaki, Aspasia Karavelia, Fanny Wai San Ko, Gary Wong, Andor Hirschberg, Helga Kraxner, Kristof Nekam, Stephen Lane, Menachem Rottem, Cristina Artesani Maria, Simona Barbaglia, Bianca Beghé, Beatrice Bilo Maria, Attilio Boner, Matteo Bonini, Sergio Bonini, Fulvio Braido, Luisa Brussino, G Walter Canonica, Lorenzo Cecchi, Giorgio Ciprandi, Enrico Compalati, Gennaro D'Amato, Giulia De Feo, Stefano Del Giacco, Alessandro Fiocchi, Enrico Heffler, Carlo Lombardi, Riccardo Monti, Antonella Muraro, Eustachio Nettis, Stefania Nicola, Giovanni Passalacqua, Vincenzo Patella, Francesca Puggioni, Giovanni Rolla, Antonino Romano, Nicola Scichilone, Massimo Triggiani, Teresa Ventura Maria, Giovanni Viegi, Cristina Boccabella, Mattia Giovannini, Anand Mahesh Padukudru, Tomohisa Iinuma, Ken Ohta, Yoshitaka Okamoto, Kimihiro Okubo, Ruby Pawankar, Daiju Sakurai, Maho Suzukawa, Masao Yamaguchi, Zhanat Ispayeva, Yoon-Seok Chang, Hae-Sim Park, Mona Al-Ahmad, Ieva Cirule, Ineta Grisle, Carla Irani, Philip Rouadi, Fares Zaitoun, Ruta Dubakiene, Regina Emuzyte, Violeta Kvedariene, Brigita Gradauskiene, Arunas Valiulis, Markus Ollert, Farah Hannachi, Dejan Dokic, Amir Hamzah Abdul Latiff, Baharudin Abdullah, S.P. Palaniappan, Kent Woo, Stephen Montefort, Martín Bedolla Barajas, María del Carmen Costa Domínguez, Jesús Guillermo Espinoza Contreras, Jose Miguel Fuentes Pèrez, José Luis Gálvez Romero, María de la Luz Hortensia García Cruz, Sandra González Diaz, Yunuen Rocío Huerta Villalobos, Désiree E. Larenas-Linnemann, Jorge Agustin Luna-Pech, Juan José Matta Campos, Daniela Rivero Yeverino, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Battur Lkhagvaa, Sandra Mavale-Manuel, Abrantes Nunes Elizabete, Niels Chavannes, Wytske J. Fokkens, Gerard Koppelman, Anke-Hilse Maitland-van der Zee, Sietze Reitsma, Ramanathan Chandrasekharan, Osman Yusuf, Maria Susana Repka-Ramirez, Juan Carlos Sisul, José E. Gereda, Marysia T. Recto, Slawomir Bialek, Artur Bialoszewski, Marta Chelminska, Radoslaw Gawlik, Ewa Jassem, Marek Jutel, Piotr Kuna, Maciej Kupczyk, Marcin Moniuszko, Marek Niedoszytko, Filip Raciborski, Jan Romantowski, Boleslaw Samolinski, Krzysztof Specjalski, Pedro Carreiro Martins, Jaime Correia de Sousa, Elisio Costa, Joao A. Fonseca, Olga Lourenço, Mario Morais-Almeida, Margarida Pereira Ana, Frederico Regateiro, Carlos Robalo Cordeiro, Jose Rosado Pinto, Bernardo Sousa-Pinto, Luis Taborda Barata, Ana Maria Todo-Bom, José Vieira Rafael, Daniela Carvalho, Maryam Ali Al-Nesf, Ioana Agache, Camelia Berghea Elena, Roxana Bumbacea, Diana Deleanu, Florin Mihaltan, Carmen Panaitescu Bunu, Musa Khaitov, Leyla Namazova-Baranova, Elena Vishneva, Ali Alshaikh Nada, Sanja Dimic-Janjic, Branislava Milenkovic, De Yun Wang, Martin Hrubiško, Natalija Edelbaher, Maja Jošt, Peter Kopac, Mitja Košnik, Nika Lalek, Antonija Poplas Susic, Irma Rozman Sinur, Tanja Soklic Košak, Nadja Triller, Katja Triller, Jure Urbancic, Mihaela Zidarn, Michael Levin, Paul Potter, Heather Zar, Isam Alobid, Aram Anto, Joan Bartra, Irina Bobolea, Paloma Campo, Vicky Cardona, Maria Carriazo Ana, José Antonio Castillo Vizuete, Tomas Chivato, Ignacio Jesus Davila Gonzalez, Joaquim Mullol, Antonio Nieto Garcia, César Picado, Santiago Quirce, Joaquin Sastre, Leticia de las Vecillas, Mikael Benson, Inger Kull, Marianne van Hage, Magnus Wickman, Nikolai Khaltaev, Yousser Mohammad, Pongsakorn Tantilipikorn, Pakit Vichyanond, Cemal Cingi, Bilun Gemicioglu, Ozlem Goksel, Omer Kalayci, Ali Fuat Kalyoncu, Cem Meço, Koyuncu Ilgim Vardaloglu, Arzu Yorgancioglu, Deniz Eyice Karabacak, Bruce Kirenga, Ian Michael Adcock, Hasan S. Arshad, Mike Bewick, Christine Bond, Christopher Brightling, Andrew Bush, Moïses Calderon, Kian Fan Chung, Adnan Custovic, Ratko Djukanovic, Stephen Durham, John Farrell, David Halpin, Michael Hyland, Sebastian Johnston, Brian Lipworth, Alla Nakonechna, David Price, Graham Roberts, Dermot Ryan, Jürgen Schwarze, Aziz Sheikh, Mike Shields, Samantha Walker, Sian Williams, Igor Kaidashev, Andrii Igorevich Kurchenko, Vladyslav Tsaryk, David Bernstein, Jonathan A. Bernstein, Thomas B. Casale, Sharon Chinthrajah, Mark Dykewicz, Gailen D. Marshall, Eli O. Meltzer, Robert M. Naclerio, Alkis Togias, Elina Toskala, Dana Wallace, Dennis M. Williams, Barbara Yawn, Fernan Caballero-Fonseca, Lan Le Thi Tuyet, and Tran Thien Quan Vu

Subjects
Allergic rhinitis, Survey, Professional-patient relation, Immunologic diseases. Allergy, RC581-607
Abstract

Background: Allergic rhinitis (AR) is a highly prevalent disease. We aimed to assess the symptoms that physicians who see patients with AR perceive as the most bothersome in their patients. Methods: We performed a cross-sectional study based on an online questionnaire sent to all members of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative. The survey included questions on the physicians' perceptions of patients’ AR symptoms as well as of their own AR symptoms. Results: Among 401 respondents, 155 (38.7%) reported having AR. ARIA members reported nasal symptoms to be the most frequent (89.7%) and bothersome (80.0%) symptoms experienced by themselves. Likewise, nasal symptoms were reported by ARIA members as the most frequent (94.8% in members with AR vs 96.0% in members without AR) and bothersome (57.0% in members with AR vs 67.9% in members without AR) in their patients. We found a significant association (p = 0.001) between physicians’ own symptoms and those perceived as the most bothersome in their patients. Conclusion: Physicians perceive nasal symptoms to be the most frequent and the most bothersome symptoms in AR patients. The physicians' personal experiences with AR may influence their perception of patients’ symptoms.

Published
2024
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2. Impact of systematic early tuberculosis detection using Xpert MTB/RIF Ultra in children with severe pneumonia in high tuberculosis burden countries (TB-Speed pneumonia): a stepped wedge cluster randomized trial

Author

Aurélia Vessière, Hélène Font, Delphine Gabillard, Laurence Adonis-Koffi, Laurence Borand, Chishala Chabala, Celso Khosa, Sandra Mavale, Raoul Moh, Veronica Mulenga, Juliet Mwanga-Amumpere, Jean-Voisin Taguebue, Mao Tan Eang, Christophe Delacourt, James A. Seddon, Manon Lounnas, Sylvain Godreuil, Eric Wobudeya, Maryline Bonnet, and Olivier Marcy

Subjects
Children, Pneumonia, Tuberculosis, Nasopharyngeal aspirate, Stool, Xpert MTB/RIF ultra, Pediatrics, RJ1-570
Abstract

Abstract Background In high tuberculosis (TB) burden settings, there is growing evidence that TB is common in children with pneumonia, the leading cause of death in children under 5 years worldwide. The current WHO standard of care (SOC) for young children with pneumonia considers a diagnosis of TB only if the child has a history of prolonged symptoms or fails to respond to antibiotic treatments. As a result, many children with TB-associated severe pneumonia are currently missed or diagnosed too late. We therefore propose a diagnostic trial to assess the impact on mortality of adding the systematic early detection of TB using Xpert MTB/RIF Ultra (Ultra) performed on nasopharyngeal aspirates (NPA) and stool samples to the WHO SOC for children with severe pneumonia, followed by immediate initiation of anti-TB treatment in children testing positive on any of the samples. Methods TB-Speed Pneumonia is a pragmatic stepped-wedge cluster randomized controlled trial conducted in six countries with high TB incidence rate (Côte d’Ivoire, Cameroon, Uganda, Mozambique, Zambia and Cambodia). We will enrol 3780 children under 5 years presenting with WHO-defined severe pneumonia across 15 hospitals over 18 months. All hospitals will start managing children using the WHO SOC for severe pneumonia; one hospital will be randomly selected to switch to the intervention every 5 weeks. The intervention consists of the WHO SOC plus rapid TB detection on the day of admission using Ultra performed on 1 nasopharyngeal aspirate and 1 stool sample. All children will be followed for 3 months, with systematic trial visits at day 3, discharge, 2 weeks post-discharge, and week 12. The primary endpoint is all-cause mortality 12 weeks after inclusion. Qualitative and health economic evaluations are embedded in the trial. Discussion In addition to testing the main hypothesis that molecular detection and early treatment will reduce TB mortality in children, the strength of such pragmatic research is that it provides some evidence regarding the feasibility of the intervention as part of routine care. Should this intervention be successful, safe and well tolerated, it could be systematically implemented at district hospital level where children with severe pneumonia are referred. Trial registration ClinicalTrials.gov, NCT03831906 . Registered 6 February 2019.

Published
2021
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3. Antigenic and genetic characterization of influenza viruses isolated in Mozambique during the 2015 season.

Author

Almiro Tivane, Rodney Daniels, Neuza Nguenha, Loira Machalele, Afonso Nacoto, Mirela Pale, Edirsse Mateonane, Sandra Mavale, Josina Chilundo, Délcio Muteto, Judite Salência, Félix Albati, Eduardo Gudo, Tufária Mussá, and John McCauley

Subjects
Medicine, Science
Abstract

BACKGROUND:Due to the high rate of antigenic variation of influenza virus, seasonal characterization of the virus is crucial to assess and monitor the emergence of new pathogenic variants and hence formulate effective control measures. However, no study has yet been conducted in Mozambique to assess genetic, antigenic and antiviral susceptibility profile of influenza virus. METHODS:A subset of samples (n = 20) from influenza positive children detected in two hospitals in Maputo city during 2015 season as part of the implementation of influenza surveillance system, were selected. The following assays were performed on these samples: antigenic characterization by hemagglutination inhibition assay, genetic characterization by Sanger sequencing of hemagglutinin (HA) and neuraminidase (NA) and susceptibility to oseltamivir and zanamivir (NA inhibitors) by enzymatic assay. RESULTS:The A(H1N1)pdm09 subtype viruses remained closely related antigenically and genetically to the 2016 vaccine virus A/California/7/2009 and other widely distributed viruses belonging to genetic group 6B. The majority of influenza A(H3N2) viruses studied were antigenically similar to the 2016-2017 vaccine virus, A/Hong Kong/4801/2014, and their HA and NA gene sequences fell into genetic subclade 3C.2a being closely related to viruses circulating in southern Africa. The influenza B viruses were antigenically similar to the 2016 season vaccine virus and HA sequences of all three fell into the B/Yamagata-lineage, clade 3, but contained NA genes of the B/Victoria-lineage. All tested viruses were sensitive to oseltamivir and zanamivir. CONCLUSION:Overall, all Mozambican influenza A and B viruses were most closely related to Southern African viruses and all were sensitive to oseltamivir and zanamivir. These findings suggest the existence of an ecological niche of influenza viruses within the region and hence highlighting the need for joint epidemiologic and virologic surveillance to monitor the evolution of influenza viruses.

Published
2018
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4. Clinical and epidemiological characterization of influenza virus infections in children with severe acute respiratory infection in Maputo, Mozambique: Results from the implementation of sentinel surveillance, 2014 - 2016.

Author

Neuza Nguenha, Almiro Tivane, Mirela Pale, Loira Machalele, Afonso Nacoto, Germano Pires, Edirsse Mationane, Judite Salência, Félix Gundane, Délcio Muteto, Josina Chilundo, Sandra Mavale, Noorbebi Adamo, Cynthia Semá-Baltazar, Orvalho Augusto, Eduardo Gudo, and Tufária Mussá

Subjects
Medicine, Science
Abstract

In Sub-Saharan Africa, where burden, impact, and incidence of acute respiratory infections (ARI) are the highest in the world, conversely, the epidemiology of influenza-associated severe acute respiratory infections (SARI) is incompletely known. The aim of this study was to describe the clinical and epidemiological features of influenza-associated SARI in hospitalized children in Maputo city, Mozambique. Nasopharyngeal and oropharyngeal swabs were collected from children aged 0-14 years old who met the case definition for SARI in two hospitals in Maputo city after their parents or legal representative consented to participate. A structured questionnaire was used to collect clinical and demographic data. Typing and subtyping of influenza were performed by real-time PCR. From January 2014 to December 2016, a total of 2,007 eligible children were recruited, of whom 1,997 (99.5%) were screened for influenza by real-time PCR. The median age of participants was 16.9 months (IQR: 7.0-38.9 months) and 53.9% (1076/1991) were male. A total of 77 were positive for influenza, yielding a frequency of 3.9% (77/1,991), with the highest frequency being reported in the age group 1-5 years old. Cases of influenza peaked twice each year, during which, its frequency reached up to 60%-80%. Among all influenza confirmed cases, 33.7% (26/77), 35.1% (27/77) and 28.6% (22/77) were typed as influenza A/H3N2, A/H1N1pdm09, and B, respectively. This represents the first report of influenza in urban/sub urban setting in Mozambique and the first evidence of distribution of strains of influenza in the country. Our data showed that frequency of influenza was lower than reported in a rural setting in Mozambique and the frequency of seasonal (A/H1N1pdm09) and (A/H3N2) subtypes were similar in children with SARI.

Published
2018
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5. Respiratory syncytial and influenza viruses in children under 2 years old with severe acute respiratory infection (SARI) in Maputo, 2015.

Author

Mirela Pale, Afonso Nacoto, Almiro Tivane, Neuza Nguenha, Loira Machalele, Félix Gundane, Délcio Muteto, Josina Chilundo, Sandra Mavale, Cynthia Semá-Baltazar, Germano Pires, Orvalho Augusto, Tufária Mussá, and Eduardo Gudo

Subjects
Medicine, Science
Abstract

Although respiratory syncytial virus (RSV) and influenza virus (influenza) infections are one of the leading causes of Severe Acute Respiratory Infections (SARI) and death in young children worldwide, little is known about the burden of these pathogens in Mozambique.From January 2015 to January 2016, nasopharyngeal swabs from 450 children, aged ≤2 years, who had been admitted to the Pediatric Department of the Maputo Central Hospital (HCM) in Mozambique, suffering with SARI were enrolled and tested for influenza and RSV using a real-time PCR assay.Influenza and RSV were detected in 2.4% (11/450) and 26.7% (113/424) of the participants. Children with influenza were slightly older than those infected with RSV (10 months in influenza-infected children compared to 3 months in RSV-infected children); male children were predominant in both groups (63.6% versus 54.9% in children with influenza and RSV, respectively). There was a trend towards a higher frequency of influenza (72.7%) and RSV (93.8%) cases in the dry season. Bronchopneumonia, bronchitis and respiratory distress were the most common diagnoses at admission. Antibiotics were administered to 27,3% and 15,9% of the children with influenza and RSV, respectively. Two children, of whom, one was positive for RSV (aged 6 months) and another was positive for Influenza (aged 3 months) died; both were children of HIV seropositive mothers and had bronchopneumonia.Our data demonstrated that RSV, and less frequently influenza, occurs in children with SARI in urban/sub-urban settings from southern Mozambique. The occurrence of deaths in small children suspected of being HIV-infected, suggests that particular attention should be given to this vulnerable population. Our data also provide evidence of antibiotics prescription in children with respiratory viral infection, which represents an important public health problem and calls for urgent interventions.

Published
2017
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6. Effect of systematic tuberculosis detection on mortality in young children with severe pneumonia in countries with high incidence of tuberculosis: a stepped-wedge cluster-randomised trial

Author

Olivier Marcy, Eric Wobudeya, Hélène Font, Aurélia Vessière, Chishala Chabala, Celso Khosa, Jean-Voisin Taguebue, Raoul Moh, Juliet Mwanga-Amumpaire, Manon Lounnas, Veronica Mulenga, Sandra Mavale, Josina Chilundo, Dalila Rego, Bwendo Nduna, Perfect Shankalala, Uzima Chirwa, Agathe De Lauzanne, Bunnet Dim, Emeline Tiogouo Ngouana, Madeleine Folquet Amorrissani, Lassina Cisse, Flore Amon Tanoh Dick, Eric A Komena, Sylvie Kwedi Nolna, Gerald Businge, Naome Natukunda, Saniata Cumbe, Prossy Mbekeka, Ang Kim, Chanrithea Kheang, Sokha Pol, Elizabeth Maleche-Obimbo, James A Seddon, Tan Eang Mao, Stephen M Graham, Christophe Delacourt, Laurence Borand, Maryline Bonnet, Angeline Serre, Anne Badrichani, Manoa Razafimanantsoa, Julien Poublan, Clémentine Roucher, Estelle Occelli, Aurélie Beuscart, Aurélie Charpin, Gemma Habiyambere, Salomé Mesnier, Eric Balestre, Bandana Bhatta, Anne-Laure Maillard, Joanna Orne-Gliemann, Emmanuelle Baillet, Nicolas Koskas, Marc D'Elbée, Delphine Gabillard, Minh Huyen, Hélène Espérou, Sandrine Couffin-Cadiergues, Alexis Kuppers, Benjamin Hamze, Laurence BORAND, Agathe de LAUZANNE, Bunnet DIM, Chanthy Keang, Long PRING, Song YIN, Channimol SARITH, Chanvirak PHAN, Sovann NHEUONG, Socheat LY, Sanary KAING, Vouchleang SRENG, Elen LUN, Leakhena SAY, Sophea SUOM, Romyka FERHY, Dina SO, Sorunna BORN, Sophea PAL, Boraneath NANG, Tan Eang MAO, Ang KIM, Viso Srey, Piseth Kan, leakhena Hout, Samnang Ith, Sophany Oum, Sokunvadhana Sau, Kim Heang Ho, Daronic Kith, Nathara Nuch, Chhun Leang Horm, Cheameas Sophon, Bosba Roeungdeth, Chhay MENG, Ravin RITH, Samnang PHY, Chanchetra SOR, Voleak SAO, Sophea KHAT, Bunthoeun MAK, Angkeaborin UY, Sreyny KHAY, Kimsan SOM, rongvirak HACH, Hay SOK, Sotheavy KUON, Synatt HENG, Amara SENG, Sopheak NIM, Reach PAN, Srean KIM, Keo SREY LEAP, Bormey NET, Viccheka NOUN, Daven LAY, Chhaing MANY, Socheata Seng, Vuthy Ly, Saran So, Sovutthik Oun, Sopheap CHEY, Rattany CHHEA, Lydeth BAONG, Vanna THOUNG, Chanrithea KHEANG, Borady BY, Vathanak Nguon, Eksophea MEACH, Sopheak Tek, Sina Ngeav, Tetra Lun, Deth HEM, Nayreang CHUT, Setha SARIK, Hgekkoung NANG, Mengnean MEACH, Sopal SRENG, Dara SAR, Rathana KIN, Phoran ROS, Chenda DORN, Chansy KAK, Srey Leak Sambath, Leakhena Son, Linda Bin, Eangnay Pengong, Samnang Khutsorn, Sorsophea Seang, Virak Soun, Vuthy Vong, Chandara Khoeung, Panha Um, Sokunthea Bou, Sarin Song Pich, Puthy Nim, Sopheak Khat, Nuon Ban Si, Sovannodom Ream, Sim Ing, Phanith Chann, Samrith Ngeth, Marina Sun, Sokea Chhoeung, Soeun Sean, Ratanak Prak, Audrey Amboua Schouame Onambele, Numfor Hycenth, Bernard Melingui, Angeline Nkembe Medounmga, Luciole Hougnang Tatmi, Nathalie Etemgoua, Vanessa Kouesso, Jean Bugin, Celestine Nzedjom, Roger Ngoya, Jules Eyike, Elyse Loudjom, Roger Lonsti, Ladi Dang, Edward Bintar, Chantal Njayong, Cinthia Ngonsoa O, Isabelle Ndzeukap, Pascaline Dzoyem, Clémentine Dzokou, Berthe Dindo, Eric Auguste Komena, Roger Aka Bony, Christian Kouadio, Serge Danho, Melissa Goli, Madeleine Folquet, Max Valère Itchy, Abdel Sidibé, Lancina Cissé, Joseph Ouattara, Mamadou Konaté, Flore Amon-Tanoh Dick, Melissa Cardena, Laurence Adonis-Koffi, Djabia Eugenie, Ferdinand Kouamé, Hervé Menan, André Inwoley, Timothée Ouassa, Marcelle Sandrine Nguessan, Emelva Manhiça, Alcina Zitha, Valter Chiúle, Eva Muxanga, Irene Gune, Yara Lima, Jorge Ribeiro, Felismina Maxanguana, Natália Morais, Julieta Manhiça, Josefina Give, Jafito Atumane, Gelson Lucas, Arsénio Thai, Adélio Chave, Lúcia Guambe, Faiaz Issa, Rosa Carneiro, Neusa Pene, Natércia Florindo, Dália Machel, Cecília Cumbane, Helena Mendes, Mule Kitungwa, Valdo Muianga, Humberto Tamele, Adelino Sulude, Roda Mabota, Herquéria Comandante, Abelardo Massangaie, Gerald Bright Businge, Faith Namulinda, Robert Sserunjogi, Rashidah Nassozi, Charlotte Barungi, Hellen Aanyu, Doreen Muwonge, Eva Kagoya, Serene Aciparu, Sophia Chemutai, Samuel Ntambi, Amir Wasswa, Juliet Nangozi, Abner Tagoola, Sajja Kenneth, John Paul Lubega, Aidah Nassali, Jessica Tagobera, Christine Agwang, Florence Kalembe, Annet Ajambo, Elizabeth Aguti, Samuel Kasibante, Henry Matende, Israel Owen Odongo, Juliet Mwanga Amumpaire, Gertrude Ngabirano, Paul Kakwenza, Simpson Nuwamanya, Miria Nyangoma, Jane Nabbuto, Florence Abok, Rinah Arinaitwe, Diana Birungi, Evans Mwesigwa, Daniel Atwine, Hassan Mbega, Patrick Orikiriza, Ivan Taremwa, Esther Turyashemererwa, Hope Derrick, Dan Nyehangane, Rodney Kaitano, Susan Logoose, Steven Businge, Charles Ntambi, Jerome Mugabi, John Mzee, Julius Besigye, Saul Kanzira, Phionah Turyatemba, Florence Twebaze, Chimuka Hambulo, Vincent Kapotwe, Marjory Ngambi, Kunda Kasakwa, Chifunda Kapula, Susan Zulu, Grace Nawakwi, Teddy Siasulingana, Jessy Chilonga, Maria Chimbini, Mutinta Chilanga, Muleya Inambao, Mwate Mwambazi, Barbra Halende, Wyclef Mumba, Endreen Mankunshe, Maureen Silavwe, Moses Chakopo, and Roy Moono

Subjects
Infectious Diseases
Abstract

Tuberculosis diagnosis might be delayed or missed in children with severe pneumonia because this diagnosis is usually only considered in cases of prolonged symptoms or antibiotic failure. Systematic tuberculosis detection at hospital admission could increase case detection and reduce mortality.We did a stepped-wedge cluster-randomised trial in 16 hospitals from six countries (Cambodia, Cameroon, Côte d'Ivoire, Mozambique, Uganda, and Zambia) with high incidence of tuberculosis. Children younger than 5 years with WHO-defined severe pneumonia received either the standard of care (control group) or standard of care plus Xpert MTB/RIF Ultra (Xpert Ultra; Cepheid, Sunnyvale, CA, USA) on nasopharyngeal aspirate and stool samples (intervention group). Clusters (hospitals) were progressively switched from control to intervention at 5-week intervals, using a computer-generated random sequence, stratified on incidence rate of tuberculosis at country level, and masked to teams until 5 weeks before switch. We assessed the effect of the intervention on primary (12-week all-cause mortality) and secondary (including tuberculosis diagnosis) outcomes, using generalised linear mixed models. The primary analysis was by intention to treat. We described outcomes in children with severe acute malnutrition in a post hoc analysis. This study is registered with ClinicalTrials.gov (NCT03831906) and the Pan African Clinical Trial Registry (PACTR202101615120643).From March 21, 2019, to March 30, 2021, we enrolled 1401 children in the control group and 1169 children in the intervention group. In the intervention group, 1140 (97·5%) children had nasopharyngeal aspirates and 942 (80·6%) had their stool collected; 24 (2·1%) had positive Xpert Ultra. At 12 weeks, 110 (7·9%) children in the control group and 91 (7·8%) children in the intervention group had died (adjusted odds ratio [OR] 0·986, 95% CI 0·597-1·630, p=0·957), and 74 (5·3%) children in the control group and 88 (7·5%) children in the intervention group had tuberculosis diagnosed (adjusted OR 1·238, 95% CI 0·696-2·202, p=0·467). In children with severe acute malnutrition, 57 (23·8%) of 240 children in the control group and 53 (17·8%) of 297 children in the intervention group died, and 36 (15·0%) of 240 children in the control group and 56 (18·9%) of 297 children in the intervention group were diagnosed with tuberculosis. The main adverse events associated with nasopharyngeal aspirates were samples with blood in 312 (27·3%) of 1147 children with nasopharyngeal aspirates attempted, dyspnoea or SpOSystematic molecular tuberculosis detection at hospital admission did not reduce mortality in children with severe pneumonia. High treatment and microbiological confirmation rates support more systematic use of Xpert Ultra in this group, notably in children with severe acute malnutrition.Unitaid and L'Initiative.For the French translation of the abstract see Supplementary Materials section.

Published
2023
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7. Impact of systematic early tuberculosis detection using Xpert MTB/RIF Ultra in children with severe pneumonia in high tuberculosis burden countries (TB-Speed pneumonia): a stepped wedge cluster randomized trial

Author

Mao Tan Eang, Laurence Borand, Maryline Bonnet, Sylvain Godreuil, Olivier Marcy, Raoul Moh, Jean-Voisin Taguebue, Sandra Mavale, Juliet Mwanga-Amumpere, Manon Lounnas, James A Seddon, Veronica Mulenga, Celso Khosa, Eric Wobudeya, Hélène Font, Aurélia Vessière, Chishala Chabala, Laurence Adonis-Koffi, Delphine Gabillard, Christophe Delacourt, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Zambia [Lusaka] (UNZA), Maputo Central Hospital, Ministry of Health [Mozambique], Centre Hospitalier Universitaire [Treichville] (CHU), Epicentre Ouganda [Mbarara] [Médecins Sans Frontières], Epicentre [Paris] [Médecins Sans Frontières], National Center for Tuberculosis and Leprosy Control [Phnom Penh, Cambodia] (CENAT), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Stellenbosch University, Imperial College London, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Bugema University [Kampala], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Pediatrics, Nasopharyngeal aspirate, Aftercare, 030204 cardiovascular system & hematology, law.invention, Study Protocol, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, Uganda, 030212 general & internal medicine, Cluster randomised controlled trial, Cameroon, Child, Children, Mozambique, Cause of death, lcsh:RJ1-570, Diagnostic Trial, Patient Discharge, 3. Good health, Stool, Child, Preschool, Cambodia, Life Sciences & Biomedicine, medicine.medical_specialty, Tuberculosis, Zambia, Disease cluster, Xpert MTB, Sensitivity and Specificity, 03 medical and health sciences, RIF ultra, medicine, Humans, Xpert, Science & Technology, business.industry, lcsh:Pediatrics, Mycobacterium tuberculosis, Pneumonia, medicine.disease, Xpert MTB/RIF ultra, Pediatrics, Perinatology and Child Health, MTB, 1114 Paediatrics and Reproductive Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Background In high tuberculosis (TB) burden settings, there is growing evidence that TB is common in children with pneumonia, the leading cause of death in children under 5 years worldwide. The current WHO standard of care (SOC) for young children with pneumonia considers a diagnosis of TB only if the child has a history of prolonged symptoms or fails to respond to antibiotic treatments. As a result, many children with TB-associated severe pneumonia are currently missed or diagnosed too late. We therefore propose a diagnostic trial to assess the impact on mortality of adding the systematic early detection of TB using Xpert MTB/RIF Ultra (Ultra) performed on nasopharyngeal aspirates (NPA) and stool samples to the WHO SOC for children with severe pneumonia, followed by immediate initiation of anti-TB treatment in children testing positive on any of the samples. Methods TB-Speed Pneumonia is a pragmatic stepped-wedge cluster randomized controlled trial conducted in six countries with high TB incidence rate (Côte d’Ivoire, Cameroon, Uganda, Mozambique, Zambia and Cambodia). We will enrol 3780 children under 5 years presenting with WHO-defined severe pneumonia across 15 hospitals over 18 months. All hospitals will start managing children using the WHO SOC for severe pneumonia; one hospital will be randomly selected to switch to the intervention every 5 weeks. The intervention consists of the WHO SOC plus rapid TB detection on the day of admission using Ultra performed on 1 nasopharyngeal aspirate and 1 stool sample. All children will be followed for 3 months, with systematic trial visits at day 3, discharge, 2 weeks post-discharge, and week 12. The primary endpoint is all-cause mortality 12 weeks after inclusion. Qualitative and health economic evaluations are embedded in the trial. Discussion In addition to testing the main hypothesis that molecular detection and early treatment will reduce TB mortality in children, the strength of such pragmatic research is that it provides some evidence regarding the feasibility of the intervention as part of routine care. Should this intervention be successful, safe and well tolerated, it could be systematically implemented at district hospital level where children with severe pneumonia are referred. Trial registration ClinicalTrials.gov, NCT03831906. Registered 6 February 2019.

Published
2021
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8. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies

Author

Bousquet, Jean, Cristol, Jean-Paul, Czarlewski, Wienczyslawa, Anto, Josep M, Martineau, Adrian, Haahtela, Tari, Fonseca, Susana C, Iaccarino, Guido, Blain, Hubert, Fiocchi, Alessandro, Canonica, G Walter, Fonseca, Joao A, Vidal, Alain, Choi, Hak-Jong, Kim, Hyun Ju, Le Moing, Vincent, Reynes, Jacques, Sheikh, Aziz, Akdis, Cezmi A, Zuberbier, Torsten, Amir Hamzah Abdul Latiff, Baharudin, Abdullah, Werner, Aberer, Nancy, Abusada, Ian, Adcock, Alejandro, Afani, Ioana, Agache, Xenofon, Aggelidis, Jenifer, Agustin, Cezmi, A Akdis, Mübeccel, Akdis, Mona, Al-Ahmad, Abou Al-Zahab Bassam, Hussam, Alburdan, Oscar, Aldrey-Palacios, Emilio Alvarez Cuesta, Hiba Alwan Salman, Ashraf, Alzaabi, Salma, Amade, Gene, Ambrocio, Rosana, Angles, Isabella, Annesi-Maesano, Ignacio, J Ansotegui, Josep, M Anto, Paula Ara Bardajo, Stefania, Arasi, Margarete, Arrais, Hasan, Arshad, Maria-Cristina, Artesani, Estrella, Asayag, Francesca, Avolio, Khuzama, Azhari, Claus, Bachert, Diego, Bagnasco, Ilaria, Baiardini, Nissera, Bajrović, Petros, Bakakos, Sergio Bakeyala Mongono, Christine, Balotro-Torres, Sergio, Barba, Cristina, Barbara, Elsa, Barbosa, Bruno, Barreto, Joan, Bartra, Xavier, Basagana, Eric, D Bateman, Lkhagvaa, Battur, Anna, Bedbrook, Martín Bedolla Barajas, Bianca, Beghé, Antra, Bekere, Elizabeth, Bel, Ali Ben Kheder, Mikael, Benson, Elena-Camelia, Berghea, Karl-Christian, Bergmann, Roberto, Bernardini, David, Bernstein, Mike, Bewick, Slawomir, Bialek, Artur, Białoszewski, Thomas, Bieber, Nils, E Billo, Maria-Beatrice, Bilo, Carsten, Bindslev-Jensen, Leif, Bjermer, Hubert, Blain, Irina, Bobolea, Malgorzata Bochenska Marciniak, Christine, Bond, Attilio, Boner, Matteo, Bonini, Sergio, Bonini, Sinthia, Bosnic-Anticevich, Isabelle, Bosse, Sofia, Botskariova, Jacques, Bouchard, Louis-Philippe, Boulet, Rodolphe, Bourret, Philippe, Bousquet, Fulvio, Braido, Andrew, Briggs, Christopher, E Brightling, Jan, Brozek, Luisa, Brussino, Roland, Buhl, Roxana, Bumbacea, Rosalva, Buquicchio, María-Teresa Burguete Cabañas, Andrew, Bush, William, W Busse, Jeroen, Buters, Fernan, Caballero-Fonseca, Moïses, A Calderon, Mario, Calvo, Paulo, Camargos, Thierry, Camuzat, R Canevari, F, Antonio, Cano, G Walter Canonica, Arnaldo, Capriles-Hulett, Luis, Caraballo, Vicky, Cardona, Kai-Hakon, Carlsen, Jonas Carmona Pirez, Jorge, Caro, Warner, Carr, Pedro, Carreiro-Martins, Fredelita, Carreon-Asuncion, Ana-Maria, Carriazo, Carme Carrion, Y Ribas, Thomas, Casale, Mary-Ann, Castor, Elizabeth, Castro, G Caviglia, A, Lorenzo, Cecchi, Alfonso Cepeda Sarabia, Maciej, Chalubinski, Ramanathan, Chandrasekharan, Yoon-Seok, Chang, Victoria, Chato-Andeza, Lida, Chatzi, Christina, Chatzidaki, Niels, H Chavannes, Claudia Chaves Loureiro, Aurora-Alejandra Chavez Garcia, Marta, Chelninska, Yuzhi, Chen, Lei, Cheng, Sharon, Chinthrajah, Tomas, Chivato, Ekaterine, Chkhartishvili, George, Christoff, Henry, Chrystyn, Derek, K Chu, Antonio, Chua, Alexander, Chuchalin, Kian Fan Chung, Alberto, Cicerán, Cemal, Cingi, Giorgio, Ciprandi, Ieva, Cirule, Ana-Carla, Coelho, Enrico, Compalati, Jannis, Constantinidis, Jaime Correia de Sousa, Elisio Manuel Costa, David, Costa, María Del Carmen Costa Domínguez, André, Coste, Cottini, M, Linda, Cox, Carlos, Crisci, Maria Angiola Crivellaro, Alvaro, A Cruz, John, Cullen, Adnan, Custovic, Biljana, Cvetkovski, Wienczyslawa, Czarlewski, Gennaro, D'Amato, Jane da Silva, Ronald, Dahl, Sven-Erik, Dahlen, Vasilis, Daniilidis, Louei Darjazini Nahhas, Ulf, Darsow, Janet, Davies, Frédéric de Blay, Giulia De Feo, Eloisa De Guia, José-Ricardo De la Torre Navarrete, Chato De Los Santos, Esteban De Manuel Keenoy, Govert De Vries, Diana, Deleanu, Pascal, Demoly, Judah, Denburg, Philippe, Devillier, Alain, Didier, Sanja Dimic Janjic, Maria, Dimou, Anh Tuan Dinh-Xuan, Ratko, Djukanovic, Maria Do Ceu Texeira, Dejan, Dokic, Margarita Gabriela Domínguez Silva, Habib, Douagui, Nikolaos, Douladiris, Maria, Doulaptsi, Gérard, Dray, Ruta, Dubakiene, Eve, Dupas, Stephen, Durham, Marzia, Duse, Mark, Dykewicz, Didier, Ebo, Natalija, Edelbaher, Thomas, Eiwegger, Patrik, Eklund, Yehia, El-Gamal, Zeinab, A El-Sayed, Shereen, S El-Sayed, Magda, El-Seify, Regina, Emuzyte, Lourdes, Enecilla, Marina, Erhola, Heidilita, Espinoza, Jesús Guillermo Espinoza Contreras, John, Farrell, Lenora, Fernandez, Paola Fimbres Jimenez, Antje Fink Wagner, Alessandro, Fiocchi, Wytske, J Fokkens, Lenia, Folletti, Joao, A Fonseca, Jean-François, Fontaine, Francesco, Forastiere, Jose Miguel Fuentes Pèrez, Emily, Gaerlan-Resureccion, Mina, Gaga, José Luis Gálvez Romero, Amiran, Gamkrelidze, Alexis, Garcia, Cecilia Yvonne García Cobas, María de la Luz Hortensia García Cruz, Valeria Garcia Ortiz, Jacques, Gayraud, Matteo, Gelardi, Bilun, Gemicioglu, Dimitra, Gennimata, Sonya, Genova, José, Gereda, Roy Gerth van Wijk, Antonio, Giuliano, René-Maximiliano, Gomez, Miguel-Ange Gonzalez Ballester, Sandra González Diaz, Maia, Gotua, Christos, Grigoreas, Ineta, Grisle, Marta, Guidacci, Nick, 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Subjects
MAPK/ERK pathway, ARIA group, Allergy, [SDV]Life Sciences [q-bio], NF-KAPPA-B, debelost, Review, Pharmacology, Resveratrol, PROTECTS, chemistry.chemical_compound, 0302 clinical medicine, RESPIRATORY SYNDROME CORONAVIRUS, ENDOPLASMIC-RETICULUM STRESS, Medicine and Health Sciences, Immunology and Allergy, Medicine, OXIDATIVE STRESS, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, 2. Zero hunger, 0303 health sciences, RESPIRATORY, INSULIN-RESISTANCE, Muscle cell proliferation, SULFORAPHANE, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, SIGNALING PATHWAY, Signal transduction, Life Sciences & Biomedicine, Pulmonary and Respiratory Medicine, NRF2 ACTIVATORS, MUSCLE-CELL PROLIFERATION, Immunology, 610 Medicine & health, Lung injury, Settore MED/10 - Malattie Dell'Apparato Respiratorio, ACUTE LUNG INJURY, 03 medical and health sciences, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, udc:616.9, odpornost proti inzulinu, SULFORAPHANE PROTECTS, Transcription factor, PI3K/AKT/mTOR pathway, 030304 developmental biology, Science & Technology, business.industry, SARS-CoV-2, food, medicine.disease, chemistry, hranila, SYNDROME CORONAVIRUS, business, hrana, GREEN TEA
Abstract

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.

Published
2020
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9. Respiratory syncytial and influenza viruses in children under 2 years old with severe acute respiratory infection (SARI) in Maputo, 2015

Author

Sandra Mavale, Tufária Mussá, Orvalho Augusto, Afonso Nacoto, Eduardo Samo Gudo, Loira Machalele, Neuza Nguenha, Josina Chilundo, Mirela Pale, Félix Gundane, Délcio Muteto, Cynthia Semá-Baltazar, Germano Pires, and Almiro Tivane

Subjects
Male, RNA viruses, Pediatrics, Viral Diseases, Influenza Viruses, Pulmonology, Antibiotics, lcsh:Medicine, Pathology and Laboratory Medicine, Geographical Locations, Families, 0302 clinical medicine, Severe acute respiratory infection, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Respiratory system, lcsh:Science, Children, Mozambique, Multidisciplinary, Respiratory distress, Antimicrobials, virus diseases, Drugs, Orthomyxoviridae, 3. Good health, Infectious Diseases, Medical Microbiology, Child, Preschool, Population Surveillance, Viral Pathogens, Viruses, Bronchitis, Female, Pathogens, Pediatric Infections, Research Article, HIV infections, medicine.medical_specialty, medicine.drug_class, 030231 tropical medicine, Respiratory Syncytial Virus Infections, Real-Time Polymerase Chain Reaction, Microbiology, Virus, 03 medical and health sciences, Microbial Control, Influenza, Human, Humans, Medical prescription, Microbial Pathogens, Pharmacology, Biology and life sciences, business.industry, Public health, lcsh:R, Infant, Newborn, Organisms, Infant, medicine.disease, Influenza, Age Groups, Respiratory Syncytial Virus, Human, Respiratory Infections, People and Places, Africa, lcsh:Q, Population Groupings, business, Orthomyxoviruses
Abstract

Introduction Although respiratory syncytial virus (RSV) and influenza virus (influenza) infections are one of the leading causes of Severe Acute Respiratory Infections (SARI) and death in young children worldwide, little is known about the burden of these pathogens in Mozambique. Material and methods From January 2015 to January 2016, nasopharyngeal swabs from 450 children, aged ≤2 years, who had been admitted to the Pediatric Department of the Maputo Central Hospital (HCM) in Mozambique, suffering with SARI were enrolled and tested for influenza and RSV using a real-time PCR assay. Results Influenza and RSV were detected in 2.4% (11/450) and 26.7% (113/424) of the participants. Children with influenza were slightly older than those infected with RSV (10 months in influenza-infected children compared to 3 months in RSV-infected children); male children were predominant in both groups (63.6% versus 54.9% in children with influenza and RSV, respectively). There was a trend towards a higher frequency of influenza (72.7%) and RSV (93.8%) cases in the dry season. Bronchopneumonia, bronchitis and respiratory distress were the most common diagnoses at admission. Antibiotics were administered to 27,3% and 15,9% of the children with influenza and RSV, respectively. Two children, of whom, one was positive for RSV (aged 6 months) and another was positive for Influenza (aged 3 months) died; both were children of HIV seropositive mothers and had bronchopneumonia. Conclusions Our data demonstrated that RSV, and less frequently influenza, occurs in children with SARI in urban/sub-urban settings from southern Mozambique. The occurrence of deaths in small children suspected of being HIV-infected, suggests that particular attention should be given to this vulnerable population. Our data also provide evidence of antibiotics prescription in children with respiratory viral infection, which represents an important public health problem and calls for urgent interventions.

Published
2017

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