Influenza-like illness is associated with high pneumococcal carriage density in Malawian children

Highlights • Influenza-like illness (ILI) in children is associated with high pneumococcal carriage density. • Children with ILI harboured more viral organisms than asymptomatic healthy children. • Children with ILI patients had higher IL-8 levels in nasal aspirates than asymptomatic healthy children.
Summary Background High pneumococcal carriage density is a risk factor for invasive pneumococcal disease (IPD) and transmission, but factors that increase pneumococcal carriage density are still unclear. Methods We undertook a cross-sectional study to evaluate the microbial composition, cytokine levels and pneumococcal carriage densities in samples from children presenting with an influenza-like illness (ILI) and asymptomatic healthy controls (HC). Results The proportion of children harbouring viral organisms (Relative risk (RR) 1.4, p = 0.0222) or ≥ 4 microbes at a time (RR 1.9, p