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RNA viruses in community-acquired childhood pneumonia in semi-urban Nepal; a cross-sectional study

Authors :
Basnet Sudha
Valentiner-Branth Palle
Chandyo Ram K
Sharma Biswa N
Strand Tor A
Mathisen Maria
Adhikari Ramesh K
Hvidsten Dag
Shrestha Prakash S
Sommerfelt Halvor
Source :
BMC Medicine, Vol 7, Iss 1, p 35 (2009)
Publication Year :
2009
Publisher :
BMC, 2009.

Abstract

Abstract Background Pneumonia is among the main causes of illness and death in children Methods From July 2004 to June 2007, we examined nasopharyngeal aspirates (NPA) from 2,230 cases of pneumonia (World Health Organization criteria) in children 2 to 35 months old recruited in a randomized trial of zinc supplementation at a field clinic in Bhaktapur, Nepal. The specimens were examined for respiratory syncytial virus (RSV), influenza virus type A (InfA) and B (InfB), parainfluenza virus types 1, 2 and 3 (PIV1, PIV2, and PIV3), and human metapneumovirus (hMPV) using a multiplex reverse transcriptase polymerase chain reaction (PCR) assay. Results We identified 919 virus isolates in 887 (40.0%) of the 2,219 NPA specimens with a valid PCR result, of which 334 (15.1%) yielded RSV, 164 (7.4%) InfA, 129 (5.8%) PIV3, 98 (4.4%) PIV1, 93 (4.2%) hMPV, 84 (3.8%) InfB, and 17 (0.8%) PIV2. CAP occurred in an epidemic pattern with substantial temporal variation during the three years of study. The largest peaks of pneumonia occurrence coincided with peaks of RSV infection, which occurred in epidemics during the rainy season and in winter. The monthly number of RSV infections was positively correlated with relative humidity (rs = 0.40, P = 0.01), but not with temperature or rainfall. An hMPV epidemic occurred during one of the three winter seasons and the monthly number of hMPV cases was also associated with relative humidity (rs = 0.55, P = 0.0005). Conclusion Respiratory RNA viruses were detected from NPA in 40% of CAP cases in our study. The most commonly isolated viruses were RSV, InfA, and PIV3. RSV infections contributed substantially to the observed CAP epidemics. The occurrence of viral CAP in this community seemed to reflect more or less overlapping micro-epidemics with several respiratory viruses, highlighting the challenges of developing and implementing effective public health control measures.

Subjects

Subjects :
Medicine

Details

Language :
English
ISSN :
17417015
Volume :
7
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.53373ee1893c4b8d896a5d897b8653a0
Document Type :
article
Full Text :
https://doi.org/10.1186/1741-7015-7-35