Centers for Disease Control and Prevention , Pretoria , South Africa ; Centers for Disease Control and Prevention , Atlanta, Georgia ; US Public Health Service, Rockville, Maryland.
South African Field Epidemiology Training Program, Johannesburg ; School of Health Systems and Public Health, Faculty of Health Sciences , University of Pretoria.
Open Forum Infect Dis. 2015 Sep 19;2(4):ofv139. doi: 10.1093/ofid/ofv139. eCollection 2015 Dec.
Background. Parainfluenza virus (PIV) is a common cause of acute respiratory tract infections, but little is known about PIV infection in children and adults in Africa, especially in settings where human immunodeficiency virus (HIV) prevalence is high. Methods. We conducted active, prospective sentinel surveillance for children and adults hospitalized with severe acute respiratory illness (SARI) from 2009 to 2014 in South Africa. We enrolled controls (outpatients without febrile or respiratory illness) to calculate the attributable fraction for PIV infection. Respiratory specimens were tested by multiplex real-time reverse-transcription polymerase chain reaction assay for parainfluenza types 1, 2, and 3. Results. Of 18 282 SARI cases enrolled, 1188 (6.5%) tested positive for any PIV type: 230 (19.4%) were type 1; 168 (14.1%) were type 2; 762 (64.1%) were type 3; and 28 (2.4%) had coinfection with 2 PIV types. After adjusting for age, HIV serostatus, and respiratory viral coinfection, the attributable fraction for PIV was 65.6% (95% CI [confidence interval], 47.1-77.7); PIV contributed to SARI among HIV-infected and -uninfected children <5 years of age and among individuals infected with PIV types 1 and 3. The observed overall incidence of PIV-associated SARI was 38 (95% CI, 36-39) cases per 100 000 population and was highest in children <1 year of age (925 [95% CI, 864-989] cases per 100 000 population). Compared with persons without HIV, persons with HIV had an increased relative risk of PIV hospitalization (9.4; 95% CI, 8.5-10.3). Conclusions. Parainfluenza virus causes substantial severe respiratory disease in South Africa among children <5 years of age, especially those that are infected with HIV.
副流感病毒（PIV）是急性呼吸道感染的常见病因，但在非洲，人们对儿童和成人中的 PIV 感染知之甚少，尤其是在艾滋病毒（HIV）流行率较高的地方。
我们对 2009 年至 2014 年期间因严重急性呼吸道感染（SARI）住院的儿童和成人进行了主动、前瞻性哨点监测。我们招募了对照（无发热或呼吸道疾病的门诊患者），以计算 PIV 感染的归因分数。呼吸道标本采用多重实时逆转录聚合酶链反应检测法检测副流感病毒 1、2 和 3 型。
在纳入的 18282 例 SARI 病例中，有 1188 例（6.5%）任何 PIV 类型检测呈阳性：230 例（19.4%）为 1 型；168 例（14.1%）为 2 型；762 例（64.1%）为 3 型；28 例（2.4%）为 2 种 PIV 型合并感染。在调整年龄、HIV 血清状态和呼吸道病毒合并感染后，PIV 的归因分数为 65.6%（95%置信区间，47.1-77.7）；PIV 导致 5 岁以下 HIV 感染和未感染儿童以及感染 1 型和 3 型 PIV 的个体发生 SARI。观察到的 PIV 相关 SARI 的总发生率为每 100000 人 38 例（95%置信区间，36-39），在 1 岁以下儿童中最高（每 100000 人 925 例[95%置信区间，864-989]）。与未感染 HIV 的个体相比，感染 HIV 的个体患 PIV 住院的相对风险增加（9.4；95%置信区间，8.5-10.3）。
在南非，副流感病毒在 5 岁以下儿童中引起大量严重呼吸道疾病，尤其是感染 HIV 的儿童。
