Epidemiology and Demography Department, Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast.
Department of Nursing and Public Health, Pwani University, Kilifi, Kenya.
Clin Infect Dis. 2018 Oct 30;67(10):1559-1567. doi: 10.1093/cid/ciy313.
Households are high-intensity close-contact environments favorable for transmission of respiratory viruses, yet little is known for low-income settings.
Active surveillance was completed on 47 households in rural coastal Kenya over 6 months during a respiratory syncytial virus (RSV) season. Nasopharyngeal swabs (NPSs) were taken from 483 household members twice weekly irrespective of symptoms. Using molecular diagnostics, NPSs from 6 households were screened for 15 respiratory viruses and the remainder of households only for the most frequent viruses observed: rhinovirus (RV), human coronavirus (HCoV; comprising strains 229E, OC43, and NL63), adenovirus (AdV), and RSV (A and B).
Of 16928 NPSs tested for the common viruses, 4259 (25.2%) were positive for ≥1 target; 596 (13.8%) had coinfections. Detection frequencies were 10.5% RV (1780), 7.5% HCoV (1274), 7.3% AdV (1232), and 3.2% RSV (537). On average, each household and individual had 6 and 3 different viruses detected over the study period, respectively. Rhinovirus and HCoV were detected in all the 47 households while AdV and RSV were detected in 45 (95.7%) and 40 (85.1%) households, respectively. The individual risk of infection over the 6-month period was 93.4%, 80.1%, 71.6%, 61.5%, and 37.1% for any virus, RV, HCoV, AdV, and RSV, respectively. NPSs collected during symptomatic days and from younger age groups had higher prevalence of virus detection relative to respective counterparts. RSV was underrepresented in households relative to hospital admission data.
In this household setting, respiratory virus infections and associated illness are ubiquitous. Future studies should address the health and economic implications of these observations.
家庭是呼吸道病毒传播的高强度密切接触环境，但在低收入环境中知之甚少。
在呼吸道合胞病毒（RSV）季节的 6 个月期间，对肯尼亚沿海农村的 47 个家庭进行了主动监测。无论症状如何，每周两次从 483 名家庭成员中采集鼻咽拭子（NPS）。使用分子诊断学，对 6 个家庭的 NPS 进行了 15 种呼吸道病毒筛查，其余家庭仅针对观察到的最常见病毒进行筛查：鼻病毒（RV）、人类冠状病毒（HCoV；包括 229E、OC43 和 NL63 株）、腺病毒（AdV）和 RSV（A 和 B）。
在对常见病毒进行的 16928 次 NPS 检测中，有 4259 次（25.2%）对≥1 种目标呈阳性；596 次（13.8%）有合并感染。检测频率分别为 RV（1780）10.5%、HCoV（1274）7.5%、AdV（1232）7.3%和 RSV（537）3.2%。平均而言，在研究期间，每个家庭和个体分别检测到 6 种和 3 种不同的病毒。47 个家庭均检测到鼻病毒和 HCoV，45 个（95.7%）和 40 个（85.1%）家庭检测到 AdV 和 RSV。个体在 6 个月期间的感染风险分别为 93.4%、80.1%、71.6%、61.5%和 37.1%，分别为任何病毒、RV、HCoV、AdV 和 RSV。与相应对照相比，在有症状的日子采集的 NPSs 和来自年龄较小的群体的 NPSs 病毒检测率更高。与住院数据相比，RSV 在家庭中的代表性不足。
在这种家庭环境中，呼吸道病毒感染和相关疾病普遍存在。未来的研究应该解决这些观察结果对健康和经济的影响。
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