Famoroti Temitayo, Sibanda Wilbert, Ndung'u Thumbi
Department of Virology, National Health Laboratory Service, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Biostatistics Unit, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
BMC Pediatr. 2018 Jul 21;18(1):240. doi: 10.1186/s12887-018-1222-8.
Acute respiratory tract infections contribute significantly to morbidity and mortality among young children in resource-poor countries. However, studies on the viral aetiology of acute respiratory infections, seasonality and the relative contributions of comorbidities such as immune deficiency states to viral respiratory tract infections in children in these countries are limited.
A retrospective analysis of laboratory test results of upper or lower respiratory specimens of children between 0 and 5 years of age collected between 1st January 2011 and 31st July 2015 from hospitals in KwaZulu-Natal, South Africa. Respiratory specimens were tested for viral respiratory pathogens using multiplex polymerase chain reaction (PCR), HIV testing was performed either by serological or PCR methods. Cytomegalovirus (CMV) respiratory infection was determined using the CMV R-gene PCR kit.
In total 2172 specimens were analysed, of which 1175 (54.1%) were from males. The median age was 3.0 months (interquartile range [IQR] 1-7). Samples from the lower respiratory tract accounted for 1949 (89.7%) of all specimens. Respiratory multiplex PCR results were positive in 834 (45.7%) specimens. Respiratory syncytial virus (RSV) was the most commonly detected virus in 316 (32.1%) patients, followed by adenovirus (ADV) in 215 (21.8%), human rhinovirus (Hrhino) in 152 (15.4%) and influenza A (FluA) in 50 (5.1%). A seasonal time series pattern was observed for ADV (winter peak), enterovirus (EV) (autumn), human bocavirus (HBoV) (summer), and parainfluenza viruses 1 and 3 (PIV1 and 3) (spring). Stationary or untrended seasonal variation was observed for FluA (winter peak) and RSV (summer). HIV results were available for 1475 (67.9%) specimens; of these 348 (23.6%) were positive. CMV results were available for 714 (32.9%) specimens, of which 416 (58.3%) were positive. There was a statistically significant association between the coinfection of HIV and CMV with ADV.
In this study, we identified the most common respiratory viral pathogens detected among hospitalized children in KwaZulu-Natal. The coinfection between HIV and CMV was found to be associated with an increased risk of only adenovirus infection. Most viral pathogens showed a seasonal trend of occurrence. Our data has implications for the rational design of public health programmes.
在资源匮乏国家，急性呼吸道感染是幼儿发病和死亡的重要原因。然而，关于这些国家儿童急性呼吸道感染的病毒病因、季节性以及免疫缺陷状态等合并症对病毒性呼吸道感染的相对影响的研究有限。
对2011年1月1日至2015年7月31日期间从南非夸祖鲁 - 纳塔尔省医院收集的0至5岁儿童的上呼吸道或下呼吸道标本的实验室检测结果进行回顾性分析。使用多重聚合酶链反应（PCR）检测呼吸道标本中的病毒性呼吸道病原体，通过血清学或PCR方法进行HIV检测。使用巨细胞病毒（CMV）R基因PCR试剂盒确定CMV呼吸道感染。
共分析了2172份标本，其中1175份（54.1%）来自男性。中位年龄为3.0个月（四分位间距[IQR]1 - 7）。下呼吸道标本占所有标本的1949份（89.7%）。834份（45.7%）标本的呼吸道多重PCR结果呈阳性。呼吸道合胞病毒（RSV）是316例（32.1%）患者中最常检测到的病毒，其次是腺病毒（ADV）215例（21.8%）、人鼻病毒（Hrhino）152例（15.4%）和甲型流感病毒（FluA）50例（5.1%）。观察到ADV（冬季高峰）、肠道病毒（EV）（秋季）、人博卡病毒（HBoV）（夏季）以及副流感病毒1型和3型（PIV1和3）（春季）的季节性时间序列模式。观察到FluA（冬季高峰）和RSV（夏季）呈平稳或无趋势的季节性变化。1475份（67.9%）标本有HIV检测结果；其中348份（23.6%）呈阳性。714份（32.9%）标本有CMV检测结果，其中416份（58.3%）呈阳性。HIV和CMV合并感染与ADV感染之间存在统计学显著关联。
在本研究中，我们确定了夸祖鲁 - 纳塔尔省住院儿童中最常见的呼吸道病毒病原体。发现HIV和CMV合并感染仅与腺病毒感染风险增加有关。大多数病毒病原体呈现出季节性发病趋势。我们的数据对公共卫生项目的合理设计具有启示意义。
