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塞内加尔疟疾传播减少的农村地区的上呼吸道感染:病原体群落研究。

Upper respiratory infections in a rural area with reduced malaria transmission in Senegal: a pathogens community study.

机构信息

Service de Parasitologie, Faculté de Médecine, Université Cheikh Anta Diop de Dakar (UCAD), BP5005, Dakar-Fann, Senegal.

Laboratoire des Virus respiratoires, Institut Pasteur de Dakar, Dakar, Senegal.

出版信息

BMC Infect Dis. 2018 Sep 10;18(1):459. doi: 10.1186/s12879-018-3362-8.

Abstract

BACKGROUND

Acute Respiratory Infections (ARI) are common causes of febrile illnesses in many settings in Senegal. These infections are usually managed presumptively due to lack of appropriate diagnostic tools. This situation, can lead to poor management of febrile illness or antibiotic misuse. In addition, there are limited data on the spectrum of pathogens commonly responsible for these ARI. This study was conducted to explore the pathogens community among patients with acute respiratory infection in a rural area in Senegal.

METHODS

A cross sectional study was conducted from August to December 2015. Children and adult patients attending Keur Socé health post for signs suggestive of acute respiratory infection were enrolled after providing inform consent. Eligible participants were recruited using a consecutive sampling method. Paired nose and throat swabs were collected for pathogen detection. Samples were processed using a multiplex PCR designed to identify 21 pathogens including both virus and bacteria.

RESULTS

Two hundred and fifty patients participated in the study. Samples positivity rate was evaluated at 95.2% (238/250). Streptococcus pneumoniae was the predominant pathogen (74%) and was present in all months and all age-groups, followed by Staphylococcus aureus (28,8%) and rhinovirus (28,4%). Respiratory syncytial virus (RSV) was detected only among children under 5 years old in August and September while coronavirus was present in all age groups, during the months of October and December.

CONCLUSION

This pilot study revealed a diversity of pathogens over the time and across all age groups, highlighting the need for further exploration. A pathogen community approach including both virus and bacteria at a larger scale becomes crucial for a better understanding of transmission dynamics at population level in order to help shape ARI control strategies.

摘要

背景

急性呼吸道感染(ARI)是塞内加尔许多环境中发热疾病的常见原因。由于缺乏适当的诊断工具,这些感染通常根据经验进行管理。这种情况可能导致发热疾病管理不善或抗生素滥用。此外,关于通常导致这些 ARI 的病原体谱的数据有限。本研究旨在探索塞内加尔农村地区急性呼吸道感染患者中的病原体群落。

方法

横断面研究于 2015 年 8 月至 12 月进行。在提供知情同意后,在 Keur Socé 卫生站就诊并出现急性呼吸道感染迹象的儿童和成年患者参加了这项研究。合格的参与者采用连续抽样法招募。采集鼻和咽拭子进行病原体检测。使用设计用于识别包括病毒和细菌在内的 21 种病原体的多重 PCR 处理样品。

结果

250 名患者参加了这项研究。样本阳性率评估为 95.2%(238/250)。肺炎链球菌是主要病原体(74%),存在于所有月份和所有年龄组中,其次是金黄色葡萄球菌(28.8%)和鼻病毒(28.4%)。呼吸道合胞病毒(RSV)仅在 8 月和 9 月的 5 岁以下儿童中检测到,而冠状病毒存在于所有年龄组中,在 10 月和 12 月期间。

结论

这项初步研究揭示了随着时间的推移和所有年龄组中病原体的多样性,突出了进一步探索的必要性。在更大范围内包括病毒和细菌在内的病原体群落方法对于更好地了解人群水平的传播动态至关重要,以便帮助制定 ARI 控制策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9acb/6131886/9c8647cd99f4/12879_2018_3362_Fig1_HTML.jpg

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