Department of Pediatrics, University of Florida, Gainesville, FL, USA; Department of Hematology Oncology, Children's National Medical Center, Washington DC, USA.
Department of Pediatrics, University of Florida, Gainesville, FL, USA.
Int J Infect Dis. 2019 Apr;81:176-183. doi: 10.1016/j.ijid.2019.02.003. Epub 2019 Feb 14.
Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention.
Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015.
Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3-5 years had more Influenza A (28% vs. 9%, p=0.002) and Adenovirus detected (14% vs. 3%, p=0.01). Similarly, S. pneumoniae was greatest in children 3-5 years old (71% 3-5yrs; 58% 6-15 years; 25% 16-20 years; p=0.008). Children 3-10 years old presented with fever more than children 11-20 years old (22% vs 7%; p=0.02) and were more often diagnosed with pneumonia (28% vs 4%, p<0.001).
Younger children had increased fever, pneumonia, and detection of Influenza A and S. pneumoniae. These data support the need for influenza and pneumococcus vaccination in early childhood in Haiti.
急性呼吸道感染(ARI)是发展中国家(包括海地)儿童发病率和死亡率的最常见原因。我们的目的是检测海地农村地区ARI 患儿中发现的病原体,以帮助制定基于证据的治疗和预防指南。
对海地农村地区四所学校的 ARI 学生进行回顾性研究。2013 年 4 月至 2015 年 11 月期间,共采集了 177 份鼻拭子,通过 qPCR 鉴定病毒和/或细菌病原体。
最常见的检测到的病毒是鼻病毒(36%)、甲型流感(16%)和腺病毒(7%),细菌是肺炎链球菌(58%)和金黄色葡萄球菌(28%)。与年龄较大的儿童相比,3-5 岁的儿童中甲型流感(28% 比 9%,p=0.002)和腺病毒(14% 比 3%,p=0.01)的检出率更高。同样,3-5 岁儿童的肺炎链球菌检出率最高(71% 3-5 岁;58% 6-15 岁;25% 16-20 岁;p=0.008)。3-10 岁的儿童发热比 11-20 岁的儿童更常见(22% 比 7%,p=0.02),更常被诊断为肺炎(28% 比 4%,p<0.001)。
年龄较小的儿童发热、肺炎和流感 A 以及肺炎链球菌的检出率更高。这些数据支持海地在儿童早期接种流感和肺炎球菌疫苗的必要性。