Adema Irene Wangwa, Kamau Everlyn, Uchi Nyiro Joyce, Otieno Grieven P, Lewa Clement, Munywoki Patrick K, Nokes D James
Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya.
School of Life Sciences and Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, Coventry, CV4 7AL, UK.
Wellcome Open Res. 2020 Sep 24;5:63. doi: 10.12688/wellcomeopenres.15703.2. eCollection 2020.
Respiratory viruses are primary agents of respiratory tract diseases. Knowledge on the types and frequency of respiratory viruses affecting school-children is important in determining the role of schools in transmission in the community and identifying targets for interventions. We conducted a one-year (term-time) surveillance of respiratory viruses in a rural primary school in Kilifi County, coastal Kenya between May 2017 and April 2018. A sample of 60 students with symptoms of ARI were targeted for nasopharyngeal swab (NPS) collection weekly. Swabs were screened for 15 respiratory virus targets using real time PCR diagnostics. Data from respiratory virus surveillance at the local primary healthcare facility was used for comparison. Overall, 469 students aged 2-19 years were followed up for 220 days. A total of 1726 samples were collected from 325 symptomatic students; median age of 7 years (IQR 5-11). At least one virus target was detected in 384 (22%) of the samples with a frequency of 288 (16.7%) for rhinovirus, 47 (2.7%) parainfluenza virus, 35 (2.0%) coronavirus, 15 (0.9%) adenovirus, 11 (0.6%) respiratory syncytial virus (RSV) and 5 (0.3%) influenza virus. The proportion of virus positive samples was higher among lower grades compared to upper grades (25.9% vs 17.5% respectively; χ = 17.2, -value <0.001). Individual virus target frequencies did not differ by age, sex, grade, school term or class size. Rhinovirus was predominant in both the school and outpatient setting. Multiple respiratory viruses circulated in this rural school population. Rhinovirus was dominant in both the school and outpatient setting and RSV was of notably low frequency in the school. The role of school children in transmitting viruses to the household setting is still unclear and further studies linking molecular data to contact patterns between the school children and their households are required.
呼吸道病毒是呼吸道疾病的主要病原体。了解影响学龄儿童的呼吸道病毒类型和频率，对于确定学校在社区传播中的作用以及确定干预目标至关重要。2017年5月至2018年4月期间，我们在肯尼亚沿海基利菲县的一所农村小学对呼吸道病毒进行了为期一年（学期期间）的监测。每周针对60名有急性呼吸道感染（ARI）症状的学生进行鼻咽拭子（NPS）采集。使用实时PCR诊断方法对拭子进行15种呼吸道病毒靶点筛查。当地初级医疗保健机构的呼吸道病毒监测数据用于比较。总体而言，对469名2至19岁的学生进行了220天的随访。从325名有症状的学生中总共采集了1726份样本；中位年龄为7岁（四分位间距5 - 11岁）。在384份（22%）样本中检测到至少一种病毒靶点，其中鼻病毒频率为288份（16.7%），副流感病毒47份（2.7%），冠状病毒35份（2.0%），腺病毒15份（0.9%），呼吸道合胞病毒（RSV）11份（0.6%），流感病毒5份（0.3%）。低年级病毒阳性样本比例高于高年级（分别为25.9%和17.5%；χ² = 17.2，P值<0.001）。单个病毒靶点频率在年龄、性别、年级、学期或班级规模方面无差异。鼻病毒在学校和门诊环境中均占主导地位。多种呼吸道病毒在这一农村学校人群中传播。鼻病毒在学校和门诊环境中均占主导地位，而RSV在学校中的频率显著较低。学龄儿童向家庭环境传播病毒的作用仍不明确，需要进一步开展将分子数据与学龄儿童及其家庭之间的接触模式相联系的研究。
