Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Division of Infectious Diseases, Department of Medicine Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Int J Infect Dis. 2021 Jan;102:291-298. doi: 10.1016/j.ijid.2020.10.054. Epub 2020 Oct 27.
The role of respiratory co-infections in modulating disease severity remains understudied in southern Africa, particularly in rural areas. This study was performed to characterize the spectrum of respiratory pathogens in rural southern Zambia and the prognostic impact of co-infections.
Respiratory specimens collected from inpatient and outpatient participants in a viral surveillance program in 2018-2019 were tested for selected viruses and atypical bacteria using the Xpert Xpress Flu/RSV assay and FilmArray Respiratory Panel EZ. Participants were followed for 3-5 weeks to assess their clinical course. Multivariable regression was used to examine the role of co-infections in influencing disease severity.
A respiratory pathogen was detected in 63.2% of samples from 671 participants who presented with influenza-like illness. Common pathogens identified included influenza virus (18.2% of samples), respiratory syncytial virus (RSV) (11.8%), rhinovirus (26.4%), and coronavirus (6.0%). Overall, 6.4% of participants were co-infected with multiple respiratory pathogens. Compared to mono-infections, co-infections were found not to be associated with severe clinical illness either overall (relative risk (RR) 0.72, 95% confidence interval (CI) 0.39-1.32) or specifically with influenza virus (RR 0.80, 95% CI 0.14-4.46) or RSV infections (RR 0.44, 95% CI 0.17-1.11).
Respiratory infections in rural southern Zambia were associated with a wide range of viruses. Respiratory co-infections in this population were not associated with clinical severity.
呼吸道合并感染在调节疾病严重程度方面的作用在南部非洲（尤其是农村地区）仍研究不足。本研究旨在描述赞比亚南部农村地区呼吸道病原体的谱，并评估合并感染的预后影响。
对 2018-2019 年病毒监测计划中住院和门诊患者的呼吸道标本进行了选择病毒和非典型细菌的检测，采用 Xpert Xpress Flu/RSV 检测和 FilmArray 呼吸道Panel EZ。对参与者进行了 3-5 周的随访，以评估其临床病程。多变量回归用于研究合并感染对疾病严重程度的影响。
671 例流感样疾病患者中有 63.2%的样本检测到呼吸道病原体。常见病原体包括流感病毒（18.2%的样本）、呼吸道合胞病毒（RSV）（11.8%）、鼻病毒（26.4%）和冠状病毒（6.0%）。总体而言，6.4%的参与者合并感染了多种呼吸道病原体。与单一感染相比，合并感染与总体严重临床疾病（相对风险（RR）0.72，95%置信区间（CI）0.39-1.32）或流感病毒（RR 0.80，95%CI 0.14-4.46）或 RSV 感染（RR 0.44，95%CI 0.17-1.11）均无相关性。
赞比亚南部农村地区的呼吸道感染与多种病毒有关。在该人群中，呼吸道合并感染与临床严重程度无关。
