Armauer Hansen Research Institute, Ministry of Health, Addis Ababa, Ethiopia.
Department of Biomedical Sciences, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Virol J. 2023 Jul 23;20(1):163. doi: 10.1186/s12985-023-02131-x.
Lower respiratory tract infections (LRTIs) are a major cause of morbidity and mortality in children worldwide and disproportionally affect Sub-Saharan Africa. Despite the heaviest burden of LRIs in Ethiopia, to date, no published studies have reported a comprehensive viral etiology of LRTIs among children in Ethiopia. The objective of this study was to determine and estimate the etiological contribution of respiratory viruses to LRTIs in < 5 years children in Ethiopia.
A prospective case-control study was conducted from September 2019 to May 2022 in two major governmental hospitals, St. Paul Hospital Millennium Medical College and ALERT Hospital in Addis Ababa, Ethiopia. Nasopharyngeal/oropharyngeal samples and socio-demographic and clinical information were collected from children under 5 years. A one-step Multiplex real-time PCR (Allplex™ Respiratory Panel Assays 1-3) was done to detect respiratory viruses. STATA software version 17 was used for the data analysis. We computed the odds ratio (OR), the attributable fraction among exposed (AFE) and the population attributable fraction (PAF) to measure the association of the detected viruses with LRTIs.
Overall, 210 LRTIs cases and 210 non-LRTI controls were included in the study. The likelihood of detecting one or more viruses from NP/OP was higher among cases than controls (83.8% vs. 50.3%, p = 0.004). The multivariate logistic regression showed a significantly higher detection rate for RSV A (OR: 14.6, 95% CI 4.1-52.3), RSV B (OR: 8.1, 95% CI 2.3-29.1), influenza A virus (OR: 5.8, 95% CI 1.5-22.9), and PIV 1 (OR: 4.3, 95% CI 1.1-16.4), among cases when compared with controls. The overall AFE and PAF for RSV A were (93.2% and 17.3%), RSV B (87.7% and 10.4%) and Influenza A virus (82.8% and 6.3%), respectively. The mean CT values were significantly lower for only RSV B detected in the case groups as compared with the mean CT values of RSV B detected in the control group (p = 0.01).
RSV, Influenza A and PIV 1 viruses were significantly associated with LRTIs in < 5 years children in Addis Ababa, Ethiopia. Therefore, we underscore the importance of developing prevention strategies for these viruses in Ethiopia and support the importance of developing and introducing an effective vaccine against these viruses.
下呼吸道感染（LRTIs）是全球儿童发病率和死亡率的主要原因，在撒哈拉以南非洲地区的影响尤为严重。尽管埃塞俄比亚的 LRTIs 负担最重，但迄今为止，尚无已发表的研究报告埃塞俄比亚儿童 LRTIs 的综合病毒病因。本研究旨在确定和估计呼吸道病毒对埃塞俄比亚<5 岁儿童 LRTIs 的病因贡献。
这是一项前瞻性病例对照研究，于 2019 年 9 月至 2022 年 5 月在埃塞俄比亚亚的斯亚贝巴的两家主要政府医院圣保禄医院千年医科大学和警报医院进行。从<5 岁的儿童中采集鼻咽/口咽样本以及社会人口统计学和临床信息。使用一步式多重实时 PCR（Allplex™呼吸道面板检测 1-3）检测呼吸道病毒。使用 STATA 软件版本 17 进行数据分析。我们计算了比值比（OR）、暴露者中的归因分数（AFE）和人群归因分数（PAF），以衡量检测到的病毒与 LRTIs 的关联。
总体而言，研究纳入了 210 例 LRTIs 病例和 210 例非 LRTI 对照。与对照组相比，病例组从 NP/OP 检测到一种或多种病毒的可能性更高（83.8%比 50.3%，p=0.004）。多变量逻辑回归显示，RSV A（OR：14.6，95%CI 4.1-52.3）、RSV B（OR：8.1，95%CI 2.3-29.1）、流感 A 病毒（OR：5.8，95%CI 1.5-22.9）和 PIV 1（OR：4.3，95%CI 1.1-16.4）的检测率显著更高。与对照组相比，RSV A、RSV B 和流感 A 病毒的总 AFE 和 PAF 分别为（93.2%和 17.3%）、（87.7%和 10.4%）和（82.8%和 6.3%）。与对照组中 RSV B 的平均 CT 值相比，仅在病例组中检测到的 RSV B 的平均 CT 值显著降低（p=0.01）。
RSV、流感 A 和 PIV 1 病毒与埃塞俄比亚<5 岁儿童的 LRTIs 显著相关。因此，我们强调在埃塞俄比亚制定针对这些病毒的预防策略的重要性，并支持开发和引入针对这些病毒的有效疫苗的重要性。
