Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
Central Public Health Laboratories, Ministry of Health and Population, Cairo, Egypt.
Sci Rep. 2023 Dec 9;13(1):21860. doi: 10.1038/s41598-023-48814-x.
In late 2022, severe acute respiratory infections (SARI) surveillance reported an abrupt increase in non-COVID-19 infections among children after three years of drastic reductions. Signals of increased absenteeism due to respiratory symptoms among primary and preparatory school children were detected by Event-Based Surveillance. We conducted a hospital-based survey of children who were admitted with SARI to identify the causative pathogen(s) and estimate the burden of infection. A survey was conducted among children < 16 years in 21 referral hospitals in the three governorates with the highest SARI rates. Patients' demographics, clinical symptoms, and severity were collected from medical records using a line list. Patients were swabbed and tested for a panel of 33 respiratory pathogens by RT-PCR at the Central Laboratory in Cairo. Descriptive data analysis was performed for demographic data. Patients' characteristics were compared by causative agents' clinical picture and severity using Chi2 with a p < 0.05 significance. Overall, 317 patients were enrolled, 58.3% were ≤ 1 year of age, 61.5% were males. Of 229 (72.7%) of positively tested patients, viruses caused 92.1% including RSV 63.8%, Rhinovirus 10.0%, Influenza 9.2%, Adenovirus 5.2%, and 1.3% co-infected with two viruses. Bacteria caused 3.5% of cases and 4.4% had mixed viral-bacterial infections. Rhinovirus was the most common cause of death among children with SARI, followed by RSV (8.7% and 1.4%), whereas influenza and Adenovirus did not result in any deaths. Patients with viral-bacterial infections are more likely to be admitted to ICU and die at the hospital than bacterial or viral infections (60% and 20% vs. 31.8% and 1.9% vs. 12.5% and 12.5%, p < 0.001). Viruses particularly RSV are the leading cause of SARI causing significant health problem among children < 16 years in Egypt. Bacterial on top of viral infection can worsen disease courses and outcomes. Studies are required to estimate the SARI burden accurately among Egyptian children and a comprehensive approach tailored to Egypt is necessary to reduce its burden.
2022 年末，急性呼吸道感染（SARI）监测报告称，经过三年的大幅减少后，儿童中 COVID-19 以外的感染病例突然增加。通过基于事件的监测，发现了小学和预备学校儿童因呼吸道症状而缺勤增加的信号。我们对因 SARI 住院的儿童进行了一项医院为基础的调查，以确定致病病原体并估计感染负担。在三个 SARI 发病率最高的省份的 21 家转诊医院中，对年龄在 16 岁以下的儿童进行了调查。使用列表从病历中收集患者的人口统计学、临床症状和严重程度。患者在开罗的中央实验室用 RT-PCR 对一组 33 种呼吸道病原体进行了检测。对人口统计学数据进行了描述性数据分析。根据致病因素的临床表现和严重程度，对患者特征进行了比较，采用卡方检验，p 值<0.05。总体而言，共纳入 317 名患者，58.3%为≤1 岁，61.5%为男性。229 名（72.7%）检测呈阳性的患者中，病毒引起 92.1%，包括 RSV 63.8%、鼻病毒 10.0%、流感 9.2%、腺病毒 5.2%和 1.3%两种病毒混合感染。细菌引起 3.5%的病例，4.4%有混合病毒-细菌感染。鼻病毒是导致 SARI 儿童死亡的最常见原因，其次是 RSV（8.7%和 1.4%），而流感和腺病毒没有导致任何死亡。与细菌或病毒感染相比，病毒-细菌感染的患者更有可能被收治重症监护病房和在医院死亡（60%和 20%比 31.8%和 1.9%比 12.5%和 12.5%，p<0.001）。病毒特别是 RSV 是导致埃及<16 岁儿童 SARI 的主要原因，给儿童健康带来重大问题。在病毒感染的基础上，细菌感染会使病情恶化，导致不良后果。需要进行研究以准确估计埃及儿童的 SARI 负担，并制定适合埃及的综合方法以减轻其负担。
