Weary Taylor E, Pappas Tressa, Tusiime Patrick, Tuhaise Shamilah, Ross Elizabeth, Gern James E, Goldberg Tony L
Department of Pathobiological Sciences, University of Wisconsin School of Veterinary Medicine, Madison, WI, United States.
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Front Pediatr. 2024 May 2;12:1379131. doi: 10.3389/fped.2024.1379131. eCollection 2024.
Respiratory illness is the most common childhood disease globally, especially in developing countries. Previous studies have detected viruses in approximately 70-80% of respiratory illnesses.
In a prospective cohort study of 234 young children (ages 3-11 years) and 30 adults (ages 22-51 years) in rural Western Uganda sampled monthly from May 2019 to August 2021, only 24.2% of nasopharyngeal swabs collected during symptomatic disease had viruses detectable by multiplex PCR diagnostics and metagenomic sequencing. In the remaining 75.8% of swabs from symptomatic participants, we measured detection rates of respiratory bacteria and by quantitative PCR.
100% of children tested positive for at least one bacterial species. Detection rates were 87.2%, 96.8%, and 77.6% in children and 10.0%, 36.7%, and 13.3% for adults for and , respectively. In children, 20.8% and 70.4% were coinfected with two and three pathogens, respectively, and in adults 6.7% were coinfected with three pathogens but none were coinfected with two. Detection of any of the three pathogens was not associated with season or respiratory symptoms severity, although parsing detection status by symptoms was challenged by children experiencing symptoms in 80.3% of monthly samplings, whereas adults only reported symptoms 26.6% of the time. Pathobiont colonization in children in Western Uganda was significantly more frequent than in children living in high-income countries, including in a study of age-matched US children that utilized identical diagnostic methods. Detection rates were, however, comparable to rates in children living in other Sub-Saharan African countries.
Overall, our results demonstrate that nonviral colds contribute significantly to respiratory disease burden among children in rural Uganda and that high rates of respiratory pathobiont colonization may play a role. These conclusions have implications for respiratory health interventions in the area, such as increasing childhood immunization rates and decreasing air pollutant exposure.
呼吸道疾病是全球最常见的儿童疾病，在发展中国家尤为如此。以往研究在约70%-80%的呼吸道疾病中检测到病毒。
在2019年5月至2021年8月期间对乌干达西部农村地区的234名幼儿（3-11岁）和30名成年人（22-51岁）进行的一项前瞻性队列研究中，在有症状疾病期间采集的鼻咽拭子中，只有24.2%可通过多重PCR诊断和宏基因组测序检测到病毒。在有症状参与者的其余75.8%的拭子中，我们通过定量PCR测量了呼吸道细菌的检出率。
100%的儿童至少有一种细菌检测呈阳性。儿童中、和的检出率分别为87.2%、96.8%和77.6%，成人为10.0%、36.7%和13.3%。在儿童中，分别有20.8%和70.4%感染了两种和三种病原体，在成人中，6.7%感染了三种病原体，但无人感染两种病原体。三种病原体中任何一种的检测与季节或呼吸道症状严重程度均无关联，尽管按症状分析检测状况受到挑战，因为80.3%的月度采样中有症状的儿童出现症状，而成年人仅26.6%的时间报告有症状。乌干达西部儿童的致病共生菌定植明显比高收入国家的儿童更频繁，包括一项对采用相同诊断方法的年龄匹配美国儿童的研究。然而，检出率与撒哈拉以南非洲其他国家儿童的检出率相当。
总体而言，我们的结果表明，非病毒性感冒对乌干达农村儿童的呼吸道疾病负担有显著影响，呼吸道致病共生菌的高定植率可能起了一定作用。这些结论对该地区的呼吸道健康干预措施有影响，如提高儿童免疫接种率和减少空气污染物暴露。
