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Pathogens Causing Respiratory Tract Infections in Children Less Than 5 Years of Age in Senegal
Rebecca B Knobbe1,2, Abdallah Diallo3, Amary Fall4
1Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal.
Insights
Influenza viruses A and B, respiratory syncytial virus (RSV), and Streptococcus pneumoniae are key causes of acute respiratory infections in young children in Senegal. Further research into antibiotic prescribing is recommended.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Public health in low- and middle-income countries
Background:
- Acute respiratory tract infections (ARTIs) are a leading cause of child mortality globally.
- Pathogen prevalence in ARTIs is dynamic, influenced by factors like hygiene, vaccination, and antibiotic resistance.
- Data on current respiratory pathogens in children, especially in low- and middle-income countries, is limited.
Purpose of the Study:
- To identify the specific respiratory pathogens responsible for ARTIs in children under five years old.
- To investigate the prevalence of these pathogens in a sub-urban primary care setting in Senegal.
Main Methods:
- A case-control study was conducted in September-October 2018.
- Oropharyngeal swabs were collected from children with fever and respiratory symptoms (cases) and vaccinated children (controls).
- Viral identification used polymerase chain reaction (PCR) for 21 viruses; bacterial identification used culture. Associations were analyzed using multivariate regression.
Main Results:
- 90.1% of cases and 53.7% of controls had detectable microorganisms (P < .001).
- Influenza A (including H1N1), Influenza B, Respiratory Syncytial Virus (RSV), and Streptococcus pneumoniae were significantly associated with ARTIs.
- Coinfections were common (49.5% of cases), with 31.7% diagnosed with pneumonia, often treated with antibiotics (90.2%).
Conclusions:
- Influenza viruses A and B, RSV, and S. pneumoniae are primary etiological agents of ARTIs in children under five in this Senegalese primary care setting.
- The findings highlight the need to understand and potentially optimize antibiotic prescription practices in similar regions.
Introduction:
While acute respiratory tract infections are the main cause of paediatric mortality and morbidity worldwide, pathogen patterns shift due to factors such as hygiene, vaccinations, and antibiotic resistance. Knowledge about current cause of respiratory infections is lacking, particularly in low- and middle-income countries. The aim of this study was to identity the various respiratory pathogens causing acute respiratory tract infections in children below 5 years of age visiting a sub-urban primary care clinic in Senegal.
Methods:
A case-control study was performed in September and October 2018. Oropharyngeal swabs were collected from cases; infants with fever and respiratory symptoms, and controls; children involved in the vaccination programme. Viral identification was conducted by polymerase chain reaction for 21 different viruses; bacteria were identified by culture studies. Associations between microorganisms, acute respiratory infection and severity of disease were calculated by multivariate regression adjusting for confounders such as age, sex, and living area.
Results:
Overall, 102 cases and 96 controls were included. Microorganisms were detected in 90.1% of cases and 53.7% of controls (P < .001). Influenza virus A (including H1N1), influenza virus B, respiratory syncytial virus (RSV), and Streptococcus pneumoniae were independently associated with acute respiratory tract infections. Co-detection of two or more pathogens was present in 49.5% of cases; 31.7% of cases had a pneumonia and 90.2% was treated with antibiotics.
Conclusions:
This case-control study in a primary care setting in sub-Saharan Africa found influenza virus A and B, RSV, and S pneumoniae to be the main causes of acute respiratory tract infections in children below 5 years of age. We recommend evaluation of antibiotics prescription behaviour in this setting.
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