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Respiratory Viral Detection in Children Hospitalized With Pneumonia During Periods of Major Population Disruptions in
Shrijana Shrestha1, Sanjeev Bijukchhe1,2, Brian Wahl3,4
1Patan Academy of Health Sciences, Patan Hospital, Satdobato Road, 44700 Lalitpur, Nepal.
Insights
Respiratory viruses were detected in 72.5% of children with pneumonia. Viral detection increased significantly after the 2015 earthquake and subsequent fuel crisis, highlighting environmental impacts on pediatric respiratory infections.
Area of Science:
- Pediatric Infectious Diseases
- Molecular Diagnostics
- Epidemiology
Background:
- Pneumonia is a leading cause of childhood illness globally.
- This study investigated respiratory viral infections in children with pneumonia in Nepal from 2014-2018.
- The study period encompassed significant environmental and public health events, including an earthquake, vaccine introduction, and fuel shortage.
Observation:
- Nasopharyngeal swabs from 1343 children diagnosed with pneumonia were analyzed using a multiplex panel.
- Genetic material from 23 respiratory pathogens was tested.
- The median age of children with detected viral nucleic acids was significantly lower than in those without.
Findings:
- At least one respiratory virus was identified in 974 (72.5%) of the children.
- Respiratory Syncytial Virus (RSV), rhino/enterovirus, and parainfluenza were the most common viruses detected.
- A notable 1.88-fold increase in viral detection was observed in the year following the 2015 earthquake and fuel crisis.
Implications:
- The findings underscore the critical role of viral diagnostics in managing pediatric pneumonia.
- Public health strategies addressing environmental factors during disasters may mitigate respiratory infections in children.
- Further research into the interplay between environmental conditions and viral epidemiology is warranted.
Background:
Respiratory viruses commonly cause pneumonia in children. We aimed to identify respiratory viral nucleic acids in the nasopharynx of children admitted with pneumonia from 2014 to 2018, a period including a major earthquake (April 2015), pneumococcal conjugate vaccine (PCV10) introduction (August 2015), and a fuel shortage (October 2015 to March 2016).
Methods:
Children 2 months to 14 years admitted to Patan Hospital between March 2014 and February 2018 with a clinical diagnosis of pneumonia had nasopharyngeal swabs collected and tested with a multiplex panel for the presence of genetic material from 23 respiratory pathogens.
Results:
Of 1343 children with pneumonia, 974 (72.5%) had the nucleic acids of at least one respiratory virus in the nasopharynx. The median age of children with any viral genetic material detected was lower than those without (1.18, IQR: 0.59-2.39 years; vs 2.01 years, IQR: 0.81-4.34 years; P < .001). Commonly detected viral nucleic acids included those of respiratory syncytial virus (RSV) (21.0%), rhino/enterovirus (30.8%), and parainfluenza (7.4%). The odds of detecting any respiratory viral genetic material in children with pneumonia increased by 1.88 (95% confidence interval: 1.15, 3.06) in the year after the earthquake, when there were several aftershocks and a fuel crisis, relative to other periods and accounting for other potential confounding factors.
Conclusions:
These findings highlight the importance of viral diagnostics in pediatric pneumonia and suggest that public health measures addressing environmental conditions during disasters might help reduce respiratory infections.
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