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Assessing Respiratory Immune Responses to Haemophilus Influenzae
Published on: June 29, 2021
Hospital-Based Investigation of Acute Respiratory Infections in Children Under Five: Epidemiology, Seasonality, and
Baijayantimala Mishra1, Diksha Mohapatra1, Sailendra Panda1
1Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, IND.
Insights
Human rhinovirus and Haemophilus influenzae are the main causes of acute respiratory infections in children under five in Eastern India. This highlights the need for targeted surveillance and vaccination strategies to reduce childhood illness.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Virology
- Bacteriology
Background:
- Acute respiratory infections (ARIs) are a major cause of illness and death in young children, particularly in resource-limited regions.
- Understanding the specific pathogens, their seasonal patterns, and co-infection rates is crucial for effective management and prevention of ARIs.
Purpose of the Study:
- To investigate the common viral and bacterial pathogens causing ARIs in children under five years old in Eastern India.
- To analyze the seasonal distribution and co-infection patterns of these respiratory pathogens.
- To correlate specific pathogen types with the severity of respiratory illness (ARI vs. severe ARI).
Main Methods:
- A hospital-based observational study was conducted from January to December 2024.
- 209 nasopharyngeal swabs, throat swabs, or bronchoalveolar lavage samples were collected from children under five presenting with ARI/SARI at a tertiary care center.
- Multiplex polymerase chain reaction (PCR) was employed to detect a broad range of viral and bacterial respiratory pathogens.
Main Results:
- Viral pathogens were identified in 59.8% of cases, with human rhinovirus (HRV) and respiratory syncytial virus (RSV) being the most prevalent.
- Bacterial pathogens were detected in 45.45% of samples, predominantly *Haemophilus influenzae* and *Klebsiella pneumoniae*.
- Co-infections were observed, with HRV-RSV being common among viral co-infections and *Streptococcus pneumoniae* and *H. influenzae* among bacterial co-infections. Viral infections peaked post-monsoon, while bacterial infections peaked during monsoon.
Conclusions:
- Human rhinovirus and *Haemophilus influenzae* are identified as the primary causative agents of ARIs in this pediatric population.
- The findings emphasize the necessity for region-specific epidemiological surveillance of respiratory pathogens.
- Improved diagnostics and targeted vaccination strategies are recommended to reduce the burden of ARIs in young children.
Background:
Acute respiratory infections (ARIs) remain a leading cause of childhood morbidity and mortality in low-resource settings. This hospital-based observational study investigated the etiology, seasonal trends, and co-infections of respiratory pathogens using the multiplex polymerase chain reaction (PCR) panel among children under five from Eastern India.
Study Design:
From January to December 2024, 209 samples (nasopharyngeal swabs/throat swabs or bronchoalveolar lavage) were collected from children under five who visited a tertiary healthcare center at Bhubaneswar, Odisha, India, with ARI/severe ARI (SARI). Multiplex PCR was used to identify the pathogens. All the data were recorded in a pre-designed case record form and analyzed using appropriate statistical tests.
Result:
Overall, 59.8% (125/209) tested positive for viral pathogens, predominantly human rhinovirus (HRV, 21.05%) and respiratory syncytial virus (RSV, 16.26%). Bacterial pathogens were detected in 45.45% (95/209), primarily Haemophilus influenzae (11%) and Klebsiella pneumoniae (7.65%). Viral co-infections occurred in 6.69% (14/209), with HRV-RSV being the most common, while bacterial co-infections (8.61%) frequently involved Streptococcus pneumoniae and H. influenzae. Seasonal peaks for viral infections occurred post-monsoon (October), whereas bacterial infections peaked during monsoon (September). ARI cases showed higher odds of bacterial etiology (OR 1.04, P = 0.87), whereas SARI cases showed higher odds of viral etiology (OR 0.65, P = 0.04).
Conclusion:
The findings underscore HRV and H. influenzae as dominant agents, highlighting the need for region-specific surveillance, improved diagnostics, and targeted vaccination strategies to mitigate ARI burden in children under five.
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