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Acute Respiratory Infections in Ghanaian Children: Epidemiology, Antimicrobial Resistance, and Prevention Strategies
Sabastine Eugene Arthur1,2, Jessica Eyeson1, Aaron Appiah Kubi1
1Medical and Scientific Research Centre, University of Ghana Medical Centre, Legon, Accra GA-337-6980, Ghana.
Insights
Acute respiratory infections (ARIs) in Ghanaian children are influenced by viruses, bacteria, and social factors. The COVID-19 era brought shifts in pathogen patterns and new interventions, highlighting the need for integrated control strategies to reduce child mortality.
Area of Science:
- Pediatric Infectious Diseases
- Global Child Health
- Public Health Surveillance
Background:
- Acute respiratory infections (ARIs) are a major cause of child morbidity and mortality in sub-Saharan Africa, with Ghana being severely impacted.
- Pre-COVID-19 (2010-2019) ARI etiology in Ghana was dominated by viruses (RSV, rhinoviruses, influenza) and bacteria (Streptococcus pneumoniae, Haemophilus influenzae), influenced by undernutrition and indoor air pollution.
- The COVID-19 pandemic era (2020-2025) has seen significant shifts in pathogen seasonality, oxygen delivery systems, and genomic surveillance for SARS-CoV-2.
Purpose of the Study:
- To review recent data on ARI etiology, clinical burden, and antimicrobial resistance (AMR) in Ghana.
- To analyze changes in ARI patterns and interventions from the pre-pandemic to the post-pandemic period.
- To identify research priorities and policy recommendations for national ARI control efforts.
Main Methods:
- Review of recent data on ARI etiology, clinical burden, and antimicrobial resistance (AMR) in Ghana.
- Analysis of trends spanning the pre-COVID-19 (2010-2019) and post-pandemic (2020-2025) eras.
- Synthesis of information on social determinants, pathogen shifts, new interventions (e.g., RSV vaccination, monoclonal antibodies), and surveillance.
Main Results:
- Viral infections (RSV, rhinoviruses, influenza) and bacterial pathogens (S. pneumoniae, H. influenzae) were primary drivers pre-pandemic, exacerbated by social determinants.
- The COVID-19 era introduced shifts in pathogen seasonality, scaled oxygen systems, and implemented genomic surveillance for SARS-CoV-2.
- New interventions like maternal RSV vaccination and monoclonal antibody therapies emerged, alongside persistent challenges in implementation and surveillance.
Conclusions:
- Integrated, multisectoral responses are crucial, combining surveillance, antibiotic stewardship, sustainable oxygen systems, and interventions for nutrition and environmental health.
- Addressing simultaneous challenges of pneumonia and hygiene requires coordinated efforts to reduce child mortality.
- Policy recommendations and research priorities are outlined to support national ARI control and achieve Sustainable Development Goals for child health.
Abstract:
Acute respiratory infections (ARIs) remain a common cause of morbidity and mortality in children, especially in sub-Saharan Africa, where countries such as Ghana are severely affected. This review presents recent data on ARI etiology, clinical burden, and antimicrobial resistance (AMR) from Ghana, spanning the pre-COVID-19 era (2010-2019) to the post-pandemic period (2020-2025). Before the COVID-19 pandemic, viral infections, such as respiratory syncytial virus (RSV), rhinoviruses, and influenza viruses, were the major contributors, along with established bacterial pathogens such as Streptococcus pneumoniae and Haemophilus influenzae. Social determinants, including undernutrition and indoor air pollution, also influenced these infections. In the COVID era, we have seen dramatic shifts in pathogen seasonality, the scaling of oxygen delivery systems, and the implementation of genomic surveillance for SARS-CoV-2, as well as new features such as maternal RSV vaccination and monoclonal antibody therapy. Despite its successes in vaccination coverage and health system strengthening, some challenges remain, including fluctuations in implementation and surveillance issues. The simultaneous challenges of pneumonia and hygiene will require integrated, coordinated, multisectoral responses that incorporate surveillance with antibiotic stewardship, sustainable oxygen systems, and interventions for nutrition and environmental health. The review also highlights research priorities and makes policy recommendations well aligned to support national ARI control efforts aimed at reducing child mortality due to ARI and achieving Sustainable Development Goals targets on child health.
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