tetano
Editor, Senior Moderator
PLoS One. 2018 Nov 21;13(11):e0205124. doi: 10.1371/journal.pone.0205124. eCollection 2018.
[h=1]Epidemiology of severe acute respiratory infections from hospital-based surveillance in Madagascar, November 2010 to July 2013.[/h] Razanajatovo NH[SUP]1[/SUP], Guillebaud J[SUP]1[/SUP], Harimanana A[SUP]2[/SUP], Rajatonirina S[SUP]2[/SUP], Ratsima EH[SUP]3[/SUP], Andrianirina ZZ[SUP]4[/SUP], Rakotoariniaina H[SUP]4[/SUP], Andriatahina T[SUP]5[/SUP], Orelle A[SUP]1[/SUP], Ratovoson R[SUP]2[/SUP], Irinantenaina J[SUP]2[/SUP], Rakotonanahary DA[SUP]1[/SUP], Ramparany L[SUP]3[/SUP], Randrianirina F[SUP]3[/SUP], Richard V[SUP]2[/SUP], Heraud JM[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Few comprehensive data exist regarding the epidemiology of severe acute respiratory infections (SARI) in low income countries. This study aimed at identifying etiologies and describing clinical features of SARI-associated hospitalization in Madagascar.
[h=4]METHODS:[/h] It is a prospective surveillance of SARI in 2 hospitals for 3 years. Nasopharyngeal swabs, sputum, and blood were collected from SARI patients enrolled and tested for viruses and bacteria. Epidemiological and clinical information were obtained from case report forms.
[h=4]RESULTS:[/h] Overall, 876 patients were enrolled in the study, of which 83.1% (728/876) were tested positive for at least one pathogen. Viral and bacterial infections occurred in 76.1% (667/876) and 35.8% (314/876) of tested samples, respectively. Among all detected viruses, respiratory syncytial virus (RSV) was the most common (37.7%; 348/924) followed by influenza virus A (FLUA, 18.4%; 170/924), rhinovirus (RV, 13.5%; 125/924), and adenovirus (ADV, 8.3%; 77/924). Among bacteria, Streptococcus pneumoniae (S. pneumoniae, 50.3%, 189/370) was the most detected followed by Haemophilus influenzae type b (Hib, 21.4%; 79/370), and Klebsiella (4.6%; 17/370). Other Streptococcus species were found in 8.1% (30/370) of samples. Compared to patients aged less than 5 years, older age groups were significantly less infected with RSV. On the other hand, patients aged more than 64 years (OR = 3.66) were at higher risk to be infected with FLUA, while those aged 15-29 years (OR = 3.22) and 30-64 years (OR = 2.39) were more likely to be infected with FLUB (influenza virus B).
[h=4]CONCLUSION:[/h] The frequency of influenza viruses detected among SARI patients aged 65 years and more highlights the need for health authorities to develop strategies to reduce morbidity amongst at-risk population through vaccine recommendation. Amongst young children, the demonstrated burden of RSV should guide clinicians for a better case management of children. These findings reveal the need to develop point-of-care tests to avoid overuse of antibiotics and to promote vaccine that could reduce drastically the RSV hospitalizations.
PMID: 30462659 DOI: 10.1371/journal.pone.0205124
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[h=1]Epidemiology of severe acute respiratory infections from hospital-based surveillance in Madagascar, November 2010 to July 2013.[/h] Razanajatovo NH[SUP]1[/SUP], Guillebaud J[SUP]1[/SUP], Harimanana A[SUP]2[/SUP], Rajatonirina S[SUP]2[/SUP], Ratsima EH[SUP]3[/SUP], Andrianirina ZZ[SUP]4[/SUP], Rakotoariniaina H[SUP]4[/SUP], Andriatahina T[SUP]5[/SUP], Orelle A[SUP]1[/SUP], Ratovoson R[SUP]2[/SUP], Irinantenaina J[SUP]2[/SUP], Rakotonanahary DA[SUP]1[/SUP], Ramparany L[SUP]3[/SUP], Randrianirina F[SUP]3[/SUP], Richard V[SUP]2[/SUP], Heraud JM[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Few comprehensive data exist regarding the epidemiology of severe acute respiratory infections (SARI) in low income countries. This study aimed at identifying etiologies and describing clinical features of SARI-associated hospitalization in Madagascar.
[h=4]METHODS:[/h] It is a prospective surveillance of SARI in 2 hospitals for 3 years. Nasopharyngeal swabs, sputum, and blood were collected from SARI patients enrolled and tested for viruses and bacteria. Epidemiological and clinical information were obtained from case report forms.
[h=4]RESULTS:[/h] Overall, 876 patients were enrolled in the study, of which 83.1% (728/876) were tested positive for at least one pathogen. Viral and bacterial infections occurred in 76.1% (667/876) and 35.8% (314/876) of tested samples, respectively. Among all detected viruses, respiratory syncytial virus (RSV) was the most common (37.7%; 348/924) followed by influenza virus A (FLUA, 18.4%; 170/924), rhinovirus (RV, 13.5%; 125/924), and adenovirus (ADV, 8.3%; 77/924). Among bacteria, Streptococcus pneumoniae (S. pneumoniae, 50.3%, 189/370) was the most detected followed by Haemophilus influenzae type b (Hib, 21.4%; 79/370), and Klebsiella (4.6%; 17/370). Other Streptococcus species were found in 8.1% (30/370) of samples. Compared to patients aged less than 5 years, older age groups were significantly less infected with RSV. On the other hand, patients aged more than 64 years (OR = 3.66) were at higher risk to be infected with FLUA, while those aged 15-29 years (OR = 3.22) and 30-64 years (OR = 2.39) were more likely to be infected with FLUB (influenza virus B).
[h=4]CONCLUSION:[/h] The frequency of influenza viruses detected among SARI patients aged 65 years and more highlights the need for health authorities to develop strategies to reduce morbidity amongst at-risk population through vaccine recommendation. Amongst young children, the demonstrated burden of RSV should guide clinicians for a better case management of children. These findings reveal the need to develop point-of-care tests to avoid overuse of antibiotics and to promote vaccine that could reduce drastically the RSV hospitalizations.
PMID: 30462659 DOI: 10.1371/journal.pone.0205124
Free full text