Pathogen Clearance and New Respiratory Tract Infections Among Febrile Children in Zanzibar Investigated With Multitargeting Real-Time Polymerase Chain Reaction on Paired Nasopharyngeal Swab Samples. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Elfving, Kristina; Shakely, Deler; Andersson, Maria; Baltzell, Kimberly; Msellem, Mwinyi I.; Björkman, Anders; Mårtensson, Andreas; Petzold, Max; Trollfors, Birger; Lindh, Magnus
• Is Part Of: Pediatric infectious disease journal. Volume 37:Issue 7(2018)
• Publication Date: 2018-07
• Subjects: children -- respiratory tract infection -- fever -- polymerase chain reaction -- pathogen shedding; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000001876
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: New molecular methods have revealed frequent and often polymicrobial respiratory infections in children in low-income settings. It is not known whether presence of multiple pathogens is due to prolonged infections or to frequent exposure. The aim of this study was to analyze short-term pathogen clearance from nasopharynx and the rate of new respiratory tract infections in febrile preschool children. Methods: Children (n = 207) with uncomplicated acute febrile illness 2–59 months of age presenting to a health center in Zanzibar, Tanzania, April–July 2011, were included. Paired nasopharyngeal swab samples, collected at enrolment and after 14 days, were analyzed by multiple real-time polymerase chain reaction for Adenovirus, bocavirus, Bordetella pertussis, Chlamydophila pneumoniae, Coronaviruses, Enterovirus, influenza A and B virus, metapneumovirus, measles virus, Mycoplasma pneumoniae, parainfluenza virus, Parechovirus, respiratory syncytial virus and Rhinovirus . An age-matched and geographically matched healthy control group (n = 166) underwent nasopharyngeal sampling on 1 occasion. Results: At baseline, 157/207 (76%) patients had at least 1 pathogen detected, in total 199 infections. At follow-up (day 14), 162/199 (81%) of these infections were not detected, including >95% of the previously detected infections with Enterovirus, influenza A virus, influenza B virus, metapneumovirus or parainfluenza virus. Still 115 (56%) children were positive for at least 1 pathogen at follow-up, of which 95/115 (83%) were not found at baseline. Detection of influenza B on day 14 was significantly associated with fever during follow-up. Conclusion: The results suggest that children with acute febrile illness in Zanzibar rapidly clear respiratory tract infections but frequently acquire new infections within 14 days. Abstract : Supplemental Digital Content is available in the text.