Viral and atypical bacterial etiology of acute respiratory infections in children under 5 years old living in a rural tropical area of Madagascar

• Published in: PloS one Vol. 7; no. 8; p. e43666
• Main Authors: Hoffmann, Jonathan, Rabezanahary, Henintsoa, Randriamarotia, Martin, Ratsimbasoa, Arsène, Najjar, Josette, Vernet, Guy, Contamin, Bénédicte, Paranhos-Baccalà, Gláucia
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 17.08.2012; Public Library of Science (PLoS)
• Subjects: Acute Disease; Bacteria; Bacteria - classification; Bacteria - genetics; Bacteria - isolation & purification; Bacterial Infections; Bacterial Infections - complications; Bacterial Infections - epidemiology; Biology; Child health; Child, Preschool; Children; Children & youth; Coinfection; Communities; Community-Acquired Infections; Community-Acquired Infections - epidemiology; Community-Acquired Infections - etiology; Consent; Coronaviridae; Coronaviruses; Cough; Cough - epidemiology; Cough - etiology; Developing countries; Development and progression; Diagnosis; Diagnostic tests; Etiology; Etiology (Medicine); Fever; Fever - epidemiology; Fever - etiology; Hospitalization; Humans; Illnesses; Infections; Influenza; Laboratories; LDCs; Life Sciences; Madagascar; Madagascar - epidemiology; Malaria; Medicine; Mortality; Mycoplasma pneumoniae; Parainfluenza; Paramyxoviridae Infections; Paramyxoviridae Infections - complications; Paramyxoviridae Infections - epidemiology; Pneumonia; Polymerase Chain Reaction; Prevalence; Prospective Studies; Respiratory syncytial virus; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus Infections - complications; Respiratory Syncytial Virus Infections - epidemiology; Respiratory tract; Respiratory tract diseases; Respiratory tract infection; Respiratory Tract Infections; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - etiology; Rhinovirus; Rural areas; Rural Population; Rural Population - statistics & numerical data; Seasons; Tropical Climate; Vector-borne diseases; Viral infections; Virus Diseases; Virus Diseases - complications; Virus Diseases - epidemiology; Viruses; Viruses - classification; Viruses - genetics; Viruses - isolation & purification; Madagascar; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0043666

In Madagascar, very little is known about the etiology and prevalence of acute respiratory infections (ARIs) in a rural tropical area. Recent data are needed to determine the viral and atypical bacterial etiologies in children with defined clinical manifestations of ARIs. During one year, we conducted a prospective study on ARIs in children between 2 to 59 months in the community hospital of Ampasimanjeva, located in the south-east of Madagascar. Respiratory samples were analyzed by multiplex real-time RT-PCR, including 18 viruses and 2 atypical bacteria. The various episodes of ARI were grouped into four clinical manifestations with well-documented diagnosis: "Community Acquired Pneumonia"(CAP, group I), "Other acute lower respiratory infections (Other ALRIs, group II)", "Upper respiratory tract infections with cough (URTIs with cough, group III)"and "Upper respiratory tract infections without cough (URTIs without cough, group IV)". 295 children were included in the study between February 2010 and February 2011. Viruses and/or atypical bacteria respiratory pathogens were detected in 74.6% of samples, the rate of co-infection was 27.3%. Human rhinovirus (HRV; 20.5%), metapneumovirus (HMPV A/B, 13.8%), coronaviruses (HCoV, 12.5%), parainfluenza virus (HPIV, 11.8%) and respiratory syncytial virus A and B (RSV A/B, 11.8%) were the most detected. HRV was predominantly single detected (23.8%) in all the clinical groups while HMPV A/B (23.9%) was mainly related to CAP (group I), HPIV (17.3%) to the "Other ALRIs" (group II), RSV A/B (19.5%) predominated in the group "URTIs with cough" (group III) and Adenovirus (HAdV, 17.8%) was mainly detected in the "without cough" (group IV). This study describes for the first time the etiology of respiratory infections in febrile children under 5 years in a malaria rural area of Madagascar and highlights the role of respiratory viruses in a well clinically defined population of ARIs.