Peer-reviewed article
Detection of viral pathogens associated with acute lower respiratory infection in children in the Eastern Highlands Province of Papua New Guinea: a matched case-control study
Sarah Javati, Debbie Kisa, Jacinta Kono, Amanda L. S. Lang, Rebecca L. Ford et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looked at which viruses are linked to serious lung infections (acute lower respiratory infection) in children under 5 in the Eastern Highlands Province of Papua New Guinea. Researchers compared nose and throat samples from 251 children with moderate or severe pneumonia and 251 healthy matched children from the community, collected in 2013–16. Viruses were found in 63.3% of sick children and 32.7% of healthy ones. The authors estimate that respiratory viruses caused at least 39.7% of these infections, with respiratory syncytial virus (HRSV) a key cause. They call for targeted interventions and continued monitoring of the viruses involved.
Key points
- Acute lower respiratory infection is the most common reason for childhood hospitalisation and death in Papua New Guinea.
- One or more respiratory viruses were found in 159 cases (63.3%) and 82 controls (32.7%).
- HRSV was detected in 21.8% of cases and 2.0% of controls; HPIV3 in 16.2% and 2.5%.
- Rhinovirus was the most common virus in both cases (23.1%) and controls (19.5%), so it did not clearly separate sick from healthy children.
- Respiratory viruses were estimated to be responsible for at least 39.7% (95% CI: 28.2–49.4%) of cases.
Limitations
Only the abstract is available, so the study's methods and weaknesses cannot be assessed in detail. The study covers one province, and it does not evaluate any intervention, so it cannot say what prevention or treatment would work.
Abstract
Introduction In Papua New Guinea, acute lower respiratory infection (ALRI) is the most common reason for childhood hospitalisation and death. Recent changes in epidemiology, diagnostic approaches and vaccine policy warrant re-examination of the aetiology of ALRI. Methods A matched case-control study was performed using nasopharyngeal samples collected from a prospective study recruiting children < 5 years of age with moderate/severe pneumonia (cases) and community controls (2013–16). Respiratory viruses and Bordetella pertussis detection was undertaken using an in-house multiplex real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) assay and the frequency of pathogen detection reported. Using multivariate logistic regression models, the population-attributable fraction was estimated. Results From the original sample cohort, 251 ALRI cases and 251 healthy matched controls were assessed. The median age was 12 months. One or more respiratory viruses were identified in 159 cases (63.3%) and 82 controls (32.7%). Rhinovirus was most frequently detected in both cases (23.1%) and controls (19.5%), followed by respiratory syncytial virus (HRSV; 21.8% and 2.0% respectively) and parainfluenza virus type 3 (HPIV3; 16.2% and 2.5% respectively). Co-infections were frequently detected. Significant differences in detection between cases and controls were observed for HRSV, influenza A, HPIV1, HPIV3, and seasonal human coronavirus types HCoV-NL63 and HCoV-229E. We estimated that respiratory viruses were responsible for at least 39.7% (95% CI: 28.2–49.4%) of ALRI. Discussion Respiratory viruses are a major contributor to ALRI in children < 5 years of age in this population, with HRSV representing a key pathogen. This underscores the need for targeted intervention strategies and ongoing surveillance of viral aetiology.