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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Influenza Virus | Research

Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar

Authors: Kazuhiro Kamata, Khin Nyo Thein, Lasham Di Ja, Nay Chi Win, Su Mon Kyaw Win, Yuko Suzuki, Ai Ito, Hidekazu Osada, Irina Chon, Wint Wint Phyu, Yuta Aizawa, Tatsuki Ikuse, Tomomi Ota, Yadanar Kyaw, Htay Htay Tin, Yugo Shobugawa, Hisami Watanabe, Reiko Saito, Akihiko Saitoh

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Background

Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major cause of ALRI. In Myanmar, ALRI is associated with high morbidity and mortality in children, and detailed information on ALRI is currently lacking.

Methods

This prospective study investigated the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children aged 1 month to 12 years at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The sample size was set to 300 patients for each year. Two nasopharyngeal swabs were obtained for the patients with suspected viral ALRI; one for rapid tests for influenza and respiratory syncytial virus (RSV), and the other for real-time PCR for the 16 ALRI-causing viruses. Pneumococcal colonization rates were also investigated using real-time PCR. Clinical information was extracted from the medical records, and enrolled patients were categorised by age and severity for comparison.

Results

Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were enrolled in this study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty in breathing (73%), while the most common signs of ALRI were tachypnoea (78%) and chest indrawing (67%). A total of 16 viruses were detected in 502 of 570 patients’ samples (88%), with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected in 221 of 570 samples (37%) collected from 570 patients. Severe ALRI was diagnosed in 107 of 570 patients (19%), and RSV B and human rhinovirus were commonly detected. The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected, and stunting and lack of immunization were frequently observed in such cases. Additionally, 45% (259/570) of the patients had pneumococcal colonization.

Conclusions

Viral ALRI in hospitalised children with a median of 8 months has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected from nasopharyngeal swabs, while influenza virus and RSV were the most frequently associated with fatal cases.
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Metadata
Title
Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar
Authors
Kazuhiro Kamata
Khin Nyo Thein
Lasham Di Ja
Nay Chi Win
Su Mon Kyaw Win
Yuko Suzuki
Ai Ito
Hidekazu Osada
Irina Chon
Wint Wint Phyu
Yuta Aizawa
Tatsuki Ikuse
Tomomi Ota
Yadanar Kyaw
Htay Htay Tin
Yugo Shobugawa
Hisami Watanabe
Reiko Saito
Akihiko Saitoh
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07342-1

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