Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Muluare PO[original query] |
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Etiology and incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007-2010
Feikin DR , Njenga MK , Bigogo G , Aura B , Aol G , Audi A , Jagero G , Muluare PO , Gikunju S , Nderitu L , Balish A , Winchell J , Schneider E , Erdman D , Oberste MS , Katz MA , Breiman RF . PLoS One 2012 7 (8) e43656 BACKGROUND: Few comprehensive data exist on disease incidence for specific etiologies of acute respiratory illness (ARI) in older children and adults in Africa. METHODOLOGY/PRINCIPAL FINDINGS: From March 1, 2007, to February 28, 2010, among a surveillance population of 21,420 persons >5 years old in rural western Kenya, we collected blood for culture and malaria smears, nasopharyngeal and oropharyngeal swabs for quantitative real-time PCR for ten viruses and three atypical bacteria, and urine for pneumococcal antigen testing on outpatients and inpatients meeting a ARI case definition (cough or difficulty breathing or chest pain and temperature >38.0 degrees C or oxygen saturation <90% or hospitalization). We also collected swabs from asymptomatic controls, from which we calculated pathogen-attributable fractions, adjusting for age, season, and HIV-status, in logistic regression. We calculated incidence by pathogen, adjusting for health-seeking for ARI and pathogen-attributable fractions. Among 3,406 ARI patients >5 years old (adjusted annual incidence 12.0 per 100 person-years), influenza A virus was the most common virus (22% overall; 11% inpatients, 27% outpatients) and Streptococcus pneumoniae was the most common bacteria (16% overall; 23% inpatients, 14% outpatients), yielding annual incidences of 2.6 and 1.7 episodes per 100 person-years, respectively. Influenza A virus, influenza B virus, respiratory syncytial virus (RSV) and human metapneumovirus were more prevalent in swabs among cases (22%, 6%, 8% and 5%, respectively) than controls. Adenovirus, parainfluenza viruses, rhinovirus/enterovirus, parechovirus, and Mycoplasma pneumoniae were not more prevalent among cases than controls. Pneumococcus and non-typhi Salmonella were more prevalent among HIV-infected adults, but prevalence of viruses was similar among HIV-infected and HIV-negative individuals. ARI incidence was highest during peak malaria season. CONCLUSIONS/SIGNFICANCE: Vaccination against influenza and pneumococcus (by potential herd immunity from childhood vaccination or of HIV-infected adults) might prevent much of the substantial ARI incidence among persons >5 years old in similar rural African settings. |
Viral and bacterial causes of severe acute respiratory illness among children less than 5 years old in a high malaria prevalence area of western Kenya, 2007-2010
Feikin DR , Njenga MK , Bigogo G , Aura B , Aol G , Audi A , Jagero G , Muluare PO , Gikunju S , Nderitu L , Winchell JM , Schneider E , Erdman DD , Oberste MS , Katz MA , Breiman RF . Pediatr Infect Dis J 2012 32 (1) e14-9 BACKGROUND: Few comprehensive data exist on the etiology of severe acute respiratory illness (SARI) among African children. METHODS: From March 1, 2007, to February 28, 2010, we collected blood for culture and nasopharyngeal and oropharyngeal swabs for real-time quantitative PCR for ten viruses and three atypical bacteria among children <5 years old with SARI, defined as WHO-classified severe or very severe pneumonia or oxygen saturation <90%, who visited a clinic in rural western Kenya. We collected swabs from controls without febrile or respiratory symptoms. We calculated odds ratios (OR) for infection among cases, adjusting for age and season in logistic regression. We calculated SARI incidence, adjusting for healthcare-seeking for SARI in the community. RESULTS: 2,973 SARI cases were identified (54% inpatient, 46% outpatient), yielding an adjusted incidence of 56 cases per 100 person-years. A pathogen was detected in 3.3% of non-contaminated blood cultures; non-typhi Salmonella (1.9%) and Streptococcus pneumoniae (0.7%) predominated. A pathogen was detected in 84% of nasopharyngeal/oropharyngeal specimens, the most common being rhino/enterovirus (50%), respiratory syncytial virus (RSV, 22%), adenovirus (16%) and influenza viruses (8%). Only RSV and influenza viruses were found more commonly among cases than controls (OR 2.9, 95% CI 1.3-6.7 and OR 4.8, 95% CI 1.1-21, respectively). Incidence of RSV, influenza viruses and S. pneumoniae were 7.1, 5.8 and 0.04 cases per 100 person-years, respectively. CONCLUSIONS: Among Kenyan children with SARI, RSV and influenza virus are the most likely viral causes and pneumococcus the most likely bacterial cause. Contemporaneous controls are important for interpreting upper respiratory tract specimens. |
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