Etiology and Incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007-2010.
Etiology and Incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007-2010.
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DOI：
10.1371/journal.pone.0043656
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Breiman RF
中科院分区：
文献类型：
--
作者：
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
关于非洲大龄儿童和成人中急性呼吸道疾病(ARI)的特定病因的发病率，几乎没有全面的数据。从2007年3月1日到2010年2月28日，在肯尼亚西部农村地区21,420名5岁儿童的监测人群中，我们采集了用于培养和疟疾涂片的血液、鼻咽和口咽拭子以进行10种病毒和3种非典型细菌的实时定量聚合酶链式反应，以及对符合ARI病例定义(咳嗽或呼吸困难或胸痛和体温；38.0°C或血氧饱和度90%或住院)的门诊患者和住院患者进行肺炎球菌抗原测试。我们还收集了无症状对照的拭子，在Logistic回归中，我们根据年龄、季节和HIV状况进行了调整，计算了病原体归因率。我们根据病原体计算发病率，调整了ARI和病原体可归因组分的求医因素。在3,406名5岁ARI患者中(调整后的年发病率为每100人年发病率12.0)，甲型流感病毒是最常见的病毒(总发病率为22%；住院患者为11%，门诊患者为27%)，肺炎链球菌是最常见的细菌(总发病率为16%；住院患者为23%，门诊患者为14%)，年发病率分别为每100人年2.6次和1.7次。病例拭子中甲型流感病毒、乙型流感病毒、呼吸道合胞病毒和人偏肺病毒的感染率分别为22%、6%、8%和5%。腺病毒、副流感病毒、鼻病毒/肠道病毒、副流感病毒和肺炎支原体在病例组中的患病率并不高于对照组。肺炎球菌和非伤寒沙门氏菌在感染艾滋病毒的成年人中更为普遍，但在艾滋病毒感染和艾滋病毒阴性的个人中，病毒的流行率相似。ARI发病率在疟疾高峰期最高。接种流感和肺炎球菌疫苗(通过儿童接种疫苗或感染艾滋病毒的成人的潜在群体免疫力)可以在类似的非洲农村环境中防止5岁人群中大量ARI的发生。
Few comprehensive data exist on disease incidence for specific etiologies of acute respiratory illness (ARI) in older children and adults in Africa. 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°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. 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.
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影响因子：
3.7
作者：
Fry, Alicia M.;Lu, Xiaoyan;Erdman, Dean
通讯作者：
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影响因子：
6.4
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影响因子：
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作者：
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DOI：
10.4269/ajtmh.2005.73.1151
发表时间：
2005-12-01
影响因子：
3.3
作者：
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通讯作者：
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