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Etiology, Seasonality, and Clinical Characteristics of Viral Respiratory Infections in Rural Honduran Children

Schlaudecker, Elizabeth P., M.D.

Abstract Details

2011, MPH, University of Cincinnati, Medicine: Public Health - Leadership, Management and Policy.
Background: Limited data are available in Honduras describing the etiology and seasonality of childhood acute respiratory infections (ARIs), and better data may lead to improved therapeutic and preventative strategies. Objective: We conducted a prospective sentinel clinic surveillance study to determine the viral etiology of ARIs in rural Honduran children less than 5 years of age to characterize the spectrum and seasonality of viruses associated with acute respiratory infections. Methods: We gathered data on age, sex, medical history, symptoms, demographics, geographic setting, vital signs, and physical exam findings. Nasopharyngeal samples were obtained via flocked swab and shipped to the U.S. in both universal transport medium (UTM) on dry ice and PrimeStore® nucleic acid stabilizing buffer at room temperature. Samples were tested for 14 respiratory viruses using the Luminex Diagnostics polymerase chain reaction (PCR) respiratory viral panel (RVP ID-TagTM). Results: 267 samples were collected from February 2010 – March 2011; 13.9% were positive for influenza, 7.9% for human metapneumovirus, 7.5% for respiratory syncytial virus (RSV), 7.1% for parainfluenza and 2.2% for adenovirus. At least one virus was identified in 194 (72.7%) cases, of which 16 (6.0%) were co-infections. Influenza rose from 1.8% of isolates in February through June to 25.7% of isolates in July through October. No cases of influenza were identified from November 2010 through February 2011. Influenza was present for 5 out of 12 months, and influenza correlated with monthly rainfall in millimeters (R² = 0.2857). Including all tested respiratory viruses except enterovirus/rhinovirus, the presence of a respiratory virus positively correlated with average monthly precipitation (R² = 0.2863). UTM and PrimeStore® results for influenza correlated well (K = 0.767, p<0.0001). Conclusions: These unique results suggest that the spectrum of viruses in rural Honduran children is similar to those found in the U.S., though the seasonality is tropical. This region of rural Honduras demonstrated one large peak in influenza positivity prior to the peak in the U.S., while monthly influenza results from the Pan American Health Organization (PAHO) obtained in the capital of Honduras demonstrated two clear peaks. Influenza and respiratory viruses in general correlated with average monthly rainfall. PrimeStore® at room temperature is an effective shipping method for subsequent isolation of influenza as compared to UTM on dry ice. Further research is needed to determine the best methods of prevention and treatment of these viral respiratory infections.
William Mase, PhD (Committee Chair)
Charles Schubert, MD (Committee Member)
Mark Steinhoff, MD (Committee Member)
56 p.

Recommended Citations

Citations

  • Schlaudecker, M.D., E. P. (2011). Etiology, Seasonality, and Clinical Characteristics of Viral Respiratory Infections in Rural Honduran Children [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307125774

    APA Style (7th edition)

  • Schlaudecker, M.D., Elizabeth. Etiology, Seasonality, and Clinical Characteristics of Viral Respiratory Infections in Rural Honduran Children. 2011. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307125774.

    MLA Style (8th edition)

  • Schlaudecker, M.D., Elizabeth. "Etiology, Seasonality, and Clinical Characteristics of Viral Respiratory Infections in Rural Honduran Children." Master's thesis, University of Cincinnati, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307125774

    Chicago Manual of Style (17th edition)