Respiratory Syncytial Virus among hospitalised children in an era of Pneumococcal Vaccination
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Background: Acute respiratory tract infection (ARTI) is the leading cause of paediatric hospitalisations in India, especially ≤5 years of age.
Methods: Study conducted from 2019-2020 in Chennai (South India) on hospitalised children with ARTI, between 1 to 60 months of age. Nasopharyngeal (NP) samples (n=256) were tested by multiplex real-time PCR for respiratory pathogens including RSV and Streptococcus pneumoniae (SPN
Results: Viral and RSV positivity was 81% and 48.6% respectively. Viral co-infections were evidenced in about a quarter of RSV positive children, common being human parechovirus (HPeV) and RSV co-infection. Fever, high respiratory rate, severe respiratory distress, cough, difficulty in breathing, chest indrawing and bronchiolitis were significant clinical RSV findings. Pneumococcal Conjugate Vaccine (PCV) uptake was high (89.4%) in subjects. 31.87% of vaccinated children had NP pneumococcal carriage. 75% of those with SPN carriage had viral ARTI while 35.6% were RSV positive. Statistically significant association observed between NP carriage and viral ARTI (p<0.05). Antibiotic usage in suspected RSV versus non-RSV viral ARTI was 68% and 93.8% respectively.
Conclusion: Significant burden of RSV in children < 5years seen with interplay of SPN
carriage and viral infections.
Keywords: RSV, Viral agent, Paediatric ARTI, RT-PCR, Nasopharyngeal Swab
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