Sheikh Jarju1, Khristianne Greenhalgh2, Miriam Wathuo3, Mustapha Banda4, Bakary Camara1, Simon Mendy4, Ghata Sowe1, Pa Omar Dahaba1, Lamin Jammeh1, Yaya Bajinka1, Papis Sanneh1, Edrissa Jallow1, Alexandra Yates5, Benjamin B Lindsey1, Stephen Owens2, Beate Kampmann1,6, Karen Forrest4, Ed Clarke1, Thushan de Silva1,7. 1. From the Department of Vaccines & Immunity Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia. 2. Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. 3. Department of Statistics. 4. Department of Clinical Services, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia. 5. Sheffield Teaching Hospitals, NHS Foundation, Royal Hallamshire Hospital, Sheffield. 6. The Vaccine Centre, London School of Hygiene and Tropical Medicine, London. 7. The Florey Institute and Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, Sheffield, United Kingdom.
Abstract
BACKGROUND: Knowledge regarding the prevalence, clinical features and etiology of pediatric influenza-like illness (ILI) remains limited in African settings. Furthermore, it is likely that many children presenting with ILI receive antibiotics unnecessarily. More data are required to develop antimicrobial stewardship practice and guide effective vaccine strategies. We undertook a 1-year prospective study of ILI in the Gambia. METHODS: Children <5 years of age presenting with ILI from March 2018 to March 2019 were recruited. Clinical and antibiotic prescribing data were collected. Nasopharyngeal swabs were collected and analyzed for 12 respiratory viruses using a multiplex polymerase chain reaction. RESULTS: From a total of 735 ILI episodes, 530 (72.1%) nasopharyngeal swabs were positive for ≥1 virus. Of these, 36.7% were positive for rhinovirus, 14.7% for respiratory syncytial virus, 8.4% for influenza and 7.2% for human metapneumovirus. Compared with children <6 months of age, influenza was more common in 6- to 23-month-old children [odd ratio (OR): 5.68; 95% confidence interval (CI): 1.72-18.76; P = 0.004]. Respiratory syncytial virus and human metapneumovirus were associated with low peripheral oxygen saturations (OR: 2.13; 95% CI: 1.23-3.69; P = 0.007; and OR: 2.44; 95% CI: 1.13-5.27; P = 0.023, respectively). Antibiotics were prescribed in 78.3% of all ILI cases. CONCLUSIONS: A broad range of viruses are responsible for pediatric ILI in the Gambia. Refined treatment guidelines, improved diagnostic capacity and vaccines to prevent respiratory viruses will all play a role in reducing antimicrobial use for these cases.
BACKGROUND: Knowledge regarding the prevalence, clinical features and etiology of pediatric influenza-like illness (ILI) remains limited in African settings. Furthermore, it is likely that many children presenting with ILI receive antibiotics unnecessarily. More data are required to develop antimicrobial stewardship practice and guide effective vaccine strategies. We undertook a 1-year prospective study of ILI in the Gambia. METHODS:Children <5 years of age presenting with ILI from March 2018 to March 2019 were recruited. Clinical and antibiotic prescribing data were collected. Nasopharyngeal swabs were collected and analyzed for 12 respiratory viruses using a multiplex polymerase chain reaction. RESULTS: From a total of 735 ILI episodes, 530 (72.1%) nasopharyngeal swabs were positive for ≥1 virus. Of these, 36.7% were positive for rhinovirus, 14.7% for respiratory syncytial virus, 8.4% for influenza and 7.2% for human metapneumovirus. Compared with children <6 months of age, influenza was more common in 6- to 23-month-old children [odd ratio (OR): 5.68; 95% confidence interval (CI): 1.72-18.76; P = 0.004]. Respiratory syncytial virus and human metapneumovirus were associated with low peripheral oxygen saturations (OR: 2.13; 95% CI: 1.23-3.69; P = 0.007; and OR: 2.44; 95% CI: 1.13-5.27; P = 0.023, respectively). Antibiotics were prescribed in 78.3% of all ILI cases. CONCLUSIONS: A broad range of viruses are responsible for pediatric ILI in the Gambia. Refined treatment guidelines, improved diagnostic capacity and vaccines to prevent respiratory viruses will all play a role in reducing antimicrobial use for these cases.
Authors: André G Costa-Martins; Karim Mane; Benjamin B Lindsey; Rodrigo L T Ogava; Ícaro Castro; Ya Jankey Jagne; Hadijatou J Sallah; Edwin P Armitage; Sheikh Jarju; Bankole Ahadzie; Rebecca Ellis-Watson; John S Tregoning; Colin D Bingle; Debby Bogaert; Ed Clarke; Jose Ordovas-Montanes; David Jeffries; Beate Kampmann; Helder I Nakaya; Thushan I de Silva Journal: Cell Rep Med Date: 2021-12-09
Authors: Chikondi Peno; Edwin P Armitage; Melanie Clerc; Carlos Balcazar Lopez; Ya Jankey Jagne; Sainabou Drammeh; Sheikh Jarju; Hadijatou Sallah; Elina Senghore; Benjamin B Lindsey; Janko Camara; Sulayman Bah; Nuredin I Mohammed; David H Dockrell; Beate Kampmann; Ed Clarke; Debby Bogaert; Thushan I de Silva Journal: Lancet Microbe Date: 2021-12