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Viral Etiology, Clinical Features and Antibiotic Use in Children <5 Years of Age in the Gambia Presenting with Influenza-like Illness

Lookup NU author(s): Dr Stephen Owens


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© 2020 Lippincott Williams and Wilkins. All rights reserved.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.

Publication metadata

Author(s): Jarju S, Greenhalgh K, Wathuo M, Banda M, Camara B, Mendy S, Sowe G, Dahaba PO, Jammeh L, Bajinka Y, Sanneh P, Jallow E, Yates A, Lindsey BB, Owens S, Kampmann B, Forrest K, Clarke E, De Silva T

Publication type: Article

Publication status: Published

Journal: Pediatric Infectious Disease Journal

Year: 2020

Volume: 39

Issue: 10

Pages: 925-930

Print publication date: 01/10/2020

Acceptance date: 28/04/2020

ISSN (print): 0891-3668

ISSN (electronic): 1532-0987

Publisher: Lippincott Williams and Wilkins


DOI: 10.1097/INF.0000000000002761

PubMed id: 32453201


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