Background: Acute respiratory tract infection (ARTI) is one of the most common acute illnesses of childhood. Mostly encountered viral etiology of ARTI in children under 5 years are respiratory syncytial virus (RSV), parainfluenza types 1, 2 and 3 (PIV), adenovirus (AV), influenza virus types A and B, coronavirus (CoV), human Boca virus (hBoV) and human metapeumo virus. (hMPV) This study was conducted to identify the viral burden in hospitalized children with ARTIs to map the occurrence of these viruses with local seasonality.
Methods & Materials: Nasopharyngeal aspirates (NPA) of inward patients (1 month - 5 years) with ARTI were collected in Teaching Hospital, Gampola (THG) and Teaching Hospital, Anuradhapura (THA) from March 2013 - August 2014. Following screening of NPA with indirect immunofluorescence assay (IFA) specific viral aetiology was detected by a direct immunofluorescence assay (DFA). IFA negative hundred NPA were tested for hMPV, hBoV and CoV. Viral seasonality and the overall viral burden were evaluated and the descriptive statistics was expressed using measures of central tendency.
Results: Out of 443 and 418 NPAs tested, RSV was detected 94 children (59.96%) in THG and 85 children (51.51%) in THA. In both cohorts RSV was detected throughout the year. In the dry zone, the peak viral incidence was noted from May-July in 2013 and 2014. In the wet zone two peaks were observed: December-January in 2013 (major peak) and in April in 2013 and 2014 (minor peak). Period prevalence of RSV ARTI in THG was 4.7% and in THA was 4.25%. The RSV incidence at THG and THA was 31.3 and 28 /100000 person years. The hMPV distribution was similar to that of RSV.
Conclusion: Knowledge of seasonality of the occurrence of viral aetiologies in children with ARTI is important to implement early preventive measures, such as vaccination for influenza A, use of respiratory precautions and health education. Identifying the viral aetiology by proper virological diagnosis will reduce the empirical use of antibiotics and thus will contribute to reduce the cost and to prevent the emergence of anti-microbial resistance.