Study on Etiology of Viral Lower Respiratory Tract Infections in Children Under 10 Years of Age

Background: Lower respiratory tract infections (LRTI) are an important cause of childhood morbidity and mortality worldwide. Respiratory viruses contribute significantly to cause lower respiratory tract infections in children. The present study will help to highlight the disease burden of LRTI due to viruses and identify the type of virus causing it.

Objectives: To determine the frequency of viral etiological agents in children under 10 years of age with acute lower respiratory tract infections in order to highlight a significant proportion of LRTIs due to viruses and to discourage the use of antibiotics in such cases.

Study Design: Cross- sectional study. Materials and Methods: One hundred and fifty paediatric patients of age less than 10 yrs of both genders who fulfilled the operational definition of LRTI and got admitted were included in the study. Nasopharyngeal aspirates from all those patients were taken from paediatric wards of Combined Military Hospital and Military Hospital, Rawalpindi. Samples were transported in viral transport medium to Virology department, Armed forces Institute of Pathology, Rawalpindi. Paediatric patients with known etiology of LRTI were not included in the study. Real time reverse transcription PCR was done to test for genomic material of the respiratory viruses which included Respiratory syncytial virus (RSV), Parainfluenza virus (1,2,3) and Influenza virus A/B. Results: A total of 150 paediatric patients were consecutively selected from children aged less than 10 years of age with diagnosis of acute lower respiratory tract infection. Out of these 150 children, 95 (63%) were male and 55 (37%) were female. Mean age was 2 years (Range 0-6 years). Parainfluenza virus 3 was detected in 27 children (18% ; 95% CI : 12-24). Respiratory syncytial virus was detected in 27 patients (18% ; 95% CI : 12- 24). Influenza A was present in 15 children (10% ; 95% CI : 5.3-14.7) and Influenza B in 3 children (3% ; 95% CI :.0-4.7%). No virological agent out of the three looked for in the study was found in 78 patients (52% ; 95% CI : 44-60).

Conclusions : This study concludes that viruses are an important cause of LRTIs in children and among them Respiratory Syncytial Virus and Parainfluenza virus type 3 contribute the most in causing acute lower respiratory tract infection (LRTI) in children