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Year : 2017  |  Volume : 1  |  Issue : 2  |  Page : 46-51

Viruses and hospitalization for childhood lower respiratory tract infection in Malaysia: A prospective study

1 Department of Paediatrics, University Malaya Medical Centre; University Malaya Paediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia
2 Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
3 Department of Medical Microbiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
4 Department of Medical Microbiology, University Malaya Medical Centre; Tropical Infectious Diseases Research and Education Centre, Kuala Lumpur, Malaysia

Correspondence Address:
Jessie Anne deBruyne
Department of Paediatrics, University Malaya Medical Centre, 50603 Kuala Lumpur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/prcm.prcm_2_17

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Context: Viruses are the main causes of acute lower respiratory tract infections (ALRIs) in childhood and its impact on hospital admission is largely unknown. Aims: The aim of this study is to determine (a) virus detection, (b) risk factors for admission, particularly virus detection, and (c) differential clinical responses to viral infections, in children attending pediatric emergency department (PED) with an ALRI in Malaysia. Subjects and Methods: This prospective study included children ≤2 years who presented to PED between September 1, 2010, and March 6, 2012, with features of lower respiratory tract infection. Nasopharyngeal aspirates (NPAs) were tested using a multiplex polymerase chain reaction (PCR) for 11 respiratory viruses. Results: Two hundred children were recruited in the study. Two-thirds (65.5%) of them were admitted. NPA-PCR was positive in 54% of all patients: 50.4% of those admitted and 60.9% of those discharged. The most common viruses detected were respiratory syncytial virus (RSV) (49.1%), rhinovirus (30.6%), and parainfluenza viruses (12.0%). Five patients had mixed infections. RSV detection was associated with previous history of wheeze (odds ratio, 2.05 [95% confidence interval 1.06, 4.00]). Viruses were detected in all severely ill patients and patients with apnea. Multivariate analysis showed that virus detection was not associated with the need for admission, but female sex, lack of breastfeeding and, attending nursery were associated with hospitalization. Conclusions: Half of the children who presented to the emergency room with ALRI had viruses detected in their NPA. There was no association between virus detection and hospitalization. RSV was associated with history of wheeze. Female gender, lack of breastfeeding, and nursery attendance were associated with hospitalization.

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