Viral pathogens and clinical manifestations associated with acute lower respiratory tract infections in children of the Sudan.

BACKGROUND

Incomplete knowledge regarding the viral agents causing respiratory infections in children living in developing countries impedes diagnosis and management of patients.

OBJECTIVES

To assess the role of viral pathogens in Sudanese children presenting with acute lower respiratory tract infections (ALRI).

STUDY

DESIGN

The study population consisted of patients presenting with ALRI at the Children's Emergency Hospital in Khartoum during 2 periods (December 1987 to April 1988 and September 1990 to March 1991). Identification of viral infections was based an antigen detection by immunofluorescence and enzyme-linked immunosorbent assay (ELISA) on nasopharyngeal secretions and/or serology.

RESULTS

After exclusion of children with measles, 102 and 111 children, respectively, were prospectively enrolled in the study during the 2 periods. Their ages ranged between one mouth and 14 years (mean 2.0 years). Radiologic pulmonary infiltrations were detected in 135 (66%) of the 206 patients who had chest radiographs, whereas 7 (3%) showed lobar pneumonia. The case fatality rate was 2.3%. Of 83 virus infections detected, 79 were in children < years and consisted mainly of respiratory syncytial virus (RSV, 28%), followed by parainfluenza (7%), adenovirus (5%) and influenza A (2%). Infiltrates on radiographs were significantly less often found in virus-infected cases than in ALRI-cases with negative virus tests.

CONCLUSIONS

RSV predominantly infected young infants (</= 3 months) compared with those who were 5 years or older (28% and 13%, respectively). A tendency for respiratory viruses to be more prevalent was seen during the cooler months (January and February). There were no significant differences in clinical features between virus-positive cases and others. The panorama of viral infections proved to be the same as in other developing countries.