Etiology and Incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007-2010

  • Feikin D
  • Njenga M
  • Bigogo G
 et al. 
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Abstract

BACKGROUND: Few comprehensive data exist on disease incidence for specific etiologies of acute respiratory illness (ARI) in older children and adults in Africa. METHODOLOGY/PRINCIPAL FINDINGS: From March 1, 2007, to February 28, 2010, among a surveillance population of 21,420 persons >5 years old in rural western Kenya, we collected blood for culture and malaria smears, nasopharyngeal and oropharyngeal swabs for quantitative real-time PCR for ten viruses and three atypical bacteria, and urine for pneumococcal antigen testing on outpatients and inpatients meeting a ARI case definition (cough or difficulty breathing or chest pain and temperature >38.0 degreeC or oxygen saturation 5 years old (adjusted annual incidence 12.0 per 100 person-years), influenza A virus was the most common virus (22% overall; 11% inpatients, 27% outpatients) and Streptococcus pneumoniae was the most common bacteria (16% overall; 23% inpatients, 14% outpatients), yielding annual incidences of 2.6 and 1.7 episodes per 100 person-years, respectively. Influenza A virus, influenza B virus, respiratory syncytial virus (RSV) and human metapneumovirus were more prevalent in swabs among cases (22%, 6%, 8% and 5%, respectively) than controls. Adenovirus, parainfluenza viruses, rhinovirus/enterovirus, parechovirus, and Mycoplasma pneumoniae were not more prevalent among cases than controls. Pneumococcus and non-typhi Salmonella were more prevalent among HIV-infected adults, but prevalence of viruses was similar among HIV-infected and HIV-negative individuals. ARI incidence was highest during peak malaria season. CONCLUSIONS/SIGNIFICANCE: Vaccination against influenza and pneumococcus (by potential herd immunity from childhood vaccination or of HIV-infected adults) might prevent much of the substantial ARI incidence among persons >5 years old in similar rural African settings.

Author-supplied keywords

  • *Influenza A virus/ip [Isolation & Purification]
  • *Influenza, Human/ep [Epidemiology]
  • *Influenza, Human/et [Etiology]
  • *Respiratory Tract Infections/ep [Epidemiology]
  • *Respiratory Tract Infections/et [Etiology]
  • *Streptococcus pneumoniae/ip [Isolation & Purifica
  • Adolescent
  • Adult
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Influenza, Human/vi [Virology]
  • Kenya/ep [Epidemiology]
  • Male
  • Middle Aged
  • Population Surveillance
  • Prevalence
  • Respiratory Tract Infections/mi [Microbiology]
  • Rural Population

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  • PMID: 22937071

Authors

  • Daniel R Feikin

  • M Kariuki Njenga

  • Godfrey Bigogo

  • Barrack Aura

  • George Aol

  • Allan Audi

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