1
|
Cohen AL, Sahr PK, Treurnicht F, Walaza S, Groome MJ, Kahn K, Dawood H, Variava E, Tempia S, Pretorius M, Moyes J, Olorunju SAS, Malope-Kgokong B, Kuonza L, Wolter N, von Gottberg A, Madhi SA, Venter M, Cohen C. Parainfluenza Virus Infection Among Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Children and Adults Hospitalized for Severe Acute Respiratory Illness in South Africa, 2009-2014. Open Forum Infect Dis 2015; 2:ofv139. [PMID: 26566534 PMCID: PMC4630450 DOI: 10.1093/ofid/ofv139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/16/2015] [Indexed: 11/13/2022] Open
Abstract
Parainfluenza is associated with a significant amount of severe respiratory disease in South Africa, especially among children <5 years of age and individuals that are HIV-infected. Background. Parainfluenza virus (PIV) is a common cause of acute respiratory tract infections, but little is known about PIV infection in children and adults in Africa, especially in settings where human immunodeficiency virus (HIV) prevalence is high. Methods. We conducted active, prospective sentinel surveillance for children and adults hospitalized with severe acute respiratory illness (SARI) from 2009 to 2014 in South Africa. We enrolled controls (outpatients without febrile or respiratory illness) to calculate the attributable fraction for PIV infection. Respiratory specimens were tested by multiplex real-time reverse-transcription polymerase chain reaction assay for parainfluenza types 1, 2, and 3. Results. Of 18 282 SARI cases enrolled, 1188 (6.5%) tested positive for any PIV type: 230 (19.4%) were type 1; 168 (14.1%) were type 2; 762 (64.1%) were type 3; and 28 (2.4%) had coinfection with 2 PIV types. After adjusting for age, HIV serostatus, and respiratory viral coinfection, the attributable fraction for PIV was 65.6% (95% CI [confidence interval], 47.1–77.7); PIV contributed to SARI among HIV-infected and -uninfected children <5 years of age and among individuals infected with PIV types 1 and 3. The observed overall incidence of PIV-associated SARI was 38 (95% CI, 36–39) cases per 100 000 population and was highest in children <1 year of age (925 [95% CI, 864–989] cases per 100 000 population). Compared with persons without HIV, persons with HIV had an increased relative risk of PIV hospitalization (9.4; 95% CI, 8.5–10.3). Conclusions. Parainfluenza virus causes substantial severe respiratory disease in South Africa among children <5 years of age, especially those that are infected with HIV.
Collapse
Affiliation(s)
- Adam L Cohen
- Centers for Disease Control and Prevention , Pretoria , South Africa ; Centers for Disease Control and Prevention , Atlanta, Georgia ; US Public Health Service, Rockville, Maryland
| | - Philip K Sahr
- South African Field Epidemiology Training Program, Johannesburg ; School of Health Systems and Public Health, Faculty of Health Sciences , University of Pretoria
| | - Florette Treurnicht
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg
| | - Sibongile Walaza
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg ; School of Public Health
| | - Michelle J Groome
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences ; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health ; Centre for Global Health Research , Umeå University , Sweden ; INDEPTH Network, Accra , Ghana
| | - Halima Dawood
- Pietermaritzburg Metropolitan Hospital Complex ; University of KwaZulu-Natal , Durban
| | - Ebrahim Variava
- Department of Internal Medicine ; Department of Internal Medicine , Klerksdorp-Tshepong Hospital Complex
| | - Stefano Tempia
- Centers for Disease Control and Prevention , Pretoria , South Africa ; Centers for Disease Control and Prevention , Atlanta, Georgia ; Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg
| | - Marthi Pretorius
- Department of Medical Virology, Zoonoses Research Unit , University of Pretoria ; National Health Laboratory Service, Tshwane Academic Division
| | - Jocelyn Moyes
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg ; School of Public Health
| | | | - Babatyi Malope-Kgokong
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg
| | - Lazarus Kuonza
- South African Field Epidemiology Training Program, Johannesburg
| | - Nicole Wolter
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg ; School of Pathology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Anne von Gottberg
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg ; School of Pathology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Shabir A Madhi
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg ; Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences ; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases
| | - Marietjie Venter
- Centers for Disease Control and Prevention , Pretoria , South Africa ; Department of Medical Virology, Zoonoses Research Unit , University of Pretoria
| | - Cheryl Cohen
- Center for Respiratory Diseases and Meningitis , National Institute for Communicable Diseases , Johannesburg ; School of Public Health
| |
Collapse
|