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Respiratory pathogens in a febrile cohort from Tanzania and associated risks for severe disease outcome

Year: 2020

Type: article

Abstract: Background: Febrile illness is a common cause of hospitalization worldwide, but the disease aetiology is often not diagnosed routinely. In northern Tanzania, diagnostics based on blood samples yielded a laboratory-confirmed diagnosis in only 50% of febrile patients. Pathogen detection in respiratory specimens has the potential to improve our understanding of febrile illness aetiologies in tropical climates. Given that reports on respiratory pathogens from sub-Saharan African countries are few and that there is a knowledge gap on febrile illness aetiologies, we sought to describe the prevalence of respiratory pathogens in a cohort of febrile inpatients in northern Tanzania. Methods and materials: Patients of all age groups admitted with febrile illness were recruited from September 2016 through May 2019 at two referral hospitals in Moshi, Tanzania as part of the ‘Investigating febrile Deaths in Tanzania (INDITe)’ study. All participants gave written consent to participate in the study. Naso-pharyngeal swab samples were tested using the Luminex Respiratory Pathogen Panel capable to detect 22 viral and bacterial respiratory pathogens in a multiplex PCR based assay. Results: Pathogens were detected in 329 (35%) of 942 participants. Rhino/enteroviruses were most frequently detected, followed by influenza viruses, Respiratory Syncytial Virus, and adenoviruses. More than one pathogen was detected in 141 (14.9%) of participants. Bacterial pathogens Chlamydia pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae were not detected. Conclusion: Our results indicate that an extensive range of respiratory viruses are present in hospitalized febrile patients in Tanzania and although they might not represent the causative agents of the current febrile episode in all cases, they can be superinfections aggravating the current episode. A high number of coinfection in the sample set further suggests widespread circulation of individual respiratory pathogens.

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2020.09.964