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Respiratory viral and bacterial pathogen dynamics among healthcare workers and community members in Ethiopia: A prospective cohort study

Year: 2026

Type: article

Abstract: OBJECTIVES: Respiratory infections cause substantial morbidity, with high burden in low-resource settings where surveillance is limited. We characterized symptomatic respiratory event burden and etiologic patterns in Ethiopia. METHODS: A prospective cohort of urban community members and healthcare workers (HCWs) at Jimma University Medical Center, Ethiopia, was followed from November 2022 to December 2024. Nasopharyngeal swabs from symptomatic episodes were tested for viral and bacterial pathogens using multiplex and quantitative PCR. Person-period logistic regression assessed factors for symptomatic episodes; generalized linear mixed models identified factors for pathogen detection. RESULTS: Among 500 participants, 163 (32.6%) experienced 237 symptomatic episodes (2.08 per 100 person-months; 95% CI: 1.81-2.34). The Tsedey (September-November) season (aOR: 1.98; P < 0.001) and HIV positivity (aOR: 1.62; P = 0.044) were independently associated with symptomatic episodes. Viral pathogens were detected in 50.4% (116/230), mainly HRV, adenovirus, and SARS-CoV-2, while bacterial nucleic acid, predominantly Streptococcus pneumoniae and Haemophilis influenzae, was detected by nasopharyngeal PCR in 60.5% (135/223) of tested episodes. The Tsedey season was associated with viral (aOR: 3.58; P = 0.004) and bacterial detection (aOR: 3.96; P = 0.002). HCWs had higher odds of viral detection (aOR: 2.29; P = 0.023). CONCLUSION: Pathogens were frequently detected in symptomatic individuals. Seasonality drove respiratory episodes and viral/bacterial detection. HIV increased symptom risk; HCW status increased viral but not bacterial detection. Findings support seasonal surveillance and targeted interventions.

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2026.109157