Viral and Bacterial Etiologies of Acute Respiratory Infections Among Children Under 5 Years in Senegal

Assane, Dieng; Makhtar, Camara; Abdoulaye, Diop; Amary, Fall; Djibril, Boiro; Amadou, Diop; Niokhor, Diouf Jean Baptiste; Amadou, Diop; Cheikh, Loucoubar; Ndongo, Dia; Mbayame, Niang; Lamine, Fall; Bouh, Boye Cheikh Saad

Respiratory tract infections (RTIs) such as acute otitis media, sinusitis, bronchitis, and community-acquired pneumonia are a leading cause of infectious disease-related morbidity, hospitalization, and mortality among children worldwide, particularly in low-income countries. 1 According to World Health Organization (WHO), the prevalence of hospitalized children under 5 years with acute respiratory infections (ARIs) is estimated to be 20% and 90% of those were due to pneumonia. 2 In addition, the number of childhood deaths annually related to ARIs is very important and is estimated between 1.9 and 2.2 million, and 70% of the deaths took place in Africa and Southeast Asia which are the most. 1, 3 Bacteria and viruses have been reported as the main causes of ARIs. In children under 5 years, ARIs are caused mainly due to viruses; respiratory syncytial viruses (RSVs), parainfluenza viruses, influenza virus A and B, and human metapneumovirus (hMPV) are the most common viruses isolated. 4, 5 However, primary infections with viral pathogens can predispose to secondary bacterial infections, and the most frequently isolated bacteria in ARIs include Streptococcus pneumonia and Haemophilus influenzae. 6 These bacteria were increasingly resistant to the most commonly used antibiotics for ARI treatment, 7 leading to increase in mortality rates, hospital durations, and health care-associated costs. 8 In resource-limited countries, bacteria have been the main cause of ARIs. This could be explained by the inaccessibility of molecular diagnostic tools thus leading to inadequate antibiotics prescription and consequently contributed to a rapid increase in antimicrobial resistance among bacteria causing RTIs. 9, 10 In Senegal, few studies on viral and bacterial etiologies of RTIs are available in pediatric settings. Respiratory tract infections are mainly empirically treated with antibiotics on a simple suspicion of bacterial infection. Indeed, this could be one of the major causes of high morbidity and mortality rates.