High Prevalence of Viral Infections Among Hospitalized Pneumonia Patients in Equatorial Sarawak, Malaysia

Toh, Teck-Hock; Hii, King-Ching; Fieldhouse, Jane K; Ting, Jakie; Berita, Antoinette; Nguyen, Tham Thi; Wong, See-Chang; Wong, Toh-Mee; Lim, Wei-Honn; Ha, Siaw-Jing; Lau, Chuet-Zou; Kong, Sing-Ling; Bailey, Emily S; Warkentien, Tyler E; Husain, Tupur S; Gray, Gregory C

The study had a number of limitations. Although the study offered the questionnaire in 3 different languages to ensure comprehension, it is possible that questions about behavior were not accurately understood. After the first 2 months of study, patients were supposedly recruited on 2 randomly selected days of the week; however, we cannot eliminate the possibility that MOs selected the sicker patients in the ward for this study. In addition, this study was limited to hospitalized patients and therefore excluded milder cases of pneumonia not requiring hospitalization. Although we used rigorously validated real-time PCR assays as the gold standard for virus detection, the study was limited to a panel of 13 viruses and we therefore likely missed other important pathogens present in specimens, including human metapneumovirus, rhinovirus, and bacteria. Specifically, this study would benefit from an understanding of the prevalence of bacterial mono-or coinfections within the patient population. This study provides data on 1 year of pneumonia admissions at 2 district government hospitals in Sarawak, Malaysia; however, prevalence of the viruses investigated can vary between years.