Respiratory Pathogen Detection Among Febrile Inpatients in Northern Tanzania, 2016-2019.

BACKGROUND: Febrile illness is a common reason for hospital admission in sub-Saharan Africa, yet the illness etiology often remains unknown. To address these knowledge gaps, we conducted respiratory pathogen testing in a cohort of febrile inpatients in northern Tanzania. METHODS: We enrolled a prospective cohort of febrile pediatric and adult inpatients within 24 hours after admission to 2 hospitals in northern Tanzania. Nasopharyngeal/oropharyngeal specimens were collected for detection of 19 pathogens with polymerase chain reaction. Participants were stratified by age (<10 or and ≥10 years) and categorized into the following 3 groups: severe acute respiratory infection (SARI), non-SARI respiratory illness, or no respiratory illness. RESULTS: Among the 1132 participants enrolled, 930 (82.1%) had nasopharyngeal/oropharyngeal specimens tested. Their median (interquartile range) age was 22.3 (2.1-44.0) years, 432 (46.5%) were female, and 378 (40.7%) had SARIs. We observed 410 pathogen detections in 359 participants (38.6%), in 256 (67.2%) of 381 in the <10-year age group and 103 (18.8%) of 549 in the older group (≥10 years old). Of the 301 pathogen detections among participants <10 years old, the most common were rhinovirus (RV)/enterovirus (EV) (n = 80 [26.6%]), influenza (n = 60 [19.9%]) and adenovirus (n = 45 [15.0%]). Of the 109 pathogen detections in participants ≥10 years old, the most common were RV/EV (n = 41 [37.6%]), influenza (n = 37 [33.9%]), and respiratory syncytial virus (RSV) (n = 6 [5.5%]). Among SARIs, the most common pathogens were influenza (n = 71 [18.8%]), RV/EV (n = 66 [17.5%]), and RSV (n = 37 [9.8%]). CONCLUSIONS: RV/EV, influenza and RSV were commonly detected among febrile inpatients in Tanzania, including in participants with SARIs. These findings have implications for vaccine development and implementation in low- and middle-income countries.

Duke Scholars

Author John Andrew Crump Medicine, Infectious Diseases

Author Deng Madut Medicine, Infectious Diseases

Author Ganga Moorthy Pediatrics, Infectious Diseases

Author Matthew P. Rubach Medicine, Infectious Diseases

Author James Samwel Ngocho Duke Global Health Institute