Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study

Abstract
Pneumonia is the leading cause of death in children, however, the microbial aetiology of pneumonia is not well elucidated in low- and middle-income countries. Our study was aimed at determining the microbial aetiologies of childhood pneumonia and associated risk factors in HIV and non-HIV infected children. We conducted a case-control study that enrolled chil dren with pneumonia as cases and non-pneumonia as controls from July 2017 to May 2020. Induced sputum and blood samples were investigated for microbial organisms using stan dard microbiological techniques. DNA/RNA was extracted from sputum samples and tested for viral and bacterial agents. Four hundred and four (404) subjects consisting of 231 (57.2%) cases and 173 (42.8%) controls were enrolled. We identified a significant (p =0.011) proportion of viruses in cases (125; 54.1%, 95%CI: 47.4–60.7) than controls (71;33.6%, 95%CI: 33.6–48.8) and these were mostly contributed to by Respiratory Syncytial Virus. Staphylococcus aureus (16; 4.0%), Klebsiella spp. (15, 3.7%) and Streptococcus pneumoniae (8, 2.0%) were the main bacterial agents identified in sputum or induced spu tum samples. HIV infected children with viral-bacterial co-detection were found to have verysevere pneumonia compared to those with only viral or bacterial infection. Indoor cooking (OR = 2.36; 95%CI:1.41–3.96) was found to be associated with pneumonia risk in patients. This study demonstrates the importance of various microbial pathogens, particularly RSV, in contributing to pneumonia in HIV and non-HIV paediatric populations. There is a need to accelerate clinical trials of RSV vaccines in African populations to support improvement of patient care
Description
This article is published by Plos One and is also available at DOI: 10. 17605/OSF.IO/827TG (link: https://osf.io/827tg/).
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Citation
PLoS ONE 19(3): e0299222. https://doi.org/ 10.1371/journal.pone.029922
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