Viral Agents Causing Acute Respiratory Infections in Children under Five: A Study from Eastern India
Identifieur interne : 000441 ( Pmc/Checkpoint ); précédent : 000440; suivant : 000442Viral Agents Causing Acute Respiratory Infections in Children under Five: A Study from Eastern India
Auteurs : Pravakar Mishra [Inde] ; Lipika Nayak [Inde] ; Rashmi Ranjan Das [Inde] ; Bhagirathi Dwibedi [Inde] ; Amitabh Singh [Inde]Source :
- International Journal of Pediatrics [ 1687-9740 ] ; 2016.
Abstract
Url:
DOI: 10.1155/2016/7235482
PubMed: 28018433
PubMed Central: 5149672
Affiliations:
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<author><name sortKey="Nayak, Lipika" sort="Nayak, Lipika" uniqKey="Nayak L" first="Lipika" last="Nayak">Lipika Nayak</name>
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<author><name sortKey="Das, Rashmi Ranjan" sort="Das, Rashmi Ranjan" uniqKey="Das R" first="Rashmi Ranjan" last="Das">Rashmi Ranjan Das</name>
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<author><name sortKey="Dwibedi, Bhagirathi" sort="Dwibedi, Bhagirathi" uniqKey="Dwibedi B" first="Bhagirathi" last="Dwibedi">Bhagirathi Dwibedi</name>
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<author><name sortKey="Singh, Amitabh" sort="Singh, Amitabh" uniqKey="Singh A" first="Amitabh" last="Singh">Amitabh Singh</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Viral Agents Causing Acute Respiratory Infections in Children under Five: A Study from Eastern India</title>
<author><name sortKey="Mishra, Pravakar" sort="Mishra, Pravakar" uniqKey="Mishra P" first="Pravakar" last="Mishra">Pravakar Mishra</name>
<affiliation wicri:level="1"><nlm:aff id="I1">SVP Post Graduate Institute of Paediatrics, SCB Medical College & Hospital, Cuttack 753007, India</nlm:aff>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>SVP Post Graduate Institute of Paediatrics, SCB Medical College & Hospital, Cuttack 753007</wicri:regionArea>
<wicri:noRegion>Cuttack 753007</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nayak, Lipika" sort="Nayak, Lipika" uniqKey="Nayak L" first="Lipika" last="Nayak">Lipika Nayak</name>
<affiliation wicri:level="1"><nlm:aff id="I1">SVP Post Graduate Institute of Paediatrics, SCB Medical College & Hospital, Cuttack 753007, India</nlm:aff>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>SVP Post Graduate Institute of Paediatrics, SCB Medical College & Hospital, Cuttack 753007</wicri:regionArea>
<wicri:noRegion>Cuttack 753007</wicri:noRegion>
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<author><name sortKey="Das, Rashmi Ranjan" sort="Das, Rashmi Ranjan" uniqKey="Das R" first="Rashmi Ranjan" last="Das">Rashmi Ranjan Das</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019, India</nlm:aff>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019</wicri:regionArea>
<wicri:noRegion>Bhubaneswar 751019</wicri:noRegion>
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<author><name sortKey="Dwibedi, Bhagirathi" sort="Dwibedi, Bhagirathi" uniqKey="Dwibedi B" first="Bhagirathi" last="Dwibedi">Bhagirathi Dwibedi</name>
<affiliation wicri:level="1"><nlm:aff id="I3">Regional Medical Research Centre (ICMR), Bhubaneswar 751016, India</nlm:aff>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>Regional Medical Research Centre (ICMR), Bhubaneswar 751016</wicri:regionArea>
<wicri:noRegion>Bhubaneswar 751016</wicri:noRegion>
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<author><name sortKey="Singh, Amitabh" sort="Singh, Amitabh" uniqKey="Singh A" first="Amitabh" last="Singh">Amitabh Singh</name>
<affiliation wicri:level="1"><nlm:aff id="I4">Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi 110031, India</nlm:aff>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi 110031</wicri:regionArea>
<wicri:noRegion>New Delhi 110031</wicri:noRegion>
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<series><title level="j">International Journal of Pediatrics</title>
<idno type="ISSN">1687-9740</idno>
<idno type="eISSN">1687-9759</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><p><italic>Background</italic>
. Acute respiratory infections (ARIs) are important cause of mortality and morbidity in children under five in developing country.<italic> Methods</italic>
. This observational study was conducted over two-year period in a tertiary care teaching hospital of Eastern India. Nasal and throat swabs were collected, transported to the laboratory at 2–8°C in viral transport media, and then processed for detection of viruses using mono/multiplex real-time polymerase chain reaction.<italic> Results</italic>
. A total of 300 children aged 2–60 months with ARIs were included. The most common age group affected with LRI was 2–12 mo and with URI was >12–60 mo. Viruses were detected in 248 cases. In URI, 77 were positive for single virus and 19 were positive for more than one virus; in LRI, 113 were positive for single virus and 12 were positive for more than one virus. The most common viruses isolated from URI cases were rhinovirus and adenovirus. The most common viruses isolated from LRI cases were respiratory syncytial virus and influenza virus. Most cases occurred in the months of January, December, and August.<italic> Conclusion</italic>
. Viruses constitute a significant cause of ARI in children under five. RSV, ADV, RV, and IFV were the most prevalent viruses isolated.</p>
</div>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Pediatr</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Pediatr</journal-id>
<journal-id journal-id-type="publisher-id">IJPEDI</journal-id>
<journal-title-group><journal-title>International Journal of Pediatrics</journal-title>
</journal-title-group>
<issn pub-type="ppub">1687-9740</issn>
<issn pub-type="epub">1687-9759</issn>
<publisher><publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28018433</article-id>
<article-id pub-id-type="pmc">5149672</article-id>
<article-id pub-id-type="doi">10.1155/2016/7235482</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Viral Agents Causing Acute Respiratory Infections in Children under Five: A Study from Eastern India</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Mishra</surname>
<given-names>Pravakar</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nayak</surname>
<given-names>Lipika</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-9587-0508</contrib-id>
<name><surname>Das</surname>
<given-names>Rashmi Ranjan</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dwibedi</surname>
<given-names>Bhagirathi</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Singh</surname>
<given-names>Amitabh</given-names>
</name>
<xref ref-type="aff" rid="I4"><sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
SVP Post Graduate Institute of Paediatrics, SCB Medical College & Hospital, Cuttack 753007, India</aff>
<aff id="I2"><sup>2</sup>
Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019, India</aff>
<aff id="I3"><sup>3</sup>
Regional Medical Research Centre (ICMR), Bhubaneswar 751016, India</aff>
<aff id="I4"><sup>4</sup>
Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi 110031, India</aff>
<author-notes><corresp id="cor1">*Rashmi Ranjan Das: <email>dr_rashmipgi@yahoo.com</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Seng Hock Quak</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>27</day>
<month>11</month>
<year>2016</year>
</pub-date>
<volume>2016</volume>
<elocation-id>7235482</elocation-id>
<history><date date-type="received"><day>20</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="rev-recd"><day>29</day>
<month>10</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>30</day>
<month>10</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2016 Pravakar Mishra et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p><italic>Background</italic>
. Acute respiratory infections (ARIs) are important cause of mortality and morbidity in children under five in developing country.<italic> Methods</italic>
. This observational study was conducted over two-year period in a tertiary care teaching hospital of Eastern India. Nasal and throat swabs were collected, transported to the laboratory at 2–8°C in viral transport media, and then processed for detection of viruses using mono/multiplex real-time polymerase chain reaction.<italic> Results</italic>
. A total of 300 children aged 2–60 months with ARIs were included. The most common age group affected with LRI was 2–12 mo and with URI was >12–60 mo. Viruses were detected in 248 cases. In URI, 77 were positive for single virus and 19 were positive for more than one virus; in LRI, 113 were positive for single virus and 12 were positive for more than one virus. The most common viruses isolated from URI cases were rhinovirus and adenovirus. The most common viruses isolated from LRI cases were respiratory syncytial virus and influenza virus. Most cases occurred in the months of January, December, and August.<italic> Conclusion</italic>
. Viruses constitute a significant cause of ARI in children under five. RSV, ADV, RV, and IFV were the most prevalent viruses isolated.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>Month-wise recruitment of URI and LRI cases.</p>
</caption>
<graphic xlink:href="IJPEDI2016-7235482.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label>
<caption><p>Month-wise recruitment of ARI cases and samples positive for viruses.</p>
</caption>
<graphic xlink:href="IJPEDI2016-7235482.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label>
<caption><p>The distribution of viruses by months of recruitment.</p>
</caption>
<graphic xlink:href="IJPEDI2016-7235482.003"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Isolation of viruses (monoinfection versus coinfection) in children with ARIs.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">Viruses</th>
<th rowspan="2" align="center" colspan="1">Total</th>
<th colspan="3" align="center" rowspan="1">Monoinfection</th>
<th colspan="3" align="center" rowspan="1">Coinfection</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1">2–6 mo</th>
<th align="center" rowspan="1" colspan="1">>6–12 mo</th>
<th align="center" rowspan="1" colspan="1">>12–60 mo</th>
<th align="center" rowspan="1" colspan="1">2–6 mo</th>
<th align="center" rowspan="1" colspan="1">>6–12 mo</th>
<th align="center" rowspan="1" colspan="1">>12–60 mo</th>
</tr>
</thead>
<tbody><tr><td colspan="8" align="center" rowspan="1">Acute URI (percentage) (<italic>N</italic>
= 106)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RSV</td>
<td align="center" rowspan="1" colspan="1">18 (17)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">7 (6.6)</td>
<td align="center" rowspan="1" colspan="1">4 (3.8)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> RSVA</td>
<td align="center" rowspan="1" colspan="1">13 (12.3)</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">5 (4.7)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> RSVB</td>
<td align="center" rowspan="1" colspan="1">5 (4.7)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">ADV</td>
<td align="center" rowspan="1" colspan="1">20 (18.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">7 (6.6)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">8 (7.6)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV</td>
<td align="center" rowspan="1" colspan="1">33 (31.1)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">8 (7.6)</td>
<td align="center" rowspan="1" colspan="1">11 (10.4)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">6 (5.7)</td>
<td align="center" rowspan="1" colspan="1">4 (3.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV</td>
<td align="center" rowspan="1" colspan="1">18 (17)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">4 (3.8)</td>
<td align="center" rowspan="1" colspan="1">6 (5.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">4 (3.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> IFVA</td>
<td align="center" rowspan="1" colspan="1">15 (14.2)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">5 (4.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> IFVB</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">hMPV</td>
<td align="center" rowspan="1" colspan="1">6 (5.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">3 (2.8)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">hBoV</td>
<td align="center" rowspan="1" colspan="1">4 (3.8)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">PIV</td>
<td align="center" rowspan="1" colspan="1">7 (6.6)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV1</td>
<td align="center" rowspan="1" colspan="1">2 (1.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0 (0.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV2</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV3</td>
<td align="center" rowspan="1" colspan="1">5 (4.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">2 (0.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
<td align="center" rowspan="1" colspan="1">1 (0.9)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV4</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">hCoV 43</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">EV</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="center" colspan="8" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td colspan="8" align="center" rowspan="1">Acute LRI (percentage) (<italic>N</italic>
= 142)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RSV</td>
<td align="center" rowspan="1" colspan="1">43 (30.3)</td>
<td align="center" rowspan="1" colspan="1">16 (11.3)</td>
<td align="center" rowspan="1" colspan="1">9 (6.3)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">7 (5.0)</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> RSVA</td>
<td align="center" rowspan="1" colspan="1">17 (12)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> RSVB</td>
<td align="center" rowspan="1" colspan="1">26 (18.3)</td>
<td align="center" rowspan="1" colspan="1">12 (8.5)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">ADV</td>
<td align="center" rowspan="1" colspan="1">19 (13.4)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">7 (5.0)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV</td>
<td align="center" rowspan="1" colspan="1">21 (14.8)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
<td align="center" rowspan="1" colspan="1">7 (5.0)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV</td>
<td align="center" rowspan="1" colspan="1">25 (17.6)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
<td align="center" rowspan="1" colspan="1">8 (5.6)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> IFVA</td>
<td align="center" rowspan="1" colspan="1">17 (12)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">6 (4.2)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> IFVB</td>
<td align="center" rowspan="1" colspan="1">8 (5.6)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">hMPV</td>
<td align="center" rowspan="1" colspan="1">8 (5.6)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">hBoV</td>
<td align="center" rowspan="1" colspan="1">7 (4.9)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">PIV</td>
<td align="center" rowspan="1" colspan="1">15 (10.5)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">4 (2.8)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV1</td>
<td align="center" rowspan="1" colspan="1">5 (3.5)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV2</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV3</td>
<td align="center" rowspan="1" colspan="1">7 (4.9)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> PIV4</td>
<td align="center" rowspan="1" colspan="1">2 (1.4)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">hCoV 43</td>
<td align="center" rowspan="1" colspan="1">3 (2.1)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">EV</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1 (0.7)</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>RSV: respiratory syncytial virus; ADV: adenovirus; RV: rhinovirus; IFV: influenza virus; hMPV: human metapneumovirus; hBoV: human bocavirus; PIV: parainfluenza virus; hCoV 43: human corona virus 43; EV: enterovirus; ARI: acute respiratory infection; URI: upper respiratory infection; LRI: lower respiratory infection.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap-group id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Viral coinfection from both acute URIs and LRIs.</p>
</caption>
<table-wrap id="tab2a" orientation="portrait" position="anchor"><label>(a)</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Acute URI coinfection types </th>
<th align="center" rowspan="1" colspan="1">Number</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">RV + RSV</td>
<td align="center" rowspan="1" colspan="1">9</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + ADV</td>
<td align="center" rowspan="1" colspan="1">7</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV + PIV</td>
<td align="center" rowspan="1" colspan="1">6</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + IFV</td>
<td align="center" rowspan="1" colspan="1">4</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">PIV + RV</td>
<td align="center" rowspan="1" colspan="1">5</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RSV + hBoV</td>
<td align="center" rowspan="1" colspan="1">3</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RSV + hMPV</td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + hMPV + hBoV</td>
<td align="center" rowspan="1" colspan="1">3</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + ADV + RSV</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">PIV + ADV + IFV</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr><td align="center" colspan="2" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Total </italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>41</italic>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2b" orientation="portrait" position="anchor"><label>(b)</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Acute LRI coinfection types</th>
<th align="center" rowspan="1" colspan="1">Number</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">IFV + RV</td>
<td align="center" rowspan="1" colspan="1">10</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">ADV + IFV</td>
<td align="center" rowspan="1" colspan="1">9</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + IFV</td>
<td align="center" rowspan="1" colspan="1">8</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + RSV</td>
<td align="center" rowspan="1" colspan="1">12</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV + RSV</td>
<td align="center" rowspan="1" colspan="1">7</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV + EV</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + hMPV</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">PIV + ADV</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RV + hMPV + ADV</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV + hCoV43 + RSV</td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">RSV + hMPV + ADV</td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">IFV + hCoV43 + RV</td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr><td align="center" colspan="2" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Total</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>56</italic>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</table-wrap-group>
<table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>Clinical and demographic profile of patients with ALRI as per virus isolation status.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Variables </th>
<th align="center" rowspan="1" colspan="1">Virus positive (<italic>n</italic>
= 142)</th>
<th align="center" rowspan="1" colspan="1">Virus negative (<italic>n</italic>
= 32)</th>
<th align="center" rowspan="1" colspan="1">OR (95%CI)</th>
<th align="center" rowspan="1" colspan="1"><italic>p</italic>
value</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Age (median)</td>
<td align="center" rowspan="1" colspan="1">11 mo</td>
<td align="center" rowspan="1" colspan="1">14 mo</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.42</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Male : female</td>
<td align="center" rowspan="1" colspan="1">1.84 : 1</td>
<td align="center" rowspan="1" colspan="1">1.46 : 1</td>
<td align="center" rowspan="1" colspan="1">1.21 (0.54–2.62)</td>
<td align="center" rowspan="1" colspan="1">0.67</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><12 mo</td>
<td align="center" rowspan="1" colspan="1">88</td>
<td align="center" rowspan="1" colspan="1">12</td>
<td align="center" rowspan="1" colspan="1">2.7 (1.24– 6.1)</td>
<td align="center" rowspan="1" colspan="1">0.01<sup><italic>∗</italic>
</sup>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Risk factors</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> ARI in family</td>
<td align="center" rowspan="1" colspan="1">77</td>
<td align="center" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">2.24 (1.06–5.12)</td>
<td align="center" rowspan="1" colspan="1">0.04<sup><italic>∗</italic>
</sup>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Prematurity</td>
<td align="center" rowspan="1" colspan="1">54</td>
<td align="center" rowspan="1" colspan="1">08</td>
<td align="center" rowspan="1" colspan="1">1.86 (0.74–4.41)</td>
<td align="center" rowspan="1" colspan="1">0.16</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Smokers in house</td>
<td align="center" rowspan="1" colspan="1">69</td>
<td align="center" rowspan="1" colspan="1">12</td>
<td align="center" rowspan="1" colspan="1">1.54 (0.68–3.48)</td>
<td align="center" rowspan="1" colspan="1">0.25</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Use of cooking fuel</td>
<td align="center" rowspan="1" colspan="1">81</td>
<td align="center" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">1.48 (0.64–3.32)</td>
<td align="center" rowspan="1" colspan="1">0.32</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Symptoms</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Cough</td>
<td align="center" rowspan="1" colspan="1">140</td>
<td align="center" rowspan="1" colspan="1">31</td>
<td align="center" rowspan="1" colspan="1">2.26 (0.18–25.7)</td>
<td align="center" rowspan="1" colspan="1">0.5</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Fever</td>
<td align="center" rowspan="1" colspan="1">122</td>
<td align="center" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">2.04 (0.76–5.24)</td>
<td align="center" rowspan="1" colspan="1">0.13</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Rhinorrhea</td>
<td align="center" rowspan="1" colspan="1">105</td>
<td align="center" rowspan="1" colspan="1">17</td>
<td align="center" rowspan="1" colspan="1">2.5 (1.14–5.58)</td>
<td align="center" rowspan="1" colspan="1">0.02<sup><italic>∗</italic>
</sup>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Sore throat</td>
<td align="center" rowspan="1" colspan="1">047</td>
<td align="center" rowspan="1" colspan="1">09</td>
<td align="center" rowspan="1" colspan="1">1.28 (0.53–2.95)</td>
<td align="center" rowspan="1" colspan="1">0.58</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Breathing difficulty</td>
<td align="center" rowspan="1" colspan="1">075</td>
<td align="center" rowspan="1" colspan="1">12</td>
<td align="center" rowspan="1" colspan="1">1.83 (0.84–4.11)</td>
<td align="center" rowspan="1" colspan="1">0.12</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Febrile convulsion</td>
<td align="center" rowspan="1" colspan="1">007</td>
<td align="center" rowspan="1" colspan="1">01</td>
<td align="center" rowspan="1" colspan="1">1.6 (0.18–13.56)</td>
<td align="center" rowspan="1" colspan="1">0.66</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Signs</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Grunting</td>
<td align="center" rowspan="1" colspan="1">19</td>
<td align="center" rowspan="1" colspan="1">03</td>
<td align="center" rowspan="1" colspan="1">1.47 (0.42–5.36)</td>
<td align="center" rowspan="1" colspan="1">0.54</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Nasal flaring</td>
<td align="center" rowspan="1" colspan="1">27</td>
<td align="center" rowspan="1" colspan="1">04</td>
<td align="center" rowspan="1" colspan="1">1.64 (0.52–5.04)</td>
<td align="center" rowspan="1" colspan="1">0.39</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Chest indrawing</td>
<td align="center" rowspan="1" colspan="1">57</td>
<td align="center" rowspan="1" colspan="1">08</td>
<td align="center" rowspan="1" colspan="1">2.01 (0.82–4.76)</td>
<td align="center" rowspan="1" colspan="1">0.11</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Stridor</td>
<td align="center" rowspan="1" colspan="1">02</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.48</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Cyanosis</td>
<td align="center" rowspan="1" colspan="1">02</td>
<td align="center" rowspan="1" colspan="1">01</td>
<td align="center" rowspan="1" colspan="1">0.44 (0.02–5.1)</td>
<td align="center" rowspan="1" colspan="1">0.5</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Clinical diagnosis</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Bronchiolitis</td>
<td align="center" rowspan="1" colspan="1">91</td>
<td align="center" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">3.21 (1.42–7.35)</td>
<td align="center" rowspan="1" colspan="1">0.003<sup><italic>∗</italic>
</sup>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Pneumonia</td>
<td align="center" rowspan="1" colspan="1">76</td>
<td align="center" rowspan="1" colspan="1">18</td>
<td align="center" rowspan="1" colspan="1">0.9 (0.38–1.98)</td>
<td align="center" rowspan="1" colspan="1">0.78</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Myocarditis</td>
<td align="center" rowspan="1" colspan="1">02</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">0.48</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p><sup><italic>∗</italic>
</sup>
<italic>p</italic>
value < 0.05; ALRI: acute lower respiratory infection; OR: Odds ratio; 95% CI: 95% confidence interval.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Inde</li>
</country>
</list>
<tree><country name="Inde"><noRegion><name sortKey="Mishra, Pravakar" sort="Mishra, Pravakar" uniqKey="Mishra P" first="Pravakar" last="Mishra">Pravakar Mishra</name>
</noRegion>
<name sortKey="Das, Rashmi Ranjan" sort="Das, Rashmi Ranjan" uniqKey="Das R" first="Rashmi Ranjan" last="Das">Rashmi Ranjan Das</name>
<name sortKey="Dwibedi, Bhagirathi" sort="Dwibedi, Bhagirathi" uniqKey="Dwibedi B" first="Bhagirathi" last="Dwibedi">Bhagirathi Dwibedi</name>
<name sortKey="Nayak, Lipika" sort="Nayak, Lipika" uniqKey="Nayak L" first="Lipika" last="Nayak">Lipika Nayak</name>
<name sortKey="Singh, Amitabh" sort="Singh, Amitabh" uniqKey="Singh A" first="Amitabh" last="Singh">Amitabh Singh</name>
</country>
</tree>
</affiliations>
</record>
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