Acute Respiratory Illness in Rural Haiti

Highlights

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  Top viruses detected in Haitian children are Rhinovirus, Influenza A and Adenovirus.

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  Top bacteria detected in Haitian children are S. pneumoniae and S. aureus.

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  Younger children are more likely to have Influenza A and S. pneumoniae detected.

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  Younger children are more likely to present with fever and diagnosed with pneumonia.

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  These data support early use of Influenza A and S. pneumoniae vaccines in Haiti.

Abstract

Objectives

Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention.

Methods

Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015.

Results

Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3–5 years had more Influenza A (28% vs. 9%, p = 0.002) and Adenovirus detected (14% vs. 3%, p = 0.01). Similarly, S. pneumoniae was greatest in children 3–5 years old (71% 3–5yrs; 58% 6–15 years; 25% 16–20 years; p = 0.008). Children 3–10 years old presented with fever more than children 11–20 years old (22% vs 7%; p = 0.02) and were more often diagnosed with pneumonia (28% vs 4%, p < 0.001).

Conclusions

Younger children had increased fever, pneumonia, and detection of Influenza A and S. pneumoniae. These data support the need for influenza and pneumococcus vaccination in early childhood in Haiti.