PLoS ONE (Jan 2024)

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

  • Michael Owusu,
  • Eric Adu,
  • Lotenna Elsie Kalu,
  • Eugene Martey,
  • Godfred Acheampong,
  • Anthony Enimil,
  • John Adabie Appiah,
  • Augustina Badu-Peprah,
  • Justice Sylverken,
  • Augustina Angelina Sylverken,
  • Samuel Blay Nguah,
  • Emilie Westeel,
  • Stephane Pouzol,
  • Christian Drosten,
  • Yaw Adu-Sarkodie

DOI
https://doi.org/10.1371/journal.pone.0299222
Journal volume & issue
Vol. 19, no. 3
p. e0299222

Abstract

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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 children 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 standard 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 sputum samples. HIV infected children with viral-bacterial co-detection were found to have very severe 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.