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Influenza-like illness is associated with high pneumococcal carriage density in Malawian children.

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Nyazika, Tinashe, Law, Alice, Swarthout, Todd D., Sibale, Lusako, ter Braake, Danielle, French, Neil, Heyderman, Robert S., Everett, Dean, Kadioglu, Aras, Jambo, Kondwani ORCID: https://orcid.org/0000-0002-3195-2210 and Neill, Daniel R. (2020) 'Influenza-like illness is associated with high pneumococcal carriage density in Malawian children.'. Journal of Infection. (In Press)

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Abstract

Background
High pneumococcal carriage density is a risk factor for invasive pneumococcal disease (IPD) and transmission, but factors that increase pneumococcal carriage density are still unclear.

Methods
We undertook a cross-sectional study to evaluate the microbial composition, cytokine levels and pneumococcal carriage densities in samples from children presenting with an influenza-like illness (ILI) and asymptomatic healthy controls (HC).

Results
The proportion of children harbouring viral organisms (Relative risk (RR) 1.4, p=0.0222) or ≥4 microbes at a time (RR 1.9, p<0.0001), was higher in ILI patients than HC. ILI patients had higher IL-8 levels in nasal aspirates than HC (median [IQR], 265.7 [0 – 452.3] vs. 0 [0 – 127.3] pg/ml; p = 0.0154). Having an ILI was associated with higher pneumococcal carriage densities compared to HC (RR 4.2, p<0.0001).

Conclusion
These findings suggest that children with an ILI have an increased propensity for high pneumococcal carriage density. This could in part contribute to increased susceptibility to IPD and transmission in the community.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections
WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 515 Human influenza
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 280 Respiratory system
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.1016/j.jinf.2020.06.079
Depositing User: Stacy Murtagh
Date Deposited: 24 Jul 2020 08:11
Last Modified: 12 Aug 2020 10:51
URI: https://archive.lstmed.ac.uk/id/eprint/15129

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