Acute bronchiolitis in tropical Africa: A hospital-based perspective in Ibadan, Nigeria
✍ Scribed by Abdul-Wahab B.R. Johnson; Wilson I. Aderele; K. Osinusi; Daniel A. Gbadero; A.H. Fagbami; N.A. Rotowa
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 1006 KB
- Volume
- 22
- Category
- Article
- ISSN
- 8755-6863
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✦ Synopsis
In a 30-month prospective study of severe acute lower respiratory infections in hospitalized pre-school Nigerian children, acute bronchiolitis was diagnosed in 67 cases; 19 (28.4%) and 2 (3.0%) of these had concomitant pneumonia or croup, respectively. The peak prevalence was in the wet (rainy) season (May-October). The male/female (M:F) ratio in infants 5 6 months was 2.9:1, differing significantly from the 1.1:l in older subjects ( P = 0.04). None of the subjects had severe malnutrition. Neither a high fever (2 39"C), nor tachypnea on admission was significantly correlated with co-existing pneumonia. Of the 29 subjects in whom it was possible to explore viral immunofluorescence studies and/or serodiagnosis, we identified 26 viral identifications in 18 (62.1%) cases; 6 (20.7%) had 2 2 viruses. Respiratory syncytial virus was identified in 11 (38.0%) of the 29 cases, and parainfluenza virus (PIV) types 1, 2, and 3 in 10 (34.5%). PIV type 3 accounted for 7 cases, including 3 with bacteremia. Bacterial isolates were made in 9 (21.4%) of 42 blood cultures and in the only lung aspirate; Staphylococcus epidermidis and Staphylococcus aureus accounted for 4 and 3 cases, respectively. Although bacteremia was 2.9 times more common in cases with co-existing pneumonia or croup, the respective frequency of virus-positive cases and that of bacteremia was not significantly different between cases with bronchiolitis alone and those with associated pneumonia or croup. No deaths were recorded, but subjects aged > 6 months had a significantly shorter hospital stay than those < 6 months old ( P = 0.02). Despite the limited sample size, our findings reflect the etiological importance of the paramyxoviruses and the seasonal pattern of bronchiolitis in tropical Africa.