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Human metapneumovirus prevalence and patterns of subgroup persistence identified through surveillance of pediatric pneumonia hospital admissions in coastal Kenya, 2007–2016

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Oketch, John W., Kamau, Everlyn, Otieno, Grieven P., Otieno, James R., Agoti, Charles N. and Nokes, D. James (2019) Human metapneumovirus prevalence and patterns of subgroup persistence identified through surveillance of pediatric pneumonia hospital admissions in coastal Kenya, 2007–2016. BMC Infectious Diseases, 19 (1). 757. doi:10.1186/s12879-019-4381-9

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Official URL: http://dx.doi.org/10.1186/s12879-019-4381-9

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Abstract

Background
Human metapneumovirus (HMPV) is an important respiratory pathogen that causes seasonal epidemics of acute respiratory illness and contributes significantly to childhood pneumonia. Current knowledge and understanding on its patterns of spread, prevalence and persistence in communities in low resource settings is limited.

Methods
We present findings of a molecular-epidemiological analysis of nasal samples from children < 5 years of age admitted with syndromic pneumonia between 2007 and 2016 to Kilifi County Hospital, coastal Kenya. HMPV infection was detected using real-time RT-PCR and positives sequenced in the fusion (F) and attachment (G) genes followed by phylogenetic analysis. The association between disease severity and HMPV subgroup was assessed using Fisher’s exact test.

Results
Over 10 years, 274/6756 (4.1%) samples screened were HMPV positive. Annual prevalence fluctuated between years ranging 1.2 to 8.7% and lowest in the recent years (2014–2016). HMPV detections were most frequent between October of one year to April of the following year. Genotyping was successful for 205/274 (74.8%) positives revealing clades A2b (41.0%) and A2c (10.7%), and subgroups B1 (23.4%) and B2 (24.9%). The dominance patterns were: clade A2b between 2007 and 11, subgroup B1 between 2012 and 14, and clade A2c in more recent epidemics. Subgroup B2 viruses were present in all the years. Temporal phylogenetic clustering within the subgroups for both local and global sequence data was seen. Subgroups occurring in each epidemic season were comprised of multiple variants. Pneumonia severity did not vary by subgroup (p = 0.264). In both the F and G gene, the sequenced regions were found to be predominantly under purifying selection.

Conclusion
Subgroup patterns from this rural African setting temporally map with global strain distribution, suggesting a well-mixed global virus transmission pool of HMPV. Persistence in the local community is characterized by repeated introductions of HMPV variants from the global pool. The factors underlying the declining prevalence of HMPV in this population should be investigated.

Item Type: Journal Article
Subjects: Q Science > QR Microbiology
R Medicine > RJ Pediatrics
Divisions: Faculty of Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH): Paramyxoviruses, Virus diseases -- Transmission -- Kenya, Children -- Diseases -- Kenya, Pneumonia in children -- Kenya
Journal or Publication Title: BMC Infectious Diseases
Publisher: BioMed Central Ltd.
ISSN: 1471-2334
Official Date: 30 August 2019
Dates:
DateEvent
30 August 2019Published
15 July 2019Accepted
Date of first compliant deposit: 10 September 2019
Volume: 19
Number: 1
Article Number: 757
DOI: 10.1186/s12879-019-4381-9
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
102975Wellcome Trusthttp://dx.doi.org/10.13039/100010269
100542Wellcome Trusthttp://dx.doi.org/10.13039/100010269
084633Wellcome Trusthttp://dx.doi.org/10.13039/100010269
077092Wellcome Trusthttp://dx.doi.org/10.13039/100010269

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