HUMAN METAPNEUMOVIRUS AND RESPIRATORY SYNCYTIAL VIRUSES IN GHANAIAN CHILDREN BELOW FIVE YEARS WITH ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN ACCRA, GHANA

ABSTRACT

Acute lower respiratory tract infection (ALRTI) in children under five years is predominantly cause by Respiratory syncytial virus (RSV) but in recent times Human Metapneumovirus (HMPV) has also been implicated in ALRTI. In Ghana, the few studies on ALRTI have focused on the prevalence of RSV and the viral etiological agents causing acute bronchiolitis, bronchopneumonia and pneumonia. This cross sectional study sought to detect, characterize and genotype respiratory syncytial virus and human metapneumovirus in children less than 5 years old presenting with ALRTIs infection at the Princess Marie Louis Children's Hospital in Accra, Ghana. Nasopharyngeal swabs were collected from September 2015 to November 2016 from 176 hospitalized young children below 5 years old for the detection of the two viral agents. A standardized questionnaire was used to obtain demographic data and medical record. Ribonucleic acid was extracted from the nasopharyngeal swaps using the QIAamp viral RNA kit (QIAGEN, USA) and cDNA syntheses performed by RT-PCR using random hexamer primers. All samples were analyzed using conventional PCR method for genotyping. Positive amplicons for RSV were sequenced, and analyzed for the different genotypes. The results were analyzed using SPSS version 22 and Stata statistical package version 13. RSV and HMPV prevalence among the sampled subjects were 11.4% and 1.7% respectively. Of the RSV positives, 8/176 (4.5%) were RSV-A and 12/176 (6.8%) were RSV-B. The highest prevalence was observed in children less than 12 months old. No co-infection was observed in this study. Phylogenetic analysis of the second xii hypervariable region of the G-gene of the RSV revealed that all RSV group A viruses belonged to the "novel” ON1 genotype containing the 72-nucleotide duplication and RSV group B viruses belong to the BA IX genotype. RSV pathogen still remains a dominant viral etiological agent in acute lower respiratory tract infections among children below five years old.