@article{65e37813301141328ef8a0d7614a983d,
title = "Influenza-like illness is associated with high pneumococcal carriage density in Malawian children",
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.",
keywords = "Carriage density, Children, IL-8, Influenza-like illness, Pneumococcal",
author = "Nyazika, {Tinashe K.} and Alice Law and Swarthout, {Todd D.} and Lusako Sibale and {ter Braake}, Danielle and Neil French and Heyderman, {Robert S.} and Dean Everett and Aras Kadioglu and Jambo, {Kondwani C.} and Neill, {Daniel R.}",
note = "Funding Information: This work was supported by the CDC through a cooperative agreement (grant 5U01CK000146–04 ). TKN is supported by training grant awarded as part of the Wellcome Strategic award number 101113/Z/13/Z084 to The Malawi-Liverpool-Wellcome Trust Clinical Research Programme . KCJ was supported by the Wellcome (UK) through an Intermediate Fellowship number 105831/Z/14/Z. DRN is supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 204457/Z/16/Z ). AL and AK were supported by a UK Medical Research Council Programme Grant ( MR/P011284/1 ). RSH, NF and TS are supported by the National Institute for Health Research (NIHR) Global Health Research Unit on Mucosal Pathogens using UK aid from the UK Government. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care”. Funding Information: AL, AK, KCJ and DRN conceived the study. TKN, AL, TDS, NF, RH, DE, AK, KCJ, DRN contributed reagents. TKN, AL, LSK, DtB, KCJ and DRN performed the experiments. TKN, AL, KCJ, DRN performed the data analysis. TKN and AL drafted the manuscript. TKN, AL, TDS, LSK, NF, RH, DE, AK, KCJ and DRN critically revised successive versions of the paper and approved the final version. The authors thank all study participants, the clinical team (Mrs Mercy Juma, Mr Andrew Sigoloti, Ms Chifundo Kondoni) and supporting staff of Malawi-Liverpool-Wellcome Trust Clinical Research Programme and Queen Elizabeth Central Hospital for their support and cooperation during the study. This work was supported by the CDC through a cooperative agreement (grant 5U01CK000146?04). TKN is supported by training grant awarded as part of the Wellcome Strategic award number 101113/Z/13/Z084 to The Malawi-Liverpool-Wellcome Trust Clinical Research Programme. KCJ was supported by the Wellcome (UK) through an Intermediate Fellowship number 105831/Z/14/Z. DRN is supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 204457/Z/16/Z). AL and AK were supported by a UK Medical Research Council Programme Grant (MR/P011284/1). RSH, NF and TS are supported by the National Institute for Health Research (NIHR) Global Health Research Unit on Mucosal Pathogens using UK aid from the UK Government. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care?. Publisher Copyright: {\textcopyright} 2020",
year = "2020",
month = oct,
doi = "10.1016/j.jinf.2020.06.079",
language = "English",
volume = "81",
pages = "549--556",
journal = "Journal of Infection",
issn = "0163-4453",
publisher = "W.B. Saunders Ltd",
number = "4",
}
