Etiology of acute respiratory infection and shedding of influenza virus among Kenyan children. (360G-Wellcome-081186_Z_06_Z)

Acute respiratory infection (ARI) is a leading cause of death among children in sub-Saharan Africa. Recent studies suggest that viruses make an important contribution to the burden of disease. Nevertheless, the precise contribution of viruses, including influenza, parainfluenzae, adenovirus, respiratory syncytial virus, human metapneumovirus and cytomegalovirus has not been quantified in tropical Africa. Such data, especially the effects of HIV and malnutrition on etiology and disease burden, may have major implications for health service planning. East Africa is at risk of avian influenza: it the final destination for many birds currently migrating from infected areas and there is close contact with poultry at household level. There is currently little data on the duration of influenza virus shedding among children in sub-Saharan Africa, where HIV infection and malnutrition are prevalent. Such data is likely to be of considerable importance to human pandemic transmission potential. We propose to study the viral etiology of ARI among 1000 Kenyan children admitted to hospital during one year, adding value to a study of bacteria, PCP and TB. We will investigate the prevalence of prolonged viral shedding among children with influenza and will establish surveillance for influenza A/H5N1, linking to the national network.