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Acute Viral Lower Respiratory Tract Infections in Cambodian Children: Clinical and Epidemiologic Characteristics

Guerrier, Gilles MD*; Goyet, Sophie MPH*; Chheng, Eak Tep MD; Rammaert, Blandine MD*‡; Borand, Laurence PharmD*; Te, Vantha MD§; Try, Patrich Lorn MD¶∥; Sareth, Rith PharmD*; Cavailler, Philippe MD*; Mayaud, Charles MD, PhD¶∥; Guillard, Bertrand MD*; Vong, Sirenda MD, PhD*; Buchy, Philippe PhD*; Tarantola, Arnaud MD*

The Pediatric Infectious Disease Journal: January 2013 - Volume 32 - Issue 1 - p e8–e13
doi: 10.1097/INF.0b013e31826fd40d
Original Studies

Background: Viruses are detected in most hospitalized children admitted for acute respiratory infections. Etiologic understanding is needed to improve clinical management and prevention, particularly in resource-limited tropical countries.

Methods: A 3-year prospective descriptive study was conducted among Cambodian children admitted to 2 provincial hospitals for acute lower respiratory tract infection. Molecular detection for 18 viral pathogens using multiplex polymerase chain reaction/reverse transcription polymerase chain reactions was performed.

Results: We enrolled 1006 children less than 5 years of age of whom 423 (42%), 428 (42%) and 155 (16%) had pneumonia, bronchiolitis and unclassified lower respiratory tract infections, respectively. Of the 551 (55%) with documented viral infection, a single virus was detected in 491 (89%), including rhinovirus (n = 169; 34%), respiratory syncytial virus (n = 167; 34%), parainfluenza virus (n = 40; 8%), human metapneumovirus (n = 39; 8%), influenza virus (n = 31; 6%), bocavirus (n = 16; 3%), adenovirus (n = 15; 3%), coronavirus (n = 9; 2%) and enterovirus (n = 5; 1%). Coinfections with multiple viruses were detected in 6% (2 viruses detected in 59 cases; 3 viruses detected in 1 case).

Conclusion: Similar to other tropical countries, rhinovirus and respiratory syncytial virus were the principal viral pathogens detected among children hospitalized for lower tract respiratory infection in Cambodia.

From the *Institut Pasteur in Cambodia, Phnom Penh, Cambodia; National Pediatric hospital, Phnom Penh, Cambodia; Université Paris-Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, APHP, Centre d’Infectiologie Necker-Pasteur, Institut Hospitalo-Universitaire Imagine, Paris, France; §Takeo Provincial hospital, Takeo, Cambodia; Kampong Cham provincial hospi­tal, Kampong Cham, Cambodia; and Hôpital Tenon, Paris, France.

Accepted for publication July 24, 2012.

This study was supported by Surveillance and Investigation of Epidemic Situations in Southeast Asia (SISEA) project.

The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Gilles Guerrier, MD, Institut Pasteur in Cambodia, Phnom Penh 1200, Cambodia. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.