Respiratory virus surveillance in hospitalized children less than
two-years of age in Kenema, Sierra Leone during the COVID-19 pandemic
(October 2020- October 2021)
Background Globally, viral pathogens are the leading cause of acute
respiratory infection in children under-five years. We aim to describe
the epidemiology of viral respiratory pathogens in hospitalized children
under-two years of age in Eastern Province of Sierra Leone, during the
second year of the SARS-CoV-2 pandemic. Methods We conducted a
prospective study of children hospitalized with respiratory symptoms
between October 2020 and October 2021. We collected demographic and
clinical characteristics and calculated each participant´s respiratory
symptom severity. Nose and throat swabs were collected at enrollment.
Total nucleic acid was purified and tested for multiple respiratory
viruses. Statistical analysis was performed using R version 4.2.0
software. Results 502 children less than two-years of age were enrolled.
376 (75%) had at least one respiratory virus detected. The most common
viruses isolated were HRV/EV (28.2%), RSV (19.5%) and PIV (13.1%).
Influenza and SARS-CoV-2 were identified in only 9.2% and 3.9% of
children, respectively. Viral co-detection was common. Human
metapneumovirus and RSV had more than two-fold higher odds of requiring
O2 therapy while hospitalized. Conclusion Viral pathogen prevalence was
high (75%) in our study population. Despite this, 100% of children
received antibiotics, underscoring a need to expand laboratory
diagnostic capacity and to revisit clinical guidelines implementation in
these children. Continuous surveillance and serologic studies among more
diverse age groups, with greater geographic breadth, are needed in
Sierra Leone to better characterize the long-term impact of COVID-19 on
respiratory virus prevalence and to better characterize the seasonality
of respiratory viruses in Sierra Leone.