Burden of Human Metapneumovirus-associated pneumonia among children attending a Tertiary Care Hospital, Kathmandu

BackgroundAcute Respiratory Tract Infection (ARI) is one of the most common causes of mortality and morbidity worldwide. Every year millions of children suffer from viral Respiratory Tract Infections (RTIs) ranging from mild to severe illnesses. Human Metapneumovirus (HMPV) is among the most frequent viruses responsible for RTIs. However, HMPV infections and their severity among children have not been explored yet in Nepal. Therefore, the study aimed to determine the incidence of HMPV among children attending Kanti Childrens Hospital and assess the clinical characteristics of the infections as well as find out the co-infections. MethodsA hospital-based cross-sectional study was carried out from September 2018 to April 2019. A total of 105 throat swabs were collected from children clinically suspected of ARIs. The collected samples were tested for the presence of HMPV RNA by Multiplex Real-time PCR (RT-PCR) assay. ResultsThe incidence of HMPV in children in Kanti Childrens Hospital was found to be 13.3%. The HMPV was more prevalent in the age group less than three years (21.8%) which was found to be statistically significant (p - 0.038). Cough and fever were the most common clinical features present in all children infected with HMPV followed by rhinorrhea, sore throat, and wheezing. HMPV positive children were diagnosed with pneumonia (42.9%), bronchiolitis (28.5%), upper respiratory tract infections (14.3%) and asthma (14.3%). The incidence of HMPV was high in late winter (14.3%) followed by early spring (13.5%). ConclusionThis study provides the baseline information on HMPV and associated co-infection with other respiratory viruses for differential diagnosis and rational use of antibiotics in clinical management.