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. 2024 May;18(5):e13303.
doi: 10.1111/irv.13303.

Respiratory Syncytial Virus and Influenza Infections in Children in Ulaanbaatar, Mongolia, 2015-2021

Lien Anh Ha Do  1   2 , Naranzul Tsedenbal  3 , Chimidregzen Khishigmunkh  3 , Bazarkhuu Tserendulam  3 , Lkhagvadorj Altanbumba  3 , Dashtseren Luvsantseren  3 , Munkhchuluun Ulziibayar  3 , Bujinlkham Suuri  3 , Dorj Narangerel  4 , Bilegtsaikhan Tsolmon  3   5 , Sodbayar Demberelsuren  6 , Casey L Pell  7 , Sam Manna  7 , Catherine Satzke  2   7   8 , Cattram Nguyen  1   2 , Tuya Mungun  3 , Claire von Mollendorf  1   2 , Darmaa Badarch  3 , Kim Mulholland  1   2   9
Affiliations

Respiratory Syncytial Virus and Influenza Infections in Children in Ulaanbaatar, Mongolia, 2015-2021

Lien Anh Ha Do et al. Influenza Other Respir Viruses. 2024 May.

Abstract

Background: Data available for RSV and influenza infections among children < 2 years in Mongolia are limited. We present data from four districts of Ulaanbaatar from April 2015 to June 2021.

Methods: This study was nested in an enhanced surveillance project evaluating pneumococcal conjugate vaccine (PCV13) impact on the incidence of hospitalized lower respiratory tract infections (LRTIs). Our study was restricted to children aged < 2 years with arterial O2 saturation < 93% and children with radiological pneumonia. Nasopharyngeal (NP) swabs collected at admission were tested for RSV and influenza using qRT-PCR. NP swabs of all patients with radiological pneumonia and of a subset of randomly selected NP swabs were tested for S. pneumoniae (S.p.) by qPCR and for serotypes by culture and DNA microarray.

Results: Among 5705 patients, 2113 (37.0%) and 386 (6.8%) had RSV and influenza infections, respectively. Children aged 2-6 months had a higher percentage of very severe RSV infection compared to those older than 6 months (42.2% versus 31.4%, p-value Fisher's exact = 0.001). S.p. carriage was detected in 1073/2281 (47.0%) patients. Among S.p. carriage cases, 363/1073 (33.8%) had S.p. and RSV codetection, and 82/1073 (7.6%) had S.p. and influenza codetection. S.p. codetection with RSV/influenza was not associated with more severe LRTIs, compared to only RSV/influenza cases.

Conclusion: In Mongolia, RSV is an important pathogen causing more severe LRTI in children under 6 months of age. Codetection of RSV or influenza virus and S.p. was not associated with increased severity.

Keywords: influenza virus; lower respiratory tract infections; respiratory syncytial virus.

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Conflict of interest statement

The funder had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit.

The author declares no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
RSV and influenza subgroups during the study period. Vertical lines are the PCV introduction phased times. Pre: before PCV13 introduced. Phase I: when PCV13 introduction started in SK and SB. Phase II: when PCV13 introduction started in BZ. Phase III: when PCV13 introduction started in the rest of UB including CHD (SK: Songinokhairkhan, SB: Sukhbataar, BZ: Bayanzurkh, CHD: Chingeltei).
FIGURE 2
FIGURE 2
Measles cases identified among study participants.
FIGURE 3
FIGURE 3
Correlations between pneumococcal density and RSV/influenza viral load. RSV load: log 10 of RSV viral load (copies/mL). Influenza virus load: log 10 of influenza viral load (copies/mL).
See this image and copyright information in PMC

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