Prevalence of Viral Severe Acute Respiratory Infections in Patients in the Intensive Care Unit and Those under Mechanical Ventilation in Moi Teaching and Referral Hospital, Uasin Gishu County, Kenya

摘要

Abstract Any nation must ensure that the prevalence and incidence of particular disease is kept in check and that the population is aware in case of an increase in incidences and prevalence of a particular disease. Viruses are responsible for a large proportion of respiratory illnesses, including pneumonia. Mechanical ventilation as part of intensive care is used to support the lungs and cannot reverse any underlying diseases; however secondary complications that occur include bacterial and viral respiratory infections. These infections prolong the length of hospital stay hence impacting on available resources, in addition it also increases morbidity and mortality rates especially in patients with chronic illnesses and those who are immunosuppressed. The aim of the study was to assess the prevalence of influenza virus, rhinovirus, respiratory syncytial virus, Human Parainfluenza virus, Human metapneumovirus, adenovirus and Coronavirus in patients who are mechanically ventilated and those in the intensive care unit. It is a comparative study that sought to determine the burden of these viruses in this group of patients. The study was done at Moi teaching and referral hospital in Uasin Gishu County. Sample collection period was from 1st April 2017 to 30th August 2017. A total of 186 samples of broncho-alveolar lavage was collected and transported at 2-8°C to KEMRI Centre for Virus Research for analysis. The viral nucleic acid was detected using reverse transcriptase polymerase (RT-PCR) chain reaction. Analysis of variance (ANOVA) was used to aid in coding, entry and analysis of data. Viral test results were log-transformed to ensure normal distribution of the data and expressed as mean±standard deviation. Comparison of the viral type based on the sex of the patient and ward type was determined using ANOVA with Bonferroni's post-test using GenStat Release 14.1 (PC/Windows). Majority of the study population was in the age bracket of above 65 years old which represented 28.8% of the study population, age group 50 to 64 years represented 24.4%, 35 to 49 years (20%), 5 to 19 years (13%), less than 5 years (11%) while the minority was age group of 20 to 34 years with 3% of the study population. Male represented 57.2% of the population that was involved and 42.3% were female. From this study the results indicate that viral respiratory tract infections are prevalent in patients both in the intensive care unit and those under mechanical ventilation in the general wards at Moi Teaching and Referral Hospital. It is evident that the infections occur across all age groups; however children less than 5 years and the elderly above 65 years recorded a higher prevalence in most viral infections as compared to other age groups. This data will find utilization in Moi Teaching and Referral Hospital in the management of the patients in the ICU and those under mechanical ventilation and overall it will contribute significantly to the reduction of mortality.