Acute Viral Respiratory Infections in Intensive Care Unit and Ventilator Support Patients in Moi Teaching and Referral Hospital, Uasin-Gishu County, Kenya.
Acute respiratory tract infections (ARTIs) are among the five most common causes of morbidity and mortality globally, accounting for approximately 3.9 million deaths annually. Most of these deaths occur among young children in developing countries Mechanical ventilation supports the breathing system but does not change any pre-existing condition. Associated challenges include viral and bacterial infections. The prevalence of these infections is high, however these infections mimic bacterial infections. There is no documentation of these infections in many healthcare facilities In Africa. This study aimed at assessing the prevalence rates of Influenza virus, HRV, RSV, HPIV, hMPV, Human Adenovirus and HCoV in study subjects on ventilator support as well as those on critical care in the intensive care unit. The study was done at MTRH in Uasin Gishu County. Samples were collected from April 2017 to August 2017. 200 samples of bronchoalveolar lavage were collected. The samples were then transported to KEMRI Nairobi at 2-8°C for analysis. The RNA/DNA of the viruses was detected using real time PCR and multiplex PCR. Data analysis as well as coding and entry were done using statistical package for social studies (SPSS). The results were log-transformed to obtain equal distribution. The results were also expressed as mean±standard deviation. The results were then compared with respect to whether in ICU or on mechanical ventilation as well age using ANOVA with Bonferroni’s post-test using GenStat Release 14.1 (PC/Windows). Presentation of the data was done using graphs, pie charts and tables/figures. The samples that tested positive for Influenza A virus, HPIV-1, HPIV-2, HPIV-3, RSV, Adenovirus, HRV Human Metapneumovirus and HCoV was 33 (16.5%) 12 (6%), 8 (4%), 11 (5.5%), 19 (9.5%), 5(2.5%), 42(21%), 22 (11%) and 9(4.5%) respectively. However significant difference in viral infection among study participants in the intensive care unit and those on ventilator support in the different age groups of the patients analyzed was noted. There was noted difference among the patients in different age categories based on whether in ICU or ventilator support by Influenza A Virus, HPIV-1, HRV and hMPV viral infections at P-Value ≤0.05. Highest infection means were indicated in age group >65 for Influenza A Virus, HPIV-1 and HRV and age group <5 for hMPV in both ICU and those on ventilator support. Lowest infection means were also observed only in age group 20-34 for Influenza A Virus HPIV-1, HRV and Human metapneumovirus in the intensive care unit and also those on ventilator support. There were 34 cases of multiple viral infections. 20 cases were in those on ventilator support while 14 cases were present in those in the intensive care unit. It is evident that these infections are common in patients in ICU and those under ventilator support at MTRH. It is also clear that these infections are common in the various age categories. Those below 5 years and those above 50 years have higher prevalence of majority of the infections in comparison to other age groups. Surveillance for viral respiratory infections should be improved in order to implement treatment and also understand seasonality of these viruses and other new respiratory viruses. Co-infections should be closely monitored especially in mechanical ventilation in order to understand the impact of ventilator support on infection rates by these viruses. More studies needs to be done focusing on nosocomial respiratory viral infections.