Investigation of the contribution of human rhinovirus to childhood respiratory illnesses leading to hospital admission and associated risk factors by use of PCR method : a prospective study in QMH paediatric patients

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Investigation of the contribution of human rhinovirus to childhood respiratory illnesses leading to hospital admission and associated risk factors by use of PCR method : a prospective study in QMH paediatric patients

 

Author: Tang, Wing-hong
Title: Investigation of the contribution of human rhinovirus to childhood respiratory illnesses leading to hospital admission and associated risk factors by use of PCR method : a prospective study in QMH paediatric patients
Degree: M.Sc.
Year: 2003
Subject: Pediatric respiratory diseases
Children -- Diseases -- Diagnosis
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
School of Nursing
Pages: iv, 82 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1691098
URI: http://theses.lib.polyu.edu.hk/handle/200/1352
Abstract: Human Rhinovirus (HRV) is recognised as a major cause of respiratory infections and is currently diagnosed by means of tissue culture which takes several days and lacks specificity. A Reverse-transcription Polymerase Chain Reaction (RT-PCR) was developed for detection HRV. By serial dilution of stock HRV, the RT-PCR developed was determined to be 1000 times more sensitive than the conventional viral isolation method. The HRV RT-PCR was specific to HRVs without cross-reactivity with other common respiratory pathogens. Using the HRV RT-PCR, 422 nasophazyneal aspirates of patients suffering from respiratory infection collected in the paediatric ward of Queen Mary Hospital between August, 2001 and July, 2002, were tested for HRV. By combining the results with other laboratory findings, HRV was found to be the sole aetiology in 33.4% of these patients with respiratory infection. 7.3% of patients with respiratory infection had evidence of double infection including HRV and another pathogen. Overall, HRV was the major cause of respiratory infection. The symptoms produced by HRV infection included upper and lower respiratory infection, tracheobronchitis and other complications. Symptoms were similar in all age groups with the exception of wheezing. HRV infection causes significantly more wheezing in children aged over 2 than in children younger than 2 (p< 0.05,x2). This one-year study showed that HRV infection had seasonality, the peak season of HRV infection being between September and October. However, this seasonality of HRV infection did not appear to be related to climatic factors, including daily temperature, relative humidity and air pollution index. Questionnaires were completed by parents of 84 subjects for admissions between April to July 2002 to investigate the effect of familial factors on incidence of respiratory infection. It was found that familial factors including daycare attendance of children, family size, presence of siblings, presence of ill family member, parental education and occupation, and smoking did not affect the aetiology of respiratory infection. As the symptoms of HRV infection resemble those of other respiratory infection, and risk factors for HRV and other respiratory infections are similar, it is difficult to differentiate HRV infection from other respiratory infection. The HRV RT-PCR provides a rapid, sensitive and reliable tool for diagnosis for respiratory infections. This allows earlier implementation of appropriate management of the infection and can reduce the use of ineffective antibiotic treatment.

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