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What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

The effect of temperature had a delay therefore mean temperature in the preceding month mean temperature 1 month before was also included as an independent variable in the analysis Table 2 . Both regression models were established p < 0.001 and the adjusted R 2 values were 0.373 and 0.231 in the mean temperature in the preceding month model and the current monthly temperature model, respectively. HBoV1 prevalence was positively correlated with temperature coefficient = 0.259 in the current temperature model p = 0.002 , coefficient = 0.328 in mean temperature in the preceding month model p < 0.001 .

What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

Data were analyzed using Chi-squared test and Fisher's exact test in SPSS 19.0 SPSS Inc., Chicago, IL, USA . Correlation with climate data was analyzed using multiple linear regression analysis. All tests were two-tailed and a p value < 0.05 was considered as statistically significant.

What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

The characteristics of the HBoV1 infection are likely to be a good model for studying the effects of co-infections. In this study, there was a significant difference in prevalence of HBoV1 in patients of different ages p < 0.001 . The majority of HBoV1 infections occurred in patients under 2 years old and the peak frequency of HBoV1 infection occurred in patients aged 7-12 months Fig.

What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

Co-infection was common in HBoV1-positive patients 45.2%, 112/248 . A significant difference in the prevalence of HBoV1 was found in patients in different age groups p < 0.001 , and the peak prevalence was found in patients aged 7–12 months 4.7%, 56/1203 . Two HBoV1 prevalence peaks were found in summer between June and September and winter between November and December .

What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

Between 2009 and 2016, the mean temperature from May to September was greater than 25°C Fig. 3 . For multiple linear regression analysis of HBoV1 prevalence and meteorological conditions correlation, independent variables of mean air pressure adjusted R 2 = 0.793, p < 0.001 and mean vapor pressure adjusted R 2 = 0.929, p < 0.001 , which linearly associated with mean temperature, and rainfall adjusted R 2 = 0.278, p < 0.001 , which strongly correlated with mean relative humidity, were excluded.

What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

To describe the epidemiology of HBoV1 in Guangzhou, we collected throat swabs from 11,399 children ≤14 years old , hospitalized with ARI and monitored HBoV1 and other common respiratory pathogens over a 7-year period Table 1 . In the current study, 86.5% 9857/11399 of patients were under the age of 5 years, with a median age of 1.75 years, indicating that infants and young children were most at risk of ARI, consistent with previous reports . Overall, 49.2% 5606/11399 of patients tested positive for one or more respiratory pathogens, 2.2% 248/11399 of patients were tested with HBoV1 infection Table 1 .

What was the male to female ratio for this study?

The male-to-female ratio was 1.82:1 7361:4038 and the median age was 1.75 years interquartile range 0.75-3.83 . Overall, 86.5% 9857/11399 of patients were under the age of 5 years. All the 11,399 patients were tested for all 18 pathogens mentioned, and 5606 49.2% were positive for one or more of those pathogens Table 1 , and had a median age of 1.50 years interquartile range 0.67-3.00 .

Some limitations of this study should be noted. First, because our study mainly focused on HBoV1 circulation in hospitalized patients with ARI, HBoV1 in outpatients and the asymptomatic population were not included. Second, many factors can affect virus epidemics, meteorological data analysis alone may not serve as a final conclusive interpretation.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community. Finally, some of the viruses detected in this study have not been detected and implicated with ARIs in Nigeria. There is no report, to the best of our knowledge, implicating coronavirus in ARIs in Nigeria, and it was detected in 12 subjects in this study.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Residues containing the nasal samples were stored at -20 °C prior to molecular analysis. Viral RNA was isolated using ZR Viral RNA ™ Kit Zymo Research, Irvine, California per manufacturer instructions id/147/r1034i.pdf . Real-time PCR polymerase chain reaction , commonly used in ARI studies , was then carried out using RV15 One Step ACE Detection Kit, catalogue numbers RV0716K01008007 and RV0717B01008001 Seegene, Seoul, South Korea for detection of 15 human viruses: parainfluenza virus 1, 2, 3 and 4 PIV1-4 , respiratory syncytial virus RSV A and B, influenza A and B FLUA, FLUB , rhinovirus type A-C, adenovirus ADV , coronavirus OC 229 E/NL63, OC43 , enterovirus HEV , metapneumovirus hMPV and bocavirus BoV .

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Double, triple and quadruple infections were another common feature of note. We identified ten different respiratory tract viruses among the subjects as shown in Fig. 1 . Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Diagnostic methods available and other constraints have limited studies there to serological surveys of only a few of these viruses and only in clinical populations . Thus, the utility of community-based surveillance may be appropriate in contexts such as in Nigeria, and the purpose of this pilot study was to investigate if clinical cases may describe the entire picture of ARI among children in Nigeria. We performed a cross-sectional study in three community centers and one clinical in Ilorin, Nigeria.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Due to the unique nature of the data generated in this study and novelty of work in the setting, it is not possible to exactly compare results to other studies. For example, though we found a similar study regarding ARIs in clinical subjects in Burkina Faso , due to the small sample size from this study it would not be feasible to infer or compare prevalence rates. Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community. Together they infected 94% 15/16, 95% CI 67.7-99.7% of clinical subjects, and 7% 5/75, 95% CI 2.5-15.5% in the community significant difference, p < 0.001 . The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses in the clinical sample; present in 93.8% 15/16 of clinical subjects, and 6.7% 5/75 of community subjects significant difference, p < 0.001 . Coronavirus OC43 was the most common virus detected in community members 13.3%, 10/75 .

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Nasal swabs were collected and tested using polymerase chain reaction. The majority 79.1% of subjects were under 6 years old, of whom 46 were infected 63.9% . A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses. This might not be surprising, as the basic difference between the community and clinic samples was an increased severity of illness in the clinical sample. This may also explain the high level of co-infection found among the clinical subjects.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

This may also explain the high level of co-infection found among the clinical subjects. The most prevalent virus in the clinical sample coronavirus OC43 was not detected in the community sample. Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

No observations used in this study had any missing data for analyses in this study. Basic participant demographics are summarized in PCR results showed that ten different viruses influenza A, coronavirus OC 229 E/NL63, RSVA, RSV B, parainfluenza 1-4 were detected. Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples.

What were the most common viruses sampled from nasal swabs in Ilorin, Nigeria

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically . This pilot study indicates that in areas of Nigeria, etiology of ARIs ascertained from clinical samples may not represent all of the ARIs circulating in the community. The main limitation of the study is the sample size.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community. Together they infected 94% 15/16, 95% CI 67.7-99.7% of clinical subjects, and 7% 5/75, 95% CI 2.5-15.5% in the community significant difference, p < 0.001 . The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Coronavirus OC43 was the most common virus detected in community members 13.3%, 10/75 . A different strain, Coronavirus OC 229 E/NL63 was detected among subjects from the clinic 2/16 and not detected in the community. This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

This may also explain the high level of co-infection found among the clinical subjects. The most prevalent virus in the clinical sample coronavirus OC43 was not detected in the community sample. Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses in the clinical sample; present in 93.8% 15/16 of clinical subjects, and 6.7% 5/75 of community subjects significant difference, p < 0.001 . Coronavirus OC43 was the most common virus detected in community members 13.3%, 10/75 .

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses. This might not be surprising, as the basic difference between the community and clinic samples was an increased severity of illness in the clinical sample. This may also explain the high level of co-infection found among the clinical subjects.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

No observations used in this study had any missing data for analyses in this study. Basic participant demographics are summarized in PCR results showed that ten different viruses influenza A, coronavirus OC 229 E/NL63, RSVA, RSV B, parainfluenza 1-4 were detected. Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples. In sum, a total of 33 of the 91 subjects surveyed had one or more respiratory tract virus 36.3%, 95% CI 26.6-47.0%, Fig. 1 .

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

1 . Furthermore, 10 of those cases were triple infections and 5 were quadruple infections illustrated by color of bars in Fig. 1 . Figure 2 indicates how frequently each pair of viruses were found in the same participant; co-infections were most common among enterovirus and parainfluenza virus 4 Fig. 2 .

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Double, triple and quadruple infections were another common feature of note. We identified ten different respiratory tract viruses among the subjects as shown in Fig. 1 . Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community. Finally, some of the viruses detected in this study have not been detected and implicated with ARIs in Nigeria. There is no report, to the best of our knowledge, implicating coronavirus in ARIs in Nigeria, and it was detected in 12 subjects in this study.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

However, the sample size was big enough to ascertain significant differences in community and clinic sourced viruses, and provides a qualitative understanding of viral etiology in samples from the community and clinic. Moreover, the sample was largely concentrated on subjects under 6 years, who are amongst the groups at highest risk of ARIs. Despite the small sample size, samples here indicate that circulation patterns in the community may differ from those in the clinic.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

What was the most common virus detected in community members in this sample?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Nasal swabs were collected and tested using polymerase chain reaction. The majority 79.1% of subjects were under 6 years old, of whom 46 were infected 63.9% . A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

In Nigeria, hospitals are visited only when symptoms are very severe. Thus, it is hypothesized that viral information from clinical sampling is insufficient to either capture disease incidence in general populations or its predictability from symptoms . Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods .

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics . Currently, the majority of all infectious disease outbreaks as recorded by the World Health Organization WHO occur in the continent of Africa where there is high transmission risk . Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock .

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock . These changing epidemiological patterns have resulted in calls for improved ARI surveillance, especially in places of high transmission risk . Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited .

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Due to the unique nature of the data generated in this study and novelty of work in the setting, it is not possible to exactly compare results to other studies. For example, though we found a similar study regarding ARIs in clinical subjects in Burkina Faso , due to the small sample size from this study it would not be feasible to infer or compare prevalence rates. Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria. Further, findings from this work also add to the growing body of research that shows value of community-data in infectious disease surveillance . As most of the work to-date has been in higher resource areas of the world this study adds perspective from an area where healthcare resources are lower.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

The main limitation of the study is the sample size. In particular, the sample is not equally representative across all ages. However, the sample size was big enough to ascertain significant differences in community and clinic sourced viruses, and provides a qualitative understanding of viral etiology in samples from the community and clinic.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

As most of the work to-date has been in higher resource areas of the world this study adds perspective from an area where healthcare resources are lower. In conclusion, results of this study provide evidence for active community surveillance to enhance public health surveillance and scientific understanding of ARIs. This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically .

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically . This pilot study indicates that in areas of Nigeria, etiology of ARIs ascertained from clinical samples may not represent all of the ARIs circulating in the community. The main limitation of the study is the sample size.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples. In sum, a total of 33 of the 91 subjects surveyed had one or more respiratory tract virus 36.3%, 95% CI 26.6-47.0%, Fig. 1 .

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Double, triple and quadruple infections were another common feature of note. We identified ten different respiratory tract viruses among the subjects as shown in Fig. 1 . Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses. This might not be surprising, as the basic difference between the community and clinic samples was an increased severity of illness in the clinical sample. This may also explain the high level of co-infection found among the clinical subjects.

How bad is the burden of disease in developing countries?

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics . Currently, the majority of all infectious disease outbreaks as recorded by the World Health Organization WHO occur in the continent of Africa where there is high transmission risk . Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock .

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g. novel polyomaviruses in Australia , human coronavirus Erasmus Medical Center HCoV-EMC in the Middle East and United Kingdom , SARS in Canada and China , yet research regarding the molecular epidemiology of ARI viruses in Nigeria is limited. Diagnostic methods available and other constraints have limited studies there to serological surveys of only a few of these viruses and only in clinical populations .

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

In Nigeria, hospitals are visited only when symptoms are very severe. Thus, it is hypothesized that viral information from clinical sampling is insufficient to either capture disease incidence in general populations or its predictability from symptoms . Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods .

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically . This pilot study indicates that in areas of Nigeria, etiology of ARIs ascertained from clinical samples may not represent all of the ARIs circulating in the community. The main limitation of the study is the sample size.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock . These changing epidemiological patterns have resulted in calls for improved ARI surveillance, especially in places of high transmission risk . Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited .

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria. Further, findings from this work also add to the growing body of research that shows value of community-data in infectious disease surveillance . As most of the work to-date has been in higher resource areas of the world this study adds perspective from an area where healthcare resources are lower.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

For ARI surveillance in particular, infections in the community are those that do not get reported clinically. Clinical data generally represents the most severe cases, and those from locations with access to healthcare institutions. In Nigeria, hospitals are visited only when symptoms are very severe.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples. In sum, a total of 33 of the 91 subjects surveyed had one or more respiratory tract virus 36.3%, 95% CI 26.6-47.0%, Fig. 1 .

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Diagnostic methods available and other constraints have limited studies there to serological surveys of only a few of these viruses and only in clinical populations . Thus, the utility of community-based surveillance may be appropriate in contexts such as in Nigeria, and the purpose of this pilot study was to investigate if clinical cases may describe the entire picture of ARI among children in Nigeria. We performed a cross-sectional study in three community centers and one clinical in Ilorin, Nigeria.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

1 . Furthermore, 10 of those cases were triple infections and 5 were quadruple infections illustrated by color of bars in Fig. 1 . Figure 2 indicates how frequently each pair of viruses were found in the same participant; co-infections were most common among enterovirus and parainfluenza virus 4 Fig. 2 .

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

Due to the unique nature of the data generated in this study and novelty of work in the setting, it is not possible to exactly compare results to other studies. For example, though we found a similar study regarding ARIs in clinical subjects in Burkina Faso , due to the small sample size from this study it would not be feasible to infer or compare prevalence rates. Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

Where do the majority of all infectious disease outbreaks happen?

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics . Currently, the majority of all infectious disease outbreaks as recorded by the World Health Organization WHO occur in the continent of Africa where there is high transmission risk . Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock .

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Double, triple and quadruple infections were another common feature of note. We identified ten different respiratory tract viruses among the subjects as shown in Fig. 1 . Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Results of this study can inform a larger study, representative across demographic and locations to systematically assess the etiology of infection and differences in clinical and community cohorts. A larger study will also enable accounting for potential confounders such as environmental risk factors. Finally, while it may be intuitive, findings from this pilot study shed light on the scope of differences in ARI patterns including different types and strains of circulating viruses.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples. In sum, a total of 33 of the 91 subjects surveyed had one or more respiratory tract virus 36.3%, 95% CI 26.6-47.0%, Fig. 1 .

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock . These changing epidemiological patterns have resulted in calls for improved ARI surveillance, especially in places of high transmission risk . Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited .

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically . This pilot study indicates that in areas of Nigeria, etiology of ARIs ascertained from clinical samples may not represent all of the ARIs circulating in the community. The main limitation of the study is the sample size.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g. novel polyomaviruses in Australia , human coronavirus Erasmus Medical Center HCoV-EMC in the Middle East and United Kingdom , SARS in Canada and China , yet research regarding the molecular epidemiology of ARI viruses in Nigeria is limited. Diagnostic methods available and other constraints have limited studies there to serological surveys of only a few of these viruses and only in clinical populations .

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community. Finally, some of the viruses detected in this study have not been detected and implicated with ARIs in Nigeria. There is no report, to the best of our knowledge, implicating coronavirus in ARIs in Nigeria, and it was detected in 12 subjects in this study.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

Due to the unique nature of the data generated in this study and novelty of work in the setting, it is not possible to exactly compare results to other studies. For example, though we found a similar study regarding ARIs in clinical subjects in Burkina Faso , due to the small sample size from this study it would not be feasible to infer or compare prevalence rates. Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses in the clinical sample; present in 93.8% 15/16 of clinical subjects, and 6.7% 5/75 of community subjects significant difference, p < 0.001 . Coronavirus OC43 was the most common virus detected in community members 13.3%, 10/75 .

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

What are some risk factors for countries to experience a high prevalence of Acute Respiratory Infections?

Nigeria is one such place with high prevalence of many of the risk factors implicated in ARI among children including; age, sex, overcrowding, nutritional status, socio-economic status, and where study of ARIs is currently limited . These broad risk factors alongside limited resources have indicated the need for community-based initiatives for surveillance and interventions . For ARI surveillance in particular, infections in the community are those that do not get reported clinically.

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections. Text: Acute Respiratory Infections ARIs the cause of both upper respiratory tract infections URIs and lower respiratory tract infections LRIs are a major cause of death among children under 5 years old particularly in developing countries where the burden of disease is 2-5 times higher than in developed countries . While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics .

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

Double, triple and quadruple infections were another common feature of note. We identified ten different respiratory tract viruses among the subjects as shown in Fig. 1 . Samples collected from the Children's specialist hospital showed 100% prevalence rate of infection with one or more viruses.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples. In sum, a total of 33 of the 91 subjects surveyed had one or more respiratory tract virus 36.3%, 95% CI 26.6-47.0%, Fig. 1 .

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses in the clinical sample; present in 93.8% 15/16 of clinical subjects, and 6.7% 5/75 of community subjects significant difference, p < 0.001 . Coronavirus OC43 was the most common virus detected in community members 13.3%, 10/75 .

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

No observations used in this study had any missing data for analyses in this study. Basic participant demographics are summarized in PCR results showed that ten different viruses influenza A, coronavirus OC 229 E/NL63, RSVA, RSV B, parainfluenza 1-4 were detected. Figure 1 shows how these infections were distributed across virus types as well as in the community versus clinic samples.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

Results of this study can inform a larger study, representative across demographic and locations to systematically assess the etiology of infection and differences in clinical and community cohorts. A larger study will also enable accounting for potential confounders such as environmental risk factors. Finally, while it may be intuitive, findings from this pilot study shed light on the scope of differences in ARI patterns including different types and strains of circulating viruses.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

While these viruses usually cause mild cold-like symptoms and can be self-limiting, in recent years novel coronaviruses such as severe acute respiratory syndrome SARS and Middle East respiratory syndrome MERS have evolved and infected humans, causing severe illness, epidemics and pandemics . Currently, the majority of all infectious disease outbreaks as recorded by the World Health Organization WHO occur in the continent of Africa where there is high transmission risk . Further, in developing areas both rural and urban , there are increasing risk factors such as human-animal interfaces due to residential-proximity to livestock .

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

Nasal swabs were collected and tested using polymerase chain reaction. The majority 79.1% of subjects were under 6 years old, of whom 46 were infected 63.9% . A total of 33 of the 91 subjects had one or more respiratory tract virus; there were 10 cases of triple infection and 5 of quadruple.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

1 . Furthermore, 10 of those cases were triple infections and 5 were quadruple infections illustrated by color of bars in Fig. 1 . Figure 2 indicates how frequently each pair of viruses were found in the same participant; co-infections were most common among enterovirus and parainfluenza virus 4 Fig. 2 .

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

Efforts worldwide including in East and Southern Africa have been focused on developing community-based participatory disease surveillance methods . Community-based approaches have been shown useful for learning more about emerging respiratory infections such as assessing under-reporting , types of viruses prevalent in communities , and prediction of epidemics . Concurrently, advancements in molecular identification methods have enabled studies regarding the emergence and epidemiology of ARI viruses in many locations e.g.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically . This pilot study indicates that in areas of Nigeria, etiology of ARIs ascertained from clinical samples may not represent all of the ARIs circulating in the community. The main limitation of the study is the sample size.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

What symptoms are associated with acute respiratory infections?

Disease Surveillance and Notification Officers, who are employed by the State Ministry of Health and familiar with the communities in this study, performed specimen and data collection. Symptoms considered were derived in accordance with other ARI surveillance efforts: sore throat, fever, couch, running nose, vomiting, body ache, leg pain, nausea, chills, shortness of breath . Gender and age, type of residential area rural/urban , education level, proximity of residence to livestock, proximity to an untarred road and number of people who sleep in same room, were all recorded.

For ARI surveillance in particular, infections in the community are those that do not get reported clinically. Clinical data generally represents the most severe cases, and those from locations with access to healthcare institutions. In Nigeria, hospitals are visited only when symptoms are very severe.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

OBJECTIVE: Recognizing increasing interest in community disease surveillance globally, the goal of this study was to investigate whether respiratory viruses circulating in the community may be represented through clinical hospital surveillance in Nigeria. RESULTS: Children were selected via convenience sampling from communities and a tertiary care center n = 91 during spring 2017 in Ilorin, Nigeria. Nasal swabs were collected and tested using polymerase chain reaction.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community. Finally, some of the viruses detected in this study have not been detected and implicated with ARIs in Nigeria. There is no report, to the best of our knowledge, implicating coronavirus in ARIs in Nigeria, and it was detected in 12 subjects in this study.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

2 . We also compared and contrasted the clinical and community results. Parainfluenza virus 4, respiratory syncytial virus B and enterovirus were the most common viruses found in the clinical sample. These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

These three infections resulted in 41 viruses detected in 15 subjects clinically, and eight infections detected in five people in the community. Together they infected 94% 15/16, 95% CI 67.7-99.7% of clinical subjects, and 7% 5/75, 95% CI 2.5-15.5% in the community significant difference, p < 0.001 . The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Diagnostic methods available and other constraints have limited studies there to serological surveys of only a few of these viruses and only in clinical populations . Thus, the utility of community-based surveillance may be appropriate in contexts such as in Nigeria, and the purpose of this pilot study was to investigate if clinical cases may describe the entire picture of ARI among children in Nigeria. We performed a cross-sectional study in three community centers and one clinical in Ilorin, Nigeria.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Coronavirus OC43 was the most common virus detected in community members 13.3%, 10/75 . A different strain, Coronavirus OC 229 E/NL63 was detected among subjects from the clinic 2/16 and not detected in the community. This pilot study provides evidence that data from the community can potentially represent different information than that sourced clinically, suggesting the need for community surveillance to enhance public health efforts and scientific understanding of respiratory infections.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

This may also explain the high level of co-infection found among the clinical subjects. The most prevalent virus in the clinical sample coronavirus OC43 was not detected in the community sample. Further, there was a significant difference between prevalence of the most common viruses in the clinical sample parainfluenza virus 4, respiratory syncytial virus B and enterovirus and their prevalence in the community.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

Due to the unique nature of the data generated in this study and novelty of work in the setting, it is not possible to exactly compare results to other studies. For example, though we found a similar study regarding ARIs in clinical subjects in Burkina Faso , due to the small sample size from this study it would not be feasible to infer or compare prevalence rates. Studies of ARI etiology have mostly been generally focused in areas of the world that are more developed , and it is important to note that the availability of molecular diagnostic methods as employed in this study substantially improve the ability to detect viruses which hitherto have not been detected in Nigeria.

What was the most common virus detected in community samples in Ilorin, Nigeria?

The most common virus detected in community samples was Coronavirus OC43; this virus was detected in 13.3% 95% CI 6.9-23.6% people in the community and not in any of the clinical samples. However a different strain, coronavirus OC 229 E/NL63 was detected in 12.5% of the clinical subjects 2/16, 95% CI 2.2-39.6% and not detected in the community. Double, triple and quadruple infections were another common feature of note.

This is not only because a minority of children with severe infection are admitted to the hospital in areas such this in Nigeria, but also findings from this pilot study which indicate that viral circulation in the community may not get detected clinically . This pilot study indicates that in areas of Nigeria, etiology of ARIs ascertained from clinical samples may not represent all of the ARIs circulating in the community. The main limitation of the study is the sample size.