Respiratory pathogen detection among febrile inpatients in northern Tanzania, 2016-2019

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ID: 315412
2026
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Abstract
Abstract Background Febrile illness is a common reason for hospital admission in sub-Saharan Africa, yet the illness etiology often remains unknown. To address these knowledge gaps, we conducted respiratory pathogen testing in a cohort of febrile inpatients in northern Tanzania. Methods We enrolled a prospective cohort of febrile pediatric and adult inpatients within 24 hours of admission to two hospitals in northern Tanzania. Naso-oropharyngeal (NP/OP) specimens were collected for detection of 19 pathogens by polymerase chain reaction. Participants were stratified by age <10 years and ≥10 years, and categorized in the following three groups: severe acute respiratory infection (SARI); non-SARI respiratory illness; no respiratory illness. Results Among 1,132 participants enrolled, 930 (82.1%) had NP/OP specimens tested. Median (interquartile range) age was 22.3 (2.1-44.0) years, 432 (46.5%) were female, and 378 (40.7%) had SARI. We observed 410 pathogen detections in 359 (38.6%) participants: 256 (67.2%) of 381 <10 years and 103 (18.8%) of 549 ≥10 years. Of 301 pathogen detections among participants <10 years, the most common were rhinovirus/enterovirus (RV/EV; n=80, 26.6%), influenza (n=60, 19.9%) and adenovirus (n=45, 15.0%). Of 109 pathogen detections in participants ≥10 years, the most common were RV/EV (n=41, 37.6%), influenza (n=37, 33.9%), and respiratory syncytial virus (RSV; n=6, 5.5%). Among SARI, the most common pathogens were influenza (n=71, 18.8%), RV/EV (n=66, 17.5%), and RSV (n=37, 9.8%). Conclusions RV/EV, influenza and RSV were commonly detected among febrile inpatients in Tanzania, including among participants with SARI. These findings have implications for vaccine development and implementation in low- and middle-income countries.
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Authors Martin Linster, Marina Zahari, Yan Zhuang, Marcus G. Mah, Manuela Carugati, Ganga Moorthy, Deng B. Madut, Michael J. Maze, Bingileki Lwezaula, Annette Marandu, Calvin Machare, Kajiru Kilonzo, Ronald Mbwasi, Blandina T Mmbaga, James S Ngocho, John P. Bonnewell, L Wang, John A Crump, Venance P. Maro, G J Smith, Matthew P. Rubach
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag317
URL
https://doi.org/10.1093/ofid/ofag317
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