Epidemiology and risk factors for Human Rhinovirus infections and severe outcomes in Burkina Faso: A cross-sectional analysis of sentinel surveillance data, 2016-2019

ABSTRACT
Background
Human rhinovirus (HRV), traditionally recognised as the primary cause of the common cold, has emerged as a significant contributor to severe lower respiratory tract infections (LRTIs), including bronchiolitis and pneumonia. We aimed to identify factors associated with HRV infection and HRV infection with severe outcomes using Burkina Faso country-wide Severe Acute Respiratory Infections (SARI) data.  
Methods
A cross-sectional study was conducted from October 2016 to April 2019, using data from four hospitals in Burkina Faso that were enrolled in the SARI sentinel surveillance program. Children and adult patients fulfilling the 2014 WHO SARI definition (acute respiratory infection with fever (≥38°C) and cough within 10 days requiring hospitalisation) were included, with specimens collected and tested for HRV and other pathogens using multiplex real-time RT-PCR. Demographic, clinical, and laboratory data were analysed using descriptive statistics and logistic regression to identify predictors of HRV infection and severity.​
Results
Among 1,540 enrolled patients, children under four years comprised the majority (49.3%). Most participants were from rural areas, with a predominance of male enrollment. HRV prevalence ranged from 29.8% to 38.1% in different sentinel sites. Young age, urban residency, early consultation, chronic conditions, and viral-bacterial coinfections were independently associated with a higher risk of HRV infection. Severe outcomes were significantly related to site location, specific viral and bacterial coinfections, especially with Adenovirus, Haemophilus influenzae, Haemophilus influenzaetype b, and any bacterial coinfection. Influenza A and viral coinfection alone appeared protective against severe outcomes.​
Conclusion
HRV represents an important etiologic agent of SARIs in Burkina Faso. Identifying demographic and clinical predictors such as young age, coinfection status, and geographical patterns can guide targeted interventions and improve outcomes in high-risk populations, especially in resource-limited settings.​
Keywords
Human rhinovirus, Severe acute respiratory infections, severe outcomes, risk factors, Burkina Faso, coinfection, sentinel surveillance