Viral pneumonia in adults and older children in sub-Saharan Africa – epidemiology, aetiology, diagnosis and management


Antonia Ho


Community-acquired pneumonia causes substantial morbidity and mortality in sub-Saharan Africa with an estimated
131 million new cases each year. Viruses – such as influenza virus, respiratory syncytial virus and parainfluenza virus
– are now recognised as important causes of respiratory disease in older children and adults in the developed world
following the emergence of sensitive molecular diagnostic tests, recent severe viral epidemics, and the discovery
of novel viruses. Few studies have comprehensively evaluated the viral aetiology of adult pneumonia in Africa,
but it is likely to differ from Western settings due to varying seasonality and the high proportion of patients with
immunosuppression and co-morbidities. Emerging data suggest a high prevalence of viral pathogens, as well as
multiple viral and viral/bacterial infections in African adults with pneumonia. However, the interpretation of positive
results from highly sensitive polymerase chain reaction tests can be challenging. Therapeutic and preventative
options against viral respiratory infections are currently limited in the African setting. This review summarises the
current state of the epidemiology, aetiology, diagnosis and management of viral pneumonia in sub-Saharan Africa.