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The Charles Mérieux Center for Infectious Disease of Antananarivo University, in Madagascar, carries a study to determine the bacterial or viral etiology of community-acquired acute respiratory infections in patients hospitalized. 

A respiratory infection is defined as a bacterial, viral, fungal, or parasitic condition affecting the tissues of the respiratory system. Respiratory infections are responsible for over 4 million deaths each year and are the leading cause of mortality in developing countries. The proportion is significantly higher in low-income countries due to inadequate healthcare management, with pneumonia being the most severe respiratory infection. Each year, influenza affects 5–15% of the global population and causes severe illness in 3 to 5 million people. The WHO closely monitors certain respiratory viruses. 

In children, the most common respiratory infections are infant bronchiolitis and pediatric pneumonia. In the early stages, symptoms do not allow differentiation between bacterial and viral infections, often leading to inappropriate therapeutic decisions and the overuse of antibiotics. In routine practice, and in most public laboratories in Madagascar, biological diagnosis of respiratory infections — particularly the identification of causative agents — remains largely unavailable. The acquisition of the FilmArray® BioFire® Respiratory Panel 2.1 plus (RP2.1 plus) system (BioFire Diagnostics, LLC, Utah, USA), which allows rapid multiplex PCR detection of these pathogens, will provide valuable support for diagnosis and appropriate patient care. 

The main objective of the study is to determine the bacterial or viral etiology of community-acquired acute respiratory infections in patients hospitalized at Tsaralalàna University Hospital Center for Mothers and Children (CHUMET). 

 
The specific objectives are to: 

• Describe the clinical and demographic characteristics of the patients tested
• Identify circulating respiratory pathogens, including SARS-CoV-2 if detected during the study period
• Monitor the circulation of pathogens responsible for respiratory outbreaks

This study has received ethical approval from the Biomedical Research Ethics Committee of the Ministry of Public Health of Madagascar. Case inclusion, sample collection, and culture are carried out at CHUMET. Part of the collected samples is sent to the CICM’s Rodolphe Merieux Laboratory for multiplex testing using the FilmArray® BioFire® respiratory panel. 

This study will highlight the importance of using the FilmArray RP2.1 respiratory panel for the rapid identification — within a few hours — of pathogens responsible for respiratory infections. It will also contribute to improved patient management, particularly in guiding appropriate medication use.