Institution: Makerere University

Project Affiliation: CAfGEN

Abstract

Introduction: In Uganda, 130,000 children (0-14 years of age) were living with HIV in 2018. While fevers are commonly attributed to malaria, most fevers in African children are not due to malaria, and clinicians are challenged by the similar clinical features of a wide spectrum of potential etiologies. Rapid diagnostic tests (RDTs) for malaria have highlighted the decreasing proportion of malaria-attributable illnesses in endemic areas. Unfortunately, once malaria is excluded, there are few accessible diagnostic tools to guide the management of severe febrile illnesses in low-resource settings. This project is utilizing shotgun metagenomics sequencing to detect and characterize microbial pathogens in HIV-infected Ugandan children and adolescents admitted to Baylor College of Medicine Children’s Foundation – Uganda with non-malarial febrile illness (NMFIs) and associated clinical presentations or comorbidities.

Objectives: 1. To identify microbial pathogens in HIV-infected Ugandan children and adolescents admitted to Mulago National Referral Hospital, Baylor-Uganda clinic with NMFIs. 2. To characterize the clinical presentations and determine associations between specific clinical syndromes with both known and novel pathogens in clinical specimens of HIV-infected Ugandan children and adolescents with NMFIs. 3. To identify and describe the frequency of comorbidities in children and adolescents with perinatally acquired HIV infection with NMFIs in Uganda

Methods: The study has recruited patients between the ages of 0 and 14 years presenting with fevers but negative for malaria. Stool samples, complete blood cell count (CBC), viral load results, and other relevant clinical data have been collected from these patients. The collected stool is undergoing shotgun metagenomics sequencing on the NovaSeq 6000 platform. The resultant FastQ files will be subjected to a customized shotgun metagenomics workflow and results will be available soon.

Conflict of interest disclosure: The authors declare no conflict of interest, in terms of scientific, financial and personal

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