Etiological agents identified in febrile children presenting to the Pediatric Outpatient Department at Patan Hospital, Nepal, during the summer and winter study periods.

†<p>4 <i>R. typhi</i> PCR positive patients had <i>S</i>. Typhi and 1 had <i>S</i>. Paratyphi A in blood culture.</p

Demographic, clinical and laboratory features of patients with culture-confirmed enteric fever and their comparison with all the other patients in the cohort^*.

*<p>Data are no. (%) unless stated otherwise. SD, standard deviation; IQR, interquartile range.</p

Pathogens responsible for blood stream infections according to age group^*.

*<p>Data are no. (%) or no. unless stated otherwise. Percents shown for column totals only for bacterial isolates by blood culture.</p>†<p>Pathogens isolated by blood culture unless indicated otherwise.</p>‡<p>Median age in months.</p>††<p>4 patients with <i>S.</i> Typhi and 1 patient with <i>S.</i> Paratyphi A were PCR positive for <i>R. typhi.</i></p

Clinical characteristics of febrile children presenting to the Pediatric Outpatient Department at Patan Hospital, Nepal, during the summer and winter study periods.

<p>Clinical characteristics of febrile children presenting to the Pediatric Outpatient Department at Patan Hospital, Nepal, during the summer and winter study periods.</p

Microarray summary

Summary of microarray detection of pneumococcal serotypes present in nasopharyngeal specimen

Mean Anti-Hib Antibody Concentrations and Percentage of Participants with Protective Levels.

<p>Only 20% of children under 5 years old have protective (>0.15 µg/ml) antibody levels, rising to 83% of 15–54 year-olds. Geometric mean anti-polyribosylribitol phosphate IgG concentrations for each age group are plotted on the left y-axis (±SE). The percentage of participants with antibody concentrations >0.15 µg/ml (‘short-term protection’: the height of the entire column) and >1 µg/ml (‘long-term’ protection: the height of only the shaded column) are plotted on the right y-axis (±SE). Sample sizes (n): Cord Blood (n = 15); 0.5–4 yrs (n = 15); 5–7 yrs (n = 15); 8–14 yrs (n = 18); 15–54 yrs (n = 12); 55–77 yrs (n = 11).</p

Heat map representation of nasopharyngeal swab isolates from children aged 6 weeks to 24 months from the Kathmandu Valley, Nepal.

<p>Isolates are ordered according to participant number and presence of pneumococcus. The depth of colour is representative of the relative abundance of the isolate identified by microarray. Each isolate was divided into three categories: S—Typeable pneumococci, N– Non-typeable pneumococci and, M—Mitis-group Streptococcus. Subsequent isolates within these categories were then ranked 1–4 according to relative abundance.</p

Multiple pneumococcal carriage by age group.

<p>The proportion of nasopharyngeal swabs from children from the Kathmandu Valley, Nepal, positive for pneumococcal serotype/s by microarray analysis categorised by age group. Error bars indicate 95% confidence interval upper limits.</p

Serotype-specific ranking of multiple pneumococcal carriage.

<p>Nasopharyngeal swabs collected from all children aged 6 weeks to 24 months from the Kathmandu Valley, Nepal were analysed by microarray, with each <i>Streptococcus</i> isolate from pneumococcus positive swabs ranked according to its relative abundance to other isolates present on the swab.</p

Serotype-specific propensity for isolation as a primary or non-primary isolate.

<p>Pneumococcal serotypes identified from nasopharyngeal swabs of Nepalese children aged 6 weeks to 24 months from the Kathmandu Valley, Nepal, were classified as to whether they occurred as a primary or non-primary isolate (*p<0·05). Specifically for each serotype: 15B, 10A, 35A, 34, 35F, 16F, 20, NT4b, 13, and NT4a p<0.0001; 6A p = 0.0005; 6B, 19A and 6C p = 0.0012; 23A and 33B p = 0.0016; NT2 p = 0.0257; 23F p = 0.0035; 4 p = 0.0101. The serotypes, 9V, 14, 19F, 3, 11D, 17F, 35B, 35C, 39, 7C, 45, 15, 7B, 8, 9N, 18C, 15A, 23B, 29, 22A, 28F, 31, 33C, 6D, 19B, 10F, 24A, 38, 48, 9L, 11A, 11B, 12F, 17A, 18A, 24B, 32F, 33A, 33F, 36, 1, 5, 7F, NT3b, 25F, 28A, 37, 40, 19C, and NT were not labelled and/or had non-significant p-values and/or were isolated on less than five occasions. MGS = Mitis-group Streptococcus.</p