{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:22:28Z","timestamp":1789424548309,"version":"build-2803163510"},"reference-count":20,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Mutah","award":["884\/2024"],"award-info":[{"award-number":["884\/2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Human parainfluenza virus (HPIV) is a major cause of respiratory illnesses in children under five years, with clinical manifestations ranging from mild upper respiratory tract infections to severe lower respiratory tract diseases. This multi-center, cross-sectional study investigated the burden, clinical features, and predictors of respiratory viral infections in hospitalized children across four sites in Jordan. Nasopharyngeal specimens from 1000 eligible children were analyzed. In this article, we focused on HPIV infections. The overall HPIV positivity rate was 22.6%, with HPIV-3 accounting for 90.3% of cases. Significant geographic variability was observed, with higher positivity rates in the southern region. HPIV-positive cases frequently presented with symptoms like nasal congestion, tachypnea, and poor feeding. Co-infections with respiratory syncytial virus (RSV) or influenza were associated with worse outcomes, including an increased need for invasive ventilation. The logistic regression identified male gender, asthma, and respiratory acidosis as predictors of complications. Geographic differences in HPIV prevalence and severity were notable, emphasizing the influence of environmental and socioeconomic factors. These findings underscore the urgent need for enhanced HPIV surveillance, targeted public health interventions, and vaccine development to mitigate the disease burden. This study provides critical insights that guide healthcare strategies and improve outcomes in young children at risk of severe HPIV infections.<\/jats:p>","DOI":"10.3390\/v17020170","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T04:59:10Z","timestamp":1737953950000},"page":"170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Epidemiology and Clinical Burdens of Human Parainfluenza Virus Infections Amongst Hospitalized Children Under 5 Years of Age in Jordan: A National Multi-Center Cross-Sectional Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2437-5547","authenticated-orcid":false,"given":"Munir","family":"Abu-Helalah","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Jordan, Amman 11942, Jordan"},{"name":"Public Health Institute, University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Abu Lubad","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Pathology, Faculty of Medicine, Mutah University, Karak 61710, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5683-1630","authenticated-orcid":false,"given":"Mohammad","family":"Al-Hanaktah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Al Tibi","sequence":"additional","affiliation":[{"name":"Molecular Genetics Supervisor, Biolab Diagnostic Laboratories, P.O. Box 5153, Amman 11183, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7246-622X","authenticated-orcid":false,"given":"Maisalreem","family":"Alhousani","sequence":"additional","affiliation":[{"name":"Research Assistant, Mutah University, Karak 61710, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6350-6557","authenticated-orcid":false,"given":"Simon B.","family":"Drysdale","sequence":"additional","affiliation":[{"name":"13 Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford OX1 2JD, UK"},{"name":"The NIHR Oxford Biomedical Research Centre, Oxford OX3 7JX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1055\/s-0036-1584798","article-title":"Parainfluenza Virus Infection","volume":"37","author":"Branche","year":"2016","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1031","DOI":"10.1016\/S2214-109X(19)30264-5","article-title":"Global Patterns in Monthly Activity of Influenza Virus, Respiratory Syncytial Virus, Parainfluenza Virus, and Metapneumovirus: A Systematic Analysis","volume":"7","author":"Li","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1128\/CMR.16.2.242-264.2003","article-title":"Parainfluenza Viruses","volume":"16","author":"Henrickson","year":"2003","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e1077","DOI":"10.1016\/S2214-109X(21)00218-7","article-title":"Global Burden of Acute Lower Respiratory Infection Associated with Human Parainfluenza Virus in Children Younger than 5 Years for 2018: A Systematic Review and Meta-Analysis","volume":"9","author":"Wang","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1186\/s12985-021-01705-x","article-title":"Clinical Features and Epidemiological Analysis of Respiratory Human Adenovirus Infection in Hospitalized Children: A Cross-Sectional Study in Zhejiang","volume":"18","author":"Wang","year":"2021","journal-title":"Virol. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Howard, L.M., Rankin, D.A., Spieker, A.J., Gu, W., Haddadin, Z., Probst, V., Rahman, H., McHenry, R., Pulido, C.G., and Williams, J.V. (2021). Clinical Features of Parainfluenza Infections among Young Children Hospitalized for Acute Respiratory Illness in Amman, Jordan. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06001-1"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Abu-Helalah, M., Al-Shatnawi, S.F., Abu Lubad, M., Al-Zayadneh, E., Jdaitawi, H., Harahsheh, M., AL-Iede, M., Nafi, O., Yousef, R., and Almaaitah, I. (2024). The Epidemiology, Clinical, and Economic Burdens of Respiratory Syncytial Virus Infections Amongst Hospitalized Children Under 5 Years of Age in Jordan: A National Multi-Center Cross-Sectional Study. Viruses, 16.","DOI":"10.3390\/v16121867"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"235","DOI":"10.46234\/ccdcw2024.047","article-title":"Epidemiological Characteristics of Human Parainfluenza Viruses Infections\u2014China, 2019-2023","volume":"6","author":"Gao","year":"2024","journal-title":"China CDC Wkly."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100049","DOI":"10.1016\/j.jcvp.2021.100049","article-title":"Epidemiological and Clinical Characteristics of Children with Human Parainfluenza Virus Associated Acute Respiratory Infection in a General Hospital in Sri Lanka","volume":"1","author":"Rafeek","year":"2021","journal-title":"J. Clin. Virol. Plus"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.jinf.2023.02.009","article-title":"Changes of Parainfluenza Virus Infection in Children before and after the COVID-19 Pandemic in Henan, China","volume":"86","author":"Li","year":"2023","journal-title":"J. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Xu, X., Zhang, Y., Xu, L., Jiang, W., and Hao, C. (2024). Analysis of Respiratory Pathogen Detection in Hospitalized Children with Acute Respiratory Tract Infections after Ending the Zero COVID Policy. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-82660-9"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s00431-024-05914-8","article-title":"Burden of Viral Respiratory Infections in the Pediatric Intensive Care Unit: Age, Virus Distribution, and the Impact of the COVID-19 Pandemic","volume":"184","author":"Cohen","year":"2024","journal-title":"Eur. J. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Xiao, M., Banu, A., Zeng, X., Shi, S., Peng, R., Chen, S., Ge, N., Tang, C., Huang, Y., and Wang, G. (2024). Epidemiology of Human Parainfluenza Virus Infections among Pediatric Patients in Hainan Island, China, 2021\u20132023. Pathogens, 13.","DOI":"10.3390\/pathogens13090740"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1824-7288-39-22","article-title":"Virological and Clinical Characterizations of Respiratory Infections in Hospitalized Children","volume":"39","author":"Bicer","year":"2013","journal-title":"Ital. J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1056\/NEJM200106213442507","article-title":"Respiratory Syncytial Virus and Parainfluenza Virus","volume":"344","author":"Hall","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Liu, W.-K., Liu, Q., Chen, D.-H., Liang, H.-X., Chen, X.-K., Huang, W.-B., Qin, S., Yang, Z.-F., and Zhou, R. (2013). Epidemiology and Clinical Presentation of the Four Human Parainfluenza Virus Types. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-28"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"010426","DOI":"10.7189\/jogh.10.010426","article-title":"The Role of Viral Co-Infections in the Severity of Acute Respiratory Infections among Children Infected with Respiratory Syncytial Virus (RSV): A Systematic Review and Meta-Analysis","volume":"10","author":"Li","year":"2020","journal-title":"J. Glob. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.1016\/S2542-5196(20)30297-7","article-title":"Seasonal Association between Viral Causes of Hospitalised Acute Lower Respiratory Infections and Meteorological Factors in China: A Retrospective Study","volume":"5","author":"Xu","year":"2021","journal-title":"Lancet Planet. Health"},{"key":"ref_19","first-page":"193","article-title":"Poverty Effects of House Holds in the Southern Region of Jordan","volume":"7","author":"Alalaya","year":"2015","journal-title":"Eur. J. Bus. Manag."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e2316376121","DOI":"10.1073\/pnas.2316376121","article-title":"Human Parainfluenza Virus 3 Vaccine Candidates Attenuated by Codon-Pair Deoptimization Are Immunogenic and Protective in Hamsters","volume":"121","author":"Afroz","year":"2024","journal-title":"Proc. Natl. Acad. Sci. USA"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/2\/170\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:10Z","timestamp":1759919770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/2\/170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,25]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["v17020170"],"URL":"https:\/\/doi.org\/10.3390\/v17020170","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,25]]}}}