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Respiratory Syncytial Virus Infection Among Hospitalized Infants in Four Middle-Income Countries
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7 31 2023
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Source: J Pediatric Infect Dis Soc. 12(7):394-405
Details:
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Alternative Title:J Pediatric Infect Dis Soc
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Personal Author:
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Description:Background:
Understanding respiratory syncytial virus (RSV) global epidemiology is important to inform future prevention strategies.
Methods:
Hospitalized infants <1-year-old with acute illness were enrolled prospectively in Albania, Jordan, Nicaragua, and Philippines during respiratory seasons in 2015–2017. Medical chart review, parental interview, and post-discharge follow up were conducted. Respiratory specimens were tested using real-time RT-PCR for RSV. Infant characteristics associated with very severe illness (intensive care unit [ICU] admission or receipt of supplemental oxygen) were assessed using logistic regression to adjust for potential confounders (age, sex, study site, and preterm birth).
Results:
Of 3634 enrolled hospitalized infants, 1129 (31%) tested positive for RSV. The median age of RSV-positive infants was 2.7 (IQR: 1.4–6.1) months and 665 (59%) were male. Very severe illness in 583 (52%) RSV-positive infants was associated with younger age (aOR 4.1, 95% CI: 2.6–6.5 for 0–2 compared to 9–11-months; P < .01), low weight-for-age z-score (aOR 1.9, 95% CI: 1.2–2.8; P < .01), ICU care after birth (aOR 1.6, 95% CI: 1.0–2.5; P = .048), and cesarean delivery (aOR 1.4, 95% CI: 1.0–1.8; P = .03). RSV subgroups A and B co-circulated at all sites with alternating predominance by year; subgroup was not associated with severity (aOR 1.0, 95% CI: 0.8–1.4). Nine (0.8%) RSV-positive infants died during admission or within ≤30 days of discharge, of which 7 (78%) were <6-months-old.
Conclusions:
RSV was associated with nearly a third of infant acute illness hospitalizations in four middle-income countries during the respiratory season, where, in addition to young age, factors including low weight-for-age might be important predictors of severity. RSV prevention strategies targeting young infants could substantially reduce RSV-associated hospitalizations in middle-income countries.
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Pubmed ID:37313727
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Pubmed Central ID:PMC11268525
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