Respiratory Syncytial Virus Infection Among Hospitalized Infants in Four Middle-Income Countries

Details

• Alternative Title:
  J Pediatric Infect Dis Soc
• Personal Author:
  Biggs, Holly M. ; Simões, Eric A. F. ; Khader, Ilham Abu ; Thompson, Mark G. ; Gordon, Aubree ; Hunt, Danielle R. ; DeGroote, Nicholas P. ; Porter, Rachael M. ; Bino, Silvia ; Marar, Basima I. ; Gresh, Lionel ; de Jesus-Cornejo, Joanne ; Langley, Gayle ; Thornburg, Natalie J. ; Peret, Teresa C. T. ; Whitaker, Brett ; Zhang, Yange ; Wang, Lijuan ; Patel, Mira C. ; McMorrow, Meredith ; Campbell, William ; Hasibra, Iris ; Duka, Enkeleda ; Al-Gazo, Mahmoud ; Kubale, John ; Sanchez, Felix ; Lucero, Marilla G. ; Tallo, Veronica L. ; Azziz-Baumgartner, Eduardo ; Simaku, Artan ; Gerber, Susan I.
• 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.
  
  
• Subjects:
  Acute Disease Aftercare Developing Countries Female Hospitalization Humans Infant Infant, Newborn Male Patient Discharge Premature Birth Respiratory Syncytial Virus, Human Respiratory Syncytial Virus Infections

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• Keywords:
  Albania Bronchiolitis Global Health Infant Jordan Nicaragua Pediatric Philippines Pneumonia Respiratory Syncytial Virus
• Source:
  J Pediatric Infect Dis Soc. 12(7):394-405
• Pubmed ID:
  37313727
• Pubmed Central ID:
  PMC11268525
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; HHSD2002013M53890B/CC/CDC HHSUnited States/
• Volume:
  12
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:5fa1e2733a980bc9ee2fb7be3bd3725c7155ce5beed6394a4cac06288387d2917489f2274675a1d9244e2b0f6e44ea61d67e0b11ebb79225e735786073836196
• Download URL:
  https://stacks.cdc.gov/view/cdc/159402/cdc_159402_DS1.pdf
• File Type:
  [PDF - 981.05 KB ]