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

Female Infant Infant, Newborn Humans Male Respiratory Syncytial Virus Infections Acute Disease Aftercare Developing Countries Patient Discharge Premature Birth Respiratory Syncytial Virus, Human Hospitalization

Albania Jordan Nicaragua Pediatric Philippines Respiratory syncytial virus bronchiolitis global health infant pneumonia

Journal

Journal of the Pediatric Infectious Diseases Society

ISSN: 2048-7207

Titre abrégé: J Pediatric Infect Dis Soc

Pays: England

ID NLM: 101586049

Informations de publication

Date de publication:
31 Jul 2023

Historique:

received: 20 12 2022

accepted: 08 06 2023

medline: 1 8 2023

pubmed: 14 6 2023

entrez: 14 6 2023

Statut: ppublish

Résumé

Understanding respiratory syncytial virus (RSV) global epidemiology is important to inform future prevention strategies. 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). 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. 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.

Sections du résumé

BACKGROUND BACKGROUND

Understanding respiratory syncytial virus (RSV) global epidemiology is important to inform future prevention strategies.

METHODS 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 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 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.

Identifiants

DOI: 10.1093/jpids/piad042 PMID: 37313727

pubmed: 37313727

pii: 7197508

doi: 10.1093/jpids/piad042

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

394-405

Subventions

Organisme : CDC HHS

ID : HHSD2002013M53890B

Pays : United States

Investigateurs

Min Z Levine (MZ)

Laura Edwards (L)

Angel Balmaseda (A)

Guillermina Kuan (G)

Nery Sanchez (N)

Sergio Ojeda (S)

Tareq M Al-Sanouri (TM)

Ali Arbaji (A)

Lei Lanna Mendoza-Dancel (LL)

Karen Iana Cruz (K)

Diozele M Sanvictores (DM)

Informations de copyright

Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society 2023.