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J Infect. 2016 Aug;73(2):145-54. doi: 10.1016/j.jinf.2016.05.007. Epub 2016 May 27.

Respiratory syncytial virus infection in infants in rural Nepal.

Author information

1
Department of Medicine, University of Washington, Seattle, WA, USA. Electronic address: helenchu@uw.edu.
2
Department of International Health, Johns Hopkins University, Baltimore, MD, USA.
3
Department of Global Health, George Washington University, Washington, D.C., USA.
4
Nepal Nutrition Intervention Project-Sarlahi, Sarlahi District, Nepal.
5
Department of Pediatrics and Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
6
Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
7
Department of Global Health, Cincinnati Children's Hospital, Cincinnati, OH, USA.
8
Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, WA, USA.

Abstract

OBJECTIVES:

Respiratory syncytial virus (RSV) pneumonia is a leading cause of infant mortality worldwide. The risk of RSV infection associated with preterm birth is not well-characterized in resource-limited settings. We aimed to obtain precise estimates of risk factors and disease burden of RSV in infants in rural southern Nepal.

METHODS:

Pregnant women were enrolled, and along with their infants, followed to six months after birth with active weekly home-based surveillance for acute respiratory illness (ARI). Mid-nasal swabs were obtained and tested for RSV by PCR for all illness episodes. Birth outcomes were assessed at a postpartum home visit.

RESULTS:

311 (9%) of 3509 infants had an RSV ARI. RSV ARI incidence decreased from 551/1000 person-years in infants born between 28 and 31 weeks to 195/1000 person-years in infants born full-term (p = 0.017). Of 220 infants (71%) evaluated in the health system, 41 (19%) visited a hospital or physician. Of 287 infants with an assessment performed, 203 (71%) had a lower respiratory tract infection.

CONCLUSIONS:

In a rural south Asian setting with intensive home-based surveillance, RSV caused a significant burden of respiratory illness. Preterm infants had the highest incidence of RSV ARI, and should be considered a priority group for RSV preventive interventions in resource-limited settings.

KEYWORDS:

Pneumonia; Preterm birth; Resource-limited setting; Respiratory syncytial virus

PMID:
27241525
PMCID:
PMC4942356
DOI:
10.1016/j.jinf.2016.05.007
[Indexed for MEDLINE]
Free PMC Article

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