Respiratory syncytial virus infection in infants in rural Nepal. Issue 2 (August 2016)

• Record Type: Journal Article
• Authors: Chu, Helen Y.; Katz, Joanne; Tielsch, James; Khatry, Subarna K.; Shrestha, Laxman; LeClerq, Steven C.; Magaret, Amalia; Kuypers, Jane; Steinhoff, Mark; Englund, Janet A.
• Is Part Of: Journal of infection. Volume 73:Issue 2(2016)
• Page Start: 145
• Page End: 154
• Publication Date: 2016-08
• Subjects: Respiratory syncytial virus -- Pneumonia -- Preterm birth -- Resource-limited setting; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2016.05.007
• Languages: English
• ISSNs: 0163-4453

Abstract

Summary: 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. Highlights: RSV caused a significant burden of respiratory illness in infants in rural Nepal. The highest incidence of RSV was in preterm infants. Most infants with RSV had lower respiratory tract infection or a health care visit. Strategies are needed to prevent RSV in preterm infants in resource-limited settings.