Hospital admissions for acute respiratory tract infections among infants from Nunavut and the burden of respiratory syncytial virus: a 10-year retrospective cohort study

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES Lancet Regional Health-Americas Pub Date : 2025-02-13 DOI:10.1016/j.lana.2025.101021

Mai-Lei Woo Kinshella , Jean Allen , Jasmine Pawa , Jesse Papenburg , Radha Jetty , Rachel Dwilow , Joanne Embree , Joan Robinson , Laura Arbour , Manish Sadarangani , Ye Shen , Jeffrey N. Bone , Celia Walker , Iryna Kayda , Holden Sheffield , Darcy Scott , Amber Miners , David M. Goldfarb

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Abstract

Background

Nunavut is a northern Canadian territory where a high proportion of infants are admitted to hospital with acute respiratory tract infection (ARI). Previous studies have been limited in regional and/or short duration of coverage. This study aimed to estimate the incidence rate, microbiology and outcomes of ARI hospitalizations in Nunavut infants.

Methods

We conducted a retrospective cohort study of infants aged <1 year from Nunavut hospitalized for ARI at two regional and four tertiary pediatric hospitals in Canada, January 1, 2010, to June 30, 2020. One regional hospital was located in Nunavut; others were located across Canada. Descriptive statistics and multivariable logistic regression were performed.

Findings

We identified 1189 ARI admissions, with an incidence rate of 133.9 per 1000 infants per year (95% confidence interval (CI): 126.8, 141.3). Of these admissions, 56.0% (n = 666) were to regional hospitals alone, 72.3% (n = 860) involved hospitalization outside of Nunavut, 15.6% (n = 185) were admitted into intensive care, and 9.2% (n = 109) underwent mechanical ventilation. Among 730 admissions with a pathogen identified, 45.8% had respiratory syncytial virus (RSV; n = 334), for a yearly incidence rate of 37.8 RSV-associated hospitalizations per 1000 infants (95% CI: 33.9, 42.1). Among RSV-associated hospitalizations, 41.1% (n = 138) were infants 0–2 months of age and 32.1% (n = 108) were >6 months. Compared with non-RSV admissions, infants with RSV had higher odds of admission into intensive care, oxygen therapy, CPAP/BiPAP respiratory support and length of hospital stay over a week.

Interpretation

Understanding the high burden of ARI among Nunavut infants can inform health policy and serve as a baseline for assessing the impact of any new interventions targeting infant ARIs.

Funding

Public Health Agency of Canada and Canadian Institutes of Health Research via the Canadian Immunization Research Network (CNF 151944).

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Lancet Regional Health-Americas Multiple-

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8.00

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0.00%

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期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.