Incidence of Respiratory Syncytial Virus Lower Respiratory Tract Infections During the First 2 Years of Life: A Prospective Study Across Diverse Global Settings

J. Langley, V. Bianco, J. Domachowske, S. Madhi, S. Stoszek, K. Zaman, Agustin Bueso, A. Ceballos, Luis Cousin, Ulises D’Andrea, I. Dieussaert, J. Englund, S. Gandhi, O. Gruselle, G. Haars, Lisa Jose, N. Klein, Amanda Leach, Koen Maleux, Thi Lien-Anh Nguyen, T. Puthanakit, P. Silas, A. Tangsathapornpong, J. Teeratakulpisarn, T. Vesikari, Rachel A. Cohen
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引用次数: 4

Abstract

Abstract Background The true burden of lower respiratory tract infections (LRTIs) due to respiratory syncytial virus (RSV) remains unclear. This study aimed to provide more robust, multinational data on RSV-LRTI incidence and burden in the first 2 years of life. Methods This prospective, observational cohort study was conducted in Argentina, Bangladesh, Canada, Finland, Honduras, South Africa, Thailand, and United States. Children were followed for 24 months from birth. Suspected LRTIs were detected via active (through regular contacts) and passive surveillance. RSV and other viruses were detected from nasopharyngeal swabs using PCR-based methods. Results Of 2401 children, 206 (8.6%) had 227 episodes of RSV-LRTI. Incidence rates (IRs) of first episode of RSV-LRTI were 7.35 (95% confidence interval [CI], 5.88–9.08), 5.50 (95% CI, 4.21–7.07), and 2.87 (95% CI, 2.18–3.70) cases/100 person-years in children aged 0–5, 6–11, and 12–23 months. IRs for RSV-LRTI, severe RSV-LRTI, and RSV hospitalization tended to be higher among 0–5 month olds and in lower-income settings. RSV was detected for 40% of LRTIs in 0–2 month olds and for approximately 20% of LRTIs in older children. Other viruses were codetected in 29.2% of RSV-positive nasopharyngeal swabs. Conclusions A substantial burden of RSV-LRTI was observed across diverse settings, impacting the youngest infants the most. Clinical Trials Registration. NCT01995175.
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生命前2年呼吸道合胞病毒下呼吸道感染的发病率:一项跨全球不同环境的前瞻性研究
背景呼吸道合胞病毒(RSV)引起的下呼吸道感染(LRTIs)的真正负担尚不清楚。本研究旨在提供关于生命最初2年RSV-LRTI发病率和负担的更可靠的跨国数据。方法本前瞻性、观察性队列研究在阿根廷、孟加拉国、加拿大、芬兰、洪都拉斯、南非、泰国和美国进行。这些孩子从出生起被跟踪了24个月。通过主动(通过定期接触)和被动监测发现了疑似下呼吸道感染。采用基于pcr的方法从鼻咽拭子中检测RSV和其他病毒。结果在2401例儿童中,206例(8.6%)有227例RSV-LRTI发作。在0-5、6-11和12-23月龄儿童中,RSV-LRTI首次发作的发病率(IRs)分别为7.35(95%可信区间[CI], 5.88-9.08)、5.50 (95% CI, 4.21-7.07)和2.87 (95% CI, 2.18-3.70)例/100人年。在0-5个月的婴儿和低收入环境中,RSV- lrti、严重RSV- lrti和RSV住院率往往更高。在0-2月龄的LRTIs中检测到40%的RSV,在较大的儿童中检测到约20%的RSV。29.2%的rsv阳性鼻咽拭子共检出其他病毒。结论在不同的环境中观察到RSV-LRTI的巨大负担,对最小的婴儿影响最大。临床试验注册。NCT01995175。
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