Burden and Risk Factors for Coronavirus Infections in Infants in Rural Nepal.
Burden and Risk Factors for Coronavirus Infections in Infants in Rural Nepal.
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尼泊尔农村地区婴儿冠状病毒感染的负担和危险因素。
DOI：
10.1093/cid/ciy317
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Katz,Joanne
中科院分区：
文献类型：
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作者：
Uddin,SMIftekhar;Englund,JanetA;Kuypers,JaneY;Chu,HelenY;Steinhoff,MarkC;Khatry,SubarnaK;LeClerq,SteveC;Tielsch,JamesM;Mullany,LukeC;Shrestha,Laxman;Katz,Joanne
背景对社区环境中儿童有症状的人冠状病毒（HCoV）感染的危险因素的了解有限。我们估计的疾病负担和出生相关的，产妇，家庭和季节性因素对HCoV感染的儿童从出生到6个月大的农村Nepal.MethodsProspective，积极的，每周监测急性呼吸道感染（阿里斯）进行了为期3年的婴儿在2个连续的，以人口为基础的随机试验，产妇流感免疫接种。收集中鼻拭子用于急性呼吸道症状，并通过逆转录聚合酶链反应检测HCoV和其他病毒。HCoV的发病率和潜在的危险因素之间的关联进行建模使用Poisson regression.ResultsOverall，282 3505（8%）婴儿经历了HCoV ARI的前6个月内的生活。HCoV的总体发病率为255.6（95%置信区间[CI]，227.3-286.5）/1000人-年，非新生儿的发病率比新生儿高两倍多（发病率比[IRR]，2.53; 95% CI，1.52-4.21）。HCoV ARI的发病率也与家庭中每个房间5岁以下儿童的数量呈正相关（IRR，1.13; 95%CI，1.01-1.28）。在检测到的296例HCoV感染中，46%与其他呼吸道病毒合并感染。虽然在整个研究期间检测到HCoV，也观察到季节性变化，发病率在2个冬季（12月至2月）和1个秋季（9月至11月）达到峰值。在出生后的第一个月内，HCoV感染的风险增加。
BackgroundKnowledge of risk factors for symptomatic human coronavirus (HCoV) infections in children in community settings is limited. We estimated the disease burden and impact of birth-related, maternal, household, and seasonal factors on HCoV infections among children from birth to 6 months old in rural Nepal.MethodsProspective, active, weekly surveillance for acute respiratory infections (ARIs) was conducted in infants over a period of 3 years during 2 consecutive, population-based randomized trials of maternal influenza immunization. Midnasal swabs were collected for acute respiratory symptoms and tested for HCoV and other viruses by reverse-transcription polymerase chain reaction. Association between HCoV incidence and potential risk factors was modeled using Poisson regression.ResultsOverall, 282 of 3505 (8%) infants experienced an HCoV ARI within the first 6 months of life. HCoV incidence overall was 255.6 (95% confidence interval [CI], 227.3–286.5) per 1000 person-years, and was more than twice as high among nonneonates than among neonates (incidence rate ratio [IRR], 2.53; 95% CI, 1.52–4.21). HCoV ARI incidence was also positively associated with the number of children <5 years of age per room in a household (IRR, 1.13; 95% CI, 1.01–1.28). Of the 296 HCoV infections detected, 46% were coinfections with other respiratory viruses. While HCoVs were detected throughout the study period, seasonal variation was also observed, with incidence peaking in 2 winters (December–February) and 1 autumn (September–November).ConclusionsHCoV is associated with a substantial proportion of illnesses among young infants in rural Nepal. There is an increased risk of HCoV infection beyond the first month of life.