Respiratory syncytial virus infection in infants in rural Nepal.
Respiratory syncytial virus infection in infants in rural Nepal.
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DOI：
10.1016/j.jinf.2016.05.007
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Englund JA
中科院分区：
文献类型：
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作者：
Chu HY;Katz J;Tielsch J;Khatry SK;Shrestha L;LeClerq SC;Magaret A;Kuypers J;Steinhoff M;Englund JA
呼吸道合胞病毒（RSV）肺炎是全球婴儿死亡的主要原因。在资源有限的环境中，与早产相关的RSV感染风险尚未得到充分表征。我们的目的是获得尼泊尔南部农村婴儿RSV的危险因素和疾病负担的精确估计。孕妇和她们沿着婴儿被纳入研究，并在出生后6个月内进行每周一次的急性呼吸道疾病（ARI）家庭监测。获得所有疾病发作的中鼻拭子并通过PCR检测RSV。在产后家访时评估出生结局。3509名婴儿中有311名（9%）患有RSV ARI。RSV ARI的发病率从28 - 31周出生婴儿的551/1000人-年降至足月出生婴儿的195/1000人-年（p = 0.017）。在卫生系统评估的220名婴儿（71%）中，41名（19%）去医院或医生那里就诊。在进行评估的287名婴儿中，203名（71%）患有下呼吸道感染。在南亚农村地区进行了密集的家庭监测，RSV造成了呼吸道疾病的重大负担。早产儿的RSV ARI发病率最高，应将其视为资源有限环境中RSV预防干预的优先人群。RSV在尼泊尔农村的婴儿中造成了重大的呼吸道疾病负担。RSV的发病率最高的是早产儿。大多数RSV婴儿有下呼吸道感染或医疗保健访问。在资源有限的环境中，需要采取预防早产儿RSV的策略。
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. 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. 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. 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. 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.