Primary and Repeated Respiratory Viral Infections Among Infants in Rural Nepal.
Primary and Repeated Respiratory Viral Infections Among Infants in Rural Nepal.
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DOI：
10.1093/jpids/piy107
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发表时间：
2020-02-28
影响因子：
3.2
通讯作者：
Chu HY
中科院分区：
文献类型：
--
作者：
Boonyaratanakornkit J;Englund JA;Magaret AS;Bu Y;Tielsch JM;Khatry SK;Katz J;Kuypers J;Shrestha L;LeClerq SC;Steinhoff MC;Chu HY
呼吸道病毒导致婴儿的严重发病和死亡; 99%的此类死亡发生在资源有限的环境中。在资源有限的环境中，婴幼儿初次和反复呼吸道病毒感染的风险因素尚未得到很好的描述。从2011年到2014年，在尼泊尔农村地区招募了一批出生婴儿，并每周进行以家庭为基础的呼吸道症状主动监测，直到6个月大。呼吸系统疾病定义为具有以下任何一种症状：发热、咳嗽、喘息、呼吸困难和/或耳朵引流。我们用逆转录聚合酶链反应检测了呼吸道疾病婴儿的鼻拭子中的多种呼吸道病毒。使用Poisson回归评估同一病毒的初次和重复感染的风险。在3528名婴儿中，1726名（49%）有原发性感染，419名（12%）有重复感染。婴儿呼吸道病毒感染的发生率为1816/1000人-年的原发性感染和1204/1000人-年的重复感染相同的病毒。接触其他儿童和男性均与原发感染风险增加相关（风险比分别为1.13 [95%可信区间（CI），1.06-1.20]和1.14 [95%CI，1.02-1.27]），而母亲教育程度越高，初次感染和重复感染的风险越低（风险比，0.96 [95% CI，0.95-0.98]）。当先前感染相同或另一种呼吸道病毒时，后续感染的发生率没有变化。对于任何呼吸道病毒检测，第一次和第二次发作的婴儿的疾病持续时间和严重程度没有显着差异。在尼泊尔农村的婴儿中，反复呼吸道病毒感染很频繁，我们发现反复感染的疾病严重程度没有降低，也没有证据表明被另一种病毒替代。在生命的前6个月提供持久保护的疫苗战略和公共卫生干预措施可以减轻多种呼吸道病毒反复感染的负担，特别是在资源匮乏的国家。
Respiratory viruses cause significant morbidity and death in infants; 99% of such deaths occur in resource-limited settings. Risk factors for initial and repeated respiratory viral infections in young infants in resource-limited settings have not been well described. From 2011 to 2014, a birth cohort of infants in rural Nepal was enrolled and followed with weekly household-based active surveillance for respiratory symptoms until 6 months of age. Respiratory illness was defined as having any of the following: fever, cough, wheeze, difficulty breathing, and/or a draining ear. We tested nasal swabs of infants with respiratory illness for multiple respiratory viruses by using a reverse transcription polymerase chain reaction assay. The risk of primary and repeated infections with the same virus was evaluated using Poisson regression. Of 3528 infants, 1726 (49%) had a primary infection, and 419 (12%) had a repeated infection. The incidences of respiratory viral infection in infants were 1816 per 1000 person-years for primary infections and 1204 per 1000 person-years for repeated infection with the same virus. Exposure to other children and male sex were each associated with an increased risk for primary infection (risk ratios, 1.13 [95% confidence interval (CI), 1.06–1.20] and 1.14 [95% CI, 1.02–1.27], respectively), whereas higher maternal education was associated with a decreased risk for both primary and repeated infections (risk ratio, 0.96 [95% CI, 0.95–0.98]). The incidence of subsequent infection did not change when previous infection with the same or another respiratory virus occurred. Illness duration and severity were not significantly different in the infants between the first and second episodes for any respiratory virus tested. In infants in rural Nepal, repeated respiratory virus infections were frequent, and we found no decrease in illness severity with repeated infections and no evidence of replacement with another virus. Vaccine strategies and public health interventions that provide durable protection in the first 6 months of life could decrease the burden of repeated infections by multiple respiratory viruses, particularly in low-resource countries.
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影响因子：
5.3
作者：
Agoti CN;Munywoki PK;Phan MVT;Otieno JR;Kamau E;Bett A;Kombe I;Githinji G;Medley GF;Cane PA;Kellam P;Cotten M;Nokes DJ
通讯作者：
Nokes DJ
DOI：
10.1016/j.jcv.2004.03.018
发表时间：
2004-10
期刊：
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
影响因子：
--
作者：
Kuypers J;Wright N;Morrow R
通讯作者：
Morrow R
DOI：
10.1016/j.jcv.2004.11.023
发表时间：
2005-08
期刊：
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
影响因子：
--
作者：
Kuypers J;Wright N;Corey L;Morrow R
通讯作者：
Morrow R
影响因子：
9.4
作者：
Kuypers, Jane;Wright, Nancy;Morrow, Rhoda
通讯作者：
Morrow, Rhoda
DOI：
10.1056/nejmoa0804877
发表时间：
2009-02-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hall CB;Weinberg GA;Iwane MK;Blumkin AK;Edwards KM;Staat MA;Auinger P;Griffin MR;Poehling KA;Erdman D;Grijalva CG;Zhu Y;Szilagyi P
通讯作者：
Szilagyi P