The attributable fraction of respiratory syncytial virus among patients of different ages with influenza-like illness and severe acute respiratory illness in a high HIV prevalence setting, South Africa, 2012-2016.
The attributable fraction of respiratory syncytial virus among patients of different ages with influenza-like illness and severe acute respiratory illness in a high HIV prevalence setting, South Africa, 2012-2016.
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2012-2016 年南非艾滋病毒高流行地区不同年龄的流感样疾病和严重急性呼吸道疾病患者中呼吸道合胞病毒的归因比例。
DOI：
10.1016/j.ijid.2023.05.009
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Cohen,Cheryl
中科院分区：
文献类型：
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作者：
Moyes,Jocelyn;Tempia,Stefano;Walaza,Sibongile;McMorrow,MeredithL;Cohen,AdamL;Treurnicht,Florette;Hellferscee,Orienka;Wolter,Nicole;VonGottberg,Anne;Dawood,Halima;Variava,Ebrahim;Kahn,Kathleen;Madhi,ShabirA;Cohen,Cheryl
目的 上呼吸道样本中检测到呼吸道合胞病毒 (RSV) 并不一定能推断疾病的因果关系。我们的目的是计算不同年龄组临床综合征中RSV的归因分数（AF）。方法使用无条件逻辑回归模型，通过比较2012-2016年南非RSV相关流感样疾病（ILI）和严重急性呼吸道疾病（SARI）病例中RSV检测流行率与健康对照，估计了RSV相关流感样疾病（ILI）和严重急性呼吸道疾病（SARI）病例的AF。该分析按 HIV 血清状态分层，在年龄类别 <1、1-4、5-24、25-44、45-64 和 ≥65 岁中进行。结果我们纳入了 12,048 名个体：2687 名对照者、5449 名 ILI 病例和 5449 名 SARI 病例。 ILI 的 RSV-AF 在 <1、1-4、5 和 24、25-44 岁年龄组中显着：84.9%（95% 置信区间 [CI] 69.3-92.6%）、74.6%（95% CI 53.6-86.0%）、60.8%（95% CI 21.4-80.5%）和分别为 64.1%（95% CI 14.9-84.9%）。同样，<1 岁和 1-4 岁年龄组中 SARI 的显着 RSV-AF 分别为 95.3% (95% CI 91.1-97.5) 和 83.4% (95% CI 70.9-90.5)。在 HIV 感染者中，RSV 与 5-44 岁个体中的 ILI 病例显着相关。结论幼儿中的高 RSV-AF 证实 RSV 检测与南非儿童（特别是婴儿）的严重呼吸道疾病相关。这些估计将有助于完善负担估计和成本效益模型。
ObjectivesThe detection of respiratory syncytial virus (RSV) in upper airway samples does not necessarily infer causality of illness. We aimed to calculate the attributable fraction (AF) of RSV in clinical syndromes across age groups.MethodsUsing unconditional logistic regression models, we estimated the AF of RSV-associated influenza-like illness (ILI) and severe acute respiratory illness (SARI) cases by comparing RSV detection prevalence among ILI and SARI cases to those of healthy controls in South Africa, 2012-2016. The analysis, stratified by HIV serostatus, was conducted in the age categories <1, 1-4, 5-24, 25-44, 45-64, and ≥65 years.ResultsWe included 12,048 individuals: 2687 controls, 5449 ILI cases, and 5449 SARI cases. RSV-AFs for ILI were significant in <1, 1-4, 5-and 24, 25-44-year age groups: 84.9% (95% confidence interval [CI] 69.3-92.6%), 74.6% (95% CI 53.6-86.0%), 60.8% (95% CI 21.4-80.5%) and 64.1% (95% CI 14.9-84.9%), respectively. Similarly, significant RSV-AFs for SARI were 95.3% (95% CI 91.1-97.5) and 83.4% (95% CI 70.9-90.5) in the <1 and 1-4-year age groups respectively. In HIV-infected persons, RSV was significantly associated with ILI cases vs controls in individuals aged 5-44 years.ConclusionHigh RSV-AFs in young children confirm RSV detection is associated with severe respiratory illness in South African children, specifically infants. These estimates will assist with refining burden estimates and cost-effectiveness models.