Association of Respiratory Syncytial Virus Infection and Underlying Risk Factors for Death Among Young Infants Who Died at University Teaching Hospital, Lusaka Zambia.
Association of Respiratory Syncytial Virus Infection and Underlying Risk Factors for Death Among Young Infants Who Died at University Teaching Hospital, Lusaka Zambia.
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DOI：
10.1093/cid/ciab466
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发表时间：
2021-09-02
期刊：
影响因子：
--
通讯作者：
Gill CJ
中科院分区：
文献类型：
--
作者：
Forman LS;Macleod W;Mwananyanda L;Kwenda G;Pieciak R;Mupila Z;Murphy C;Thea D;Chikoti C;Yankonde B;Ngoma B;Chimoga C;Gill CJ
呼吸道合胞病毒（RSV）是急性下呼吸道感染和儿童死亡的主要原因。虽然RSV疾病负担在低收入和中等收入国家最高，但有关致死性RSV疾病风险因素的大多数知识来自高收入环境。在赞比亚卢萨卡的大学教学医院死亡的4天至<6个月的婴儿中，我们使用逆转录酶-定量聚合酶链反应检测了死后获得的鼻咽拭子中的RSV。通过对死亡证明和医院记录的系统回顾，我们确定了10大类与婴儿死亡相关的潜在医疗条件。我们使用后向选择模型计算每种基础疾病与RSV状态之间关联的调整和未调整风险比（RR）。在720例婴儿死亡中，6%（44例）为RSV阳性，70%为<4周龄，54%为男性。在85%的婴儿中发现至少1种基础疾病，而63%的婴儿有≥2种。早产/低出生体重（53% [384]）和分娩并发症（32% [230]）是最常见的情况。先天性心脏病与RSV感染风险增加显著相关（4%，32;校正RR：3.57; 95% CI：1.71-7.44）。无其他基础疾病与RSV显著相关。除先天性心脏病外，我们发现RSV与潜在危险因素之间缺乏相关性。这与高收入环境不同，在高收入环境中，RSV死亡率集中在高危婴儿中。在这一人群中，与出生相关的结局是最高的死亡风险因素。改善新生儿护理对于降低新生儿死亡率仍然至关重要。
Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections and child mortality. While RSV disease burden is highest in low- and middle-income countries, most knowledge about risk factors for fatal RSV disease comes from high-income settings. Among infants aged 4 days to <6 months who died at University Teaching Hospital in Lusaka, Zambia, we tested nasopharyngeal swabs obtained postmortem for RSV using reverse transcriptase–quantitative polymerase chain reaction. Through a systematic review of death certificates and hospital records, we identified 10 broad categories of underlying medical conditions associated with infant deaths. We used backward-selection models to calculate adjusted and unadjusted risk ratios (RRs) for the association between each underlying condition and RSV status. From 720 infant deaths, 6% (44) were RSV-positive, 70% were <4 weeks old, and 54% were male. At least 1 underlying condition was found in 85% of infants, while 63% had ≥2. Prematurity/low birth weight (53% [384]) and complications of labor and delivery (32% [230]) were the most common conditions. Congenital cardiac conditions were significantly associated with an increased risk of RSV infection (4%, 32; adjusted RR: 3.57; 95% CI: 1.71–7.44). No other underlying conditions were significantly associated with RSV. Other than congenital cardiac conditions, we found a lack of association between RSV and underlying risk factors. This differs from high-income settings, where RSV mortality is concentrated among high-risk infants. In this population, birth-related outcomes are the highest mortality risk factors. Improved neonatal care remains crucial in the fight against neonatal mortality.
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影响因子：
3.1
作者：
Wang, Lijuan;Piedra, Pedro A.;Peret, Teresa C. T.
通讯作者：
Peret, Teresa C. T.
影响因子：
168.9
作者：
O'Brien, Katherine L.;Levine, Orin S.;Mitchell, Joanne L.
通讯作者：
Mitchell, Joanne L.
影响因子：
5.1
作者：
WANG, EEL;LAW, BJ;HAMMOND, G
通讯作者：
HAMMOND, G
DOI：
10.1016/s0140-6736(17)30938-8
发表时间：
2017-09-02
期刊：
Lancet (London, England)
影响因子：
--
作者：
Shi T;McAllister DA;O'Brien KL;Simoes EAF;Madhi SA;Gessner BD;Polack FP;Balsells E;Acacio S;Aguayo C;Alassani I;Ali A;Antonio M;Awasthi S;Awori JO;Azziz-Baumgartner E;Baggett HC;Baillie VL;Balmaseda A;Barahona A;Basnet S;Bassat Q;Basualdo W;Bigogo G;Bont L;Breiman RF;Brooks WA;Broor S;Bruce N;Bruden D;Buchy P;Campbell S;Carosone-Link P;Chadha M;Chipeta J;Chou M;Clara W;Cohen C;de Cuellar E;Dang DA;Dash-Yandag B;Deloria-Knoll M;Dherani M;Eap T;Ebruke BE;Echavarria M;de Freitas Lázaro Emediato CC;Fasce RA;Feikin DR;Feng L;Gentile A;Gordon A;Goswami D;Goyet S;Groome M;Halasa N;Hirve S;Homaira N;Howie SRC;Jara J;Jroundi I;Kartasasmita CB;Khuri-Bulos N;Kotloff KL;Krishnan A;Libster R;Lopez O;Lucero MG;Lucion F;Lupisan SP;Marcone DN;McCracken JP;Mejia M;Moisi JC;Montgomery JM;Moore DP;Moraleda C;Moyes J;Munywoki P;Mutyara K;Nicol MP;Nokes DJ;Nymadawa P;da Costa Oliveira MT;Oshitani H;Pandey N;Paranhos-Baccalà G;Phillips LN;Picot VS;Rahman M;Rakoto-Andrianarivelo M;Rasmussen ZA;Rath BA;Robinson A;Romero C;Russomando G;Salimi V;Sawatwong P;Scheltema N;Schweiger B;Scott JAG;Seidenberg P;Shen K;Singleton R;Sotomayor V;Strand TA;Sutanto A;Sylla M;Tapia MD;Thamthitiwat S;Thomas ED;Tokarz R;Turner C;Venter M;Waicharoen S;Wang J;Watthanaworawit W;Yoshida LM;Yu H;Zar HJ;Campbell H;Nair H;RSV Global Epidemiology Network
通讯作者：
RSV Global Epidemiology Network
影响因子：
168.9
作者：
Liu, Li;Oza, Shefali;Hogan, Dan;Chu, Yue;Perin, Jamie;Zhu, Jun;Lawn, Joy E.;Cousens, Simon;Mathers, Colin;Black, Robert E.
通讯作者：
Black, Robert E.