A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India.
A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India.
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DOI：
10.1371/journal.pone.0000491
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发表时间：
2007-06-06
期刊：
影响因子：
3.7
通讯作者：
Sullender WM
中科院分区：
文献类型：
--
作者：
Broor S;Parveen S;Bharaj P;Prasad VS;Srinivasulu KN;Sumanth KM;Kapoor SK;Fowler K;Sullender WM
急性呼吸道感染（ARI）是发展中国家儿童的主要杀手。虽然ARI的发生率在发达国家和发展中国家相似，但发展中国家ARI的死亡率要高出10-50倍。病毒是这些儿童ARI的常见原因，但这些感染在农村社区的疾病负担尚不清楚。在两个印度农村出生的儿童中进行了一项前瞻性纵向研究，每周随访ARI的发展，分为上呼吸道感染，急性下呼吸道感染（ALRI）或严重ALRI。采用直接荧光抗体试验（DFA）检测鼻咽吸出物中呼吸道合胞病毒（RSV）、流感病毒、副流感病毒和腺病毒，并进行RSV离心增强培养。281名婴儿在39个月内入组，并随访至42个月。在440个儿童年的随访中，有1307例阿里斯，包括236例ALRI和19例重度ALRI。RSV每1000儿童年的病毒特异性发病率为总ARI 234，ALRI 39，重度ALRI 9;甲型流感总ARI 141，ALRI 39; INF B总ARI 37; PIV 1总ARI 23，PIV 2总ARI 28，ALRI 5;对于副流感病毒3型，总ARI为229，ALRI为48，重度ALRI为5，对于腺病毒，总ARI为18，ALRI为5。在18名儿童中观察到RSV重复感染。RSV、甲型流感病毒和副流感病毒3是印度农村社区儿童ARI的重要病因。这些数据将有助于疫苗的设计、开发和实施。
Acute respiratory infection (ARI) is a major killer of children in developing countries. Although the frequency of ARI is similar in both developed and developing countries, mortality due to ARI is 10–50 times higher in developing countries. Viruses are common causes of ARI among such children, yet the disease burden of these infections in rural communities is unknown. A prospective longitudinal study was carried out in children enrolled from two rural Indian villages at birth and followed weekly for the development of ARI, classified as upper respiratory infection, acute lower respiratory infection (ALRI), or severe ALRI. Respiratory syncytial virus (RSV), influenza, parainfluenza viruses and adenoviruses in nasopharyngeal aspirates were detected by direct fluorescent antibody testing (DFA) and, in addition, centrifugation enhanced culture for RSV was done. 281 infants enrolled in 39 months and followed until 42 months. During 440 child years of follow-up there were 1307 ARIs, including 236 ALRIs and 19 severe ALRIs. Virus specific incidence rates per 1000 child years for RSV were total ARI 234, ALRI 39, and severe ALRI 9; for influenza A total ARI 141, ALRI 39; for INF B total ARI 37; for PIV1 total ARI 23, for PIV2 total ARI 28, ALRI 5; for parainfluenza virus 3 total ARI 229, ALRI 48, and severe ALRI 5 and for adenovirus total ARI 18, ALRI 5. Repeat infections with RSV were seen in 18 children. RSV, influenza A and parainfluenza virus 3 were important causes of ARI among children in rural communities in India. These data will be useful for vaccine design, development and implementation purposes.