Risk Factors for Respiratory Syncytial Virus-Associated Community Deaths in Zambian Infants.
Risk Factors for Respiratory Syncytial Virus-Associated Community Deaths in Zambian Infants.
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DOI：
10.1093/cid/ciab453
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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：
Murphy C;MacLeod WB;Forman LS;Mwananyanda L;Kwenda G;Pieciak RC;Mupila Z;Thea D;Chikoti C;Yankonde B;Ngoma B;Chimoga C;Gill CJ
呼吸道合胞病毒（RSV）是婴儿死亡的主要原因。对低收入和中等收入国家的流行病学了解甚少。与社区环境中发生的RSV相关婴儿死亡相关的风险因素尚不完全清楚。在赞比亚卢萨卡主要城市停尸房进行的3年尸检RSV流行率研究中，确定了4天至6个月婴儿的社区死亡，其中80%的死亡登记在该停尸房。本分析侧重于死亡的子集，其中简要的口头尸检是可用的，并打算通过临床裁定将死亡分类为呼吸或非呼吸原因。在死亡后48小时内采集后鼻咽拭子样本，并使用定量逆转录聚合酶链反应检测RSV。潜在危险因素之间的关联被确定为相对风险和95%置信区间（CI）。我们前瞻性地纳入了798例社区婴儿死亡病例，包括口头尸检和RSV实验室结果，其中62例结果为阳性。婴儿的平均年龄为10周，其中41.4%为男性。在所有死亡病例中，44%是由呼吸道疾病引起的。在7.8%的社区婴儿中检测到RSV，并与呼吸道死亡显著相关（风险比，4.0 [95%CI，2.2-7.1]）。与年龄较大的婴儿相比，0-8周的婴儿死于RSV的风险增加2.83（95%CI，1.30-6.15）。0-8周龄组的RSV风险增加至5.24（1.56-33.14），调整了人口统计学、父母教育和地理位置。RSV死亡随着医院过度拥挤而增加，并集中在卢萨卡的贫困和密集社区（风险比，2.00 [95% CI，1.22-3.27]）。RSV是该人群中社区呼吸道死亡的重要原因，特别是在出生后的前3个月以及卢萨卡较贫穷和人口稠密的地区。
Respiratory syncytial virus (RSV) is a major cause of infant deaths. Its epidemiology in low- and middle-income countries is poorly understood. Risk factors associated with RSV-associated infant deaths that occur in community settings are incompletely known. Community deaths for infants aged 4 days to 6 months were identified during a 3-year postmortem RSV prevalence study at the main city morgue in Lusaka, Zambia, where 80% of deaths are registered. This analysis focuses on the subset of deaths for which an abbreviated verbal autopsy was available and intended to sort deaths into respiratory or nonrespiratory causes by clinical adjudication. Posterior nasopharyngeal swab samples were collected within 48 hours of death and tested for RSV using quantitative reverse-transcription polymerase chain reaction. Associations between potential risk factors were determined as relative risks with 95% confidence intervals (CIs). We prospectively enrolled 798 community infant deaths with verbal autopsies and RSV laboratory results, of which 62 results were positive. The mean age of the infants was 10 weeks, and 41.4% of them were male. Of all deaths, 44% were attributed to respiratory causes. RSV was detected in 7.8% of the community infants and was significantly associated with respiratory deaths (risk ratio, 4.0 [95% CI, 2.2–7.1]). Compared with older infants, those aged 0–8 weeks had a 2.83 (95% CI, 1.30–6.15) increased risk of dying with RSV. The risk of RSV for the 0–8-week age group increased to 5.24 (1.56–33.14) with adjustment for demographics, parental education, and geography. RSV deaths were increased with domiciliary overcrowding and were concentrated in poor and dense neighborhoods in Lusaka (risk ratio, 2.00 [95% CI, 1.22–3.27]). RSV is a significant contributor to community respiratory deaths in this population, particularly in the first 3 months of life and in the more poor and dense parts of Lusaka.
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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.
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.
影响因子：
3
作者：
Esposito, Susanna;Molteni, Claudio Giuseppe;Principi, Nicola
通讯作者：
Principi, Nicola
DOI：
10.1086/606055
发表时间：
2009-11-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Nokes DJ;Ngama M;Bett A;Abwao J;Munywoki P;English M;Scott JA;Cane PA;Medley GF
通讯作者：
Medley GF