Burden of RSV and Influenza Virus in Children in Pakistan

巴基斯坦的儿童死亡人数位居世界第四，有50多万儿童死亡 在5岁之前每年一次。近四分之一的死亡率是由下呼吸道引起的。 感染(LRTI)。呼吸道病毒作为主要病原体或与细菌共病的作用 巴基斯坦的儿童LRTI尚未确定。我们推测呼吸道合胞病毒(RSV) 流感病毒在巴基斯坦5岁以下儿童下呼吸道感染的病因学中起着重要作用。这个 这项建议的目的是确定#年儿童因呼吸道合胞病毒和流感病毒造成的疾病负担。 巴基斯坦。具体目标是1)提高巴基斯坦的病毒诊断能力2)确定 2005年因发热或呼吸道疾病住院的5岁儿童中呼吸道合胞病毒和流感病毒的流行率 巴基斯坦卡拉奇的两家三级保健医院和3)确定以社区为基础的下呼吸道感染发病率 卡拉奇Bilal Colony(一个城市贫民窟)5岁儿童中与RSV和流感病毒有关， 巴基斯坦。由于目前已有流感疫苗可用，RSV疫苗也处于高级开发阶段， 这些研究将确定基线发病率，并客观评估是否需要引入 这些疫苗在巴基斯坦。在研究的第一年，阿里博士将领导建立病毒培养集 在美国范德比尔特大学导师的帮助下，我们来到了巴基斯坦的阿加汗大学。这 接下来是两年的医院监测，然后是两年的社区活动 住院和门诊5岁儿童呼吸道合胞病毒和流感病毒负担监测 背景设在巴基斯坦卡拉奇。如果确认了重大负担，那么一项使用病毒疫苗来减少 这一负担可以向其他资助机构提出。肺炎是巴基斯坦儿童死亡的主要原因。呼吸道合胞病毒与流感的关系 病毒在巴基斯坦儿童肺炎中的病因学尚不清楚，并将成为这一事件的重点 调查。如果这些病毒被发现是重要的病原体，那么针对这些病毒的疫苗可能 降低巴基斯坦肺炎相关儿童死亡率。

Pakistan has the fourth highest number of child deaths in the world with more than 500,000 children dying annually before the age of 5 years. Nearly one quarter of this mortality is due to lower respiratory tract infections (LRTI). The role of respiratory viruses as primary pathogens, or co-pathogens with bacteria in childhood LRTI in Pakistan has not been determined. We hypothesize that respiratory syncytial virus (RSV) and influenza virus play an important role in the etiology of LRTI in children <5 year old in Pakistan. The objective of this proposal is to determine the disease burden due to RSV and influenza virus in children in Pakistan. The specific aims are 1) To advance viral diagnostic capacity in Pakistan 2) To determine the prevalence of RSV and influenza virus in < 5 year old children hospitalized with fever or respiratory illness at two tertiary care hospitals in Karachi, Pakistan and 3) To determine the community based incidence of LRTI associated with RSV and influenza virus in < 5 year old children at Bilal Colony (an urban slum) in Karachi, Pakistan. Since influenza vaccines are currently available and RSV vaccines are in advanced development, these studies will establish baseline disease rates and present objective assessment of the need for introducing these vaccines in Pakistan. In the first year of the study, Dr. Ali will lead the establishment of viral culture set up at Aga Khan University in Pakistan, with the help of mentors at Vanderbilt University in United States. This will be followed by 2 years of hospital based surveillance and then 2 years of community based active surveillance to find the burden of RSV and influenza virus in < 5 year old children in inpatient and outpatient settings in Karachi, Pakistan. If a significant burden is confirmed, then a study to use viral vaccines to reduce this burden can be proposed to other funding agencies. Pneumonia is the leading cause of child mortality in Pakistan. Role of respiratory syncytial virus and influenza virus in the etiology of childhood pneumonia in Pakistan is not known, and will be the focus of this investigation. If these viruses are found to be significant pathogens, then vaccines against these viruses may reduce the pneumonia associated child mortality in Pakistan.