PLoS ONE
Volume 7, Issue 11, 2012

A High Burden of Respiratory Syncytial Virus Associated Pneumonia in Children Less than Two Years of Age in a South East Asian Refugee Population (Article) (Open Access)

Turner C.* , Turner P. , Cararra V. , Eh Lwe N. , Watthanaworawit W. , Day N.P. , White N.J. , Goldblatt D. , Nosten F.
  • a Shoklo Malaria Research Unit, Mae Sot, Thailand, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
  • b Shoklo Malaria Research Unit, Mae Sot, Thailand, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
  • c Shoklo Malaria Research Unit, Mae Sot, Thailand
  • d Shoklo Malaria Research Unit, Mae Sot, Thailand
  • e Shoklo Malaria Research Unit, Mae Sot, Thailand, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
  • f Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
  • g Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom
  • h Immunobiology Unit, Institute of Child Health, University College London, London, United Kingdom
  • i Shoklo Malaria Research Unit, Mae Sot, Thailand, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand, Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom

Abstract

Background: Pneumonia is a major cause of childhood mortality and morbidity approximately 1.6 million deaths and 150 million episodes occur annually in children <5 years. Respiratory syncytial virus (RSV) may be responsible for up to 25% of cases and 12% of deaths making it an important potential vaccine target, although data from South East Asia is scarce. Methods: We followed a birth cohort of Burmese refugee children, born over a one year period, for two years. Pneumonia episodes were diagnosed using WHO criteria. A chest radiograph, nasopharyngeal aspirate and non-specific markers of infection were taken during each episode. Results: The incidence of RSV-associated pneumonia was 0.24 (95% CI 0.22-0.26) episodes per child year. All children with pneumonia received antibiotic treatment, following WHO guidelines. The highest incidence was in the 2-12 month age group. The commonest diagnosis in a child with RSV-associated pneumonia was non-severe pneumonia (239/362:66.0%), however the incidence of RSV-associated severe or very severe pneumonia was 0.08 (95% CI 0.01-0.10) episodes per child year. Birth in the wet season increased the risk of severe disease in children who had their first episode of RSV-associated pneumonia aged 2-11 months (OR 28.7, 95% CI 6.6-125.0, p<0.001). RSV episodes were highly seasonal being responsible for 80.0% of all the pneumonia episodes occurring each October and November over the study period. Conclusions: There was a high incidence of RSV associated pneumonia in this refugee population. Interventions to prevent RSV infection have the potential to reduce the incidence of clinically diagnosed pneumonia and hence unnecessary antibiotic usage in this population. © 2012 Turner et al.

Author Keywords

[No Keywords available]

Index Keywords

Respiratory syncytial pneumovirus refugee respiratory tract infection predictive value follow up clinical feature human infection rate trend study Refugees Burmese Ethnic Groups antibiotic agent ethnic group Seasons Humans diagnostic value Severity of Illness Index Infant, Newborn male Southeast Asia preschool child female Infant Child, Preschool Risk Factors Myanmar population research Incidence seasonal variation Article sensitivity and specificity infection prevention major clinical study antibiotic therapy infection risk pneumonia virus load thorax radiography cohort analysis disease severity Pneumonia, Viral Respiratory Syncytial Virus Infections disease association disease marker Respiratory syncytial virus nasopharyngeal aspiration Respiratory Syncytial Viruses Rice stripe virus Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84869772274&doi=10.1371%2fjournal.pone.0050100&partnerID=40&md5=93fa8811b9b85b870b5c1b19e3aae3be
DOI: 10.1371/journal.pone.0050100
ISSN: 19326203
Cited by: 9
Original Language: English