Abstract
BackgroundEstimating the real impact of respiratory syncytial virus (RSV) disease is key for the development of vaccines and treatments. Ascertaining the burden of community mortality due to RSV is challenging due to the lack of primary data. Therefore, conducting observational studies to determine the factors associated with community mortality due to the virus in developing countries is important.ObjectiveOur aim in this study was to describe the obstacles, gaps, and challenges that investigators face in low-income, vulnerable regions in 4 developing countries on 3 continents.ResultsThe main obstacles and challenges of ascertaining community mortality due to RSV were defining strategies to consent families for testing before burial, sampling individuals at the household level, supporting bereaved parents with different cultural and religious backgrounds, establishing tailored strategies for studies in challenging settings, and integrating RSV mortality data from nasopharyngeal samples.ConclusionDetailed logistical planning based on population sociodemographic information, grief counseling, staff training, and a multidisciplinary approach with adequate laboratory infrastructure is critical to successful observational community-based RSV studies.
Highlights
Estimating the real impact of respiratory syncytial virus (RSV) disease is key for the development of vaccines and treatments
Our goal in this study was to outline challenges at representative sites in LMICs on different continents (Buenos Aires, Argentina; Melghat, India; Lusaka, Zambia; Karachi, Pakistan) and propose strategies to more accurately assess the impact of RSV as a COD in young children worldwide
This was supplemented with a study of real-time polymerase chain reaction (RT-PCR) detection of viral RNA in nasal secretions of fatal lung disease at the local morgue and an ongoing evaluation of viral etiologies in fatal LRTI using viral RNA detection from nasopharyngeal swabs (NPS); minimally invasive tissue sampling (MITS) studies of histopathology combined with molecular detection of viral, bacterial, and fungal agents; and verbal autopsy (VA) followed by COD allocation using determination of COD (DeCoDe) diagnosis standards from the Child Health and Mortality Prevention Surveillance Network (Figure 1) [13, 14]
Summary
The southern region of Buenos Aires has a catchment population of 320 000 children aged
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