Abstract
BackgroundEthnic disparities have been shown in respiratory syncytial virus (RSV) bronchiolitis. However, it is unclear whether such differences are related to access to care. We compared demographic and clinical characteristics of Arab and Jewish children hospitalized for RSV bronchiolitis in Israel, a country with universal health insurance.MethodsWe reviewed the medical records of all children (n = 309) aged less than 24 months who were hospitalized with RSV between 2008 and 2011 in one medical center in Israel. Demographic, clinical, laboratory and radiological data were collected. The RSV antigen was identified using immunochromatography.ResultsThe annual incidence of RSV hospitalization was 5.4/1000 and 6.8/1000 among Arab and Jewish children, respectively. Arab patients were significantly younger and had significantly younger parents; most lived in low socioeconomic status towns (93.7% vs. 13.3%; p<0.001) and had more siblings (median 2 vs. 1; p = 0.01) compared to Jewish patients. Disease severity did not differ between the two ethnic groups (p = 0.3). The main predictors of severe illness were having pneumonia (adjusted odds ratio [OR] 3.86; 95% confidence intervals [CI] 1.87–7.97) and history of respiratory diseases (adjusted OR 3.89; 95% CI 1.22–12.38).ConclusionsThe incidence of hospitalizations for RSV bronchiolitis tended to be higher among Jewish than Arab children, possibly due to differences in health care utilization patterns. Differences between the Jewish and Arab patients in demographic factors likely mirror differences between the groups in the general population. Pneumonia, and not ethnicity, affected the severity of RSV bronchiolitis.
Highlights
Respiratory syncytial virus (RSV), a single-stranded RNA virus of the Paramyxoviridae family [1, 2], is the most common pathogen identified in young children hospitalized with acute lower respiratory infection; winter outbreaks of RSV are typical [3, 4]
We reviewed the medical records of all children (n = 309) aged less than 24 months who were hospitalized with RSV between 2008 and 2011 in one medical center in Israel
The main predictors of severe illness were having pneumonia and history of respiratory diseases
Summary
Respiratory syncytial virus (RSV), a single-stranded RNA virus of the Paramyxoviridae family [1, 2], is the most common pathogen identified in young children hospitalized with acute lower respiratory infection; winter outbreaks of RSV are typical [3, 4]. RSV is estimated to cause 34 million episodes of acute lower respiratory infection annually in children younger than age five years[3]. Immuno-prophylaxis with RSV specific neutralizing monoclonal antibody, palivizumab, is recommended for high-risk groups such as premature infants and individuals with bronchopulmonary dysplasia [6,7,8,9]. RSV immuno-prophylaxis is used in many high-income countries, including the United States, European countries and Israel. Ethnic disparities have been shown in respiratory syncytial virus (RSV) bronchiolitis. It is unclear whether such differences are related to access to care. We compared demographic and clinical characteristics of Arab and Jewish children hospitalized for RSV bronchiolitis in Israel, a country with universal health insurance
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