Respiratory Syncytial Virus and Other Viral Infections among Children under Two Years Old in Southern Vietnam 2009-2010: Clinical Characteristics and Disease Severity.

Lien Anh Ha ,Minh Tien Nguyen,Lu Viet Ho,Hong Nhien Trinh,Thi Thu Loan Tran,Bach Hue Nguyen,Ngoc Quang Minh Ngo,Thi Kim Huyen Dang,H Rogier Van Doorn,Ngoc Huong Cao,Thi Thanh Hai Nguyen,Jeremy Farrar,Quynh Huong Tran,Thu Van Tran,Juliet E Bryant,Bao Tinh Le Binh,Thanh Vu Vo,Nguyen Anh Tran Dac,Quang Tung Thai,Khanh Le,Quoc Bao Vo,Menno D De Jong ,Anh Tuấn Trần

doi:10.1371/journal.pone.0160606

Abstract

BackgroundDespite a high burden of respiratory syncytial virus (RSV) infections among children, data on demographic and clinical characteristics of RSV are scarce in low and middle income countries. This study aims to describe the viral etiologies, the demographic, epidemiological, and clinical characteristics of children under two years of age who were hospitalized with a lower respiratory tract infections (LRTI), focusing on RSV (prevalence, seasonality, subgroups, viral load) and its association with disease severity.MethodsA prospective study among children under two years of age, hospitalized with LRTI was conducted in two referral pediatric hospitals in Ho Chi Minh City, Vietnam, from May 2009 to December 2010. Socio-demographic, clinical data and nasopharyngeal swabs were collected on enrolment and discharge. Multiplex real-time RT-PCR (13 viruses) and quantitative RSV RT-PCR were used to identify viral pathogens, RSV load and subgroups.ResultsAmong 632 cases, 48% were RSV positive. RSV infections occurred at younger age than three other leading viral infections i.e rhinovirus (RV), metapneumovirus (MPV), parainfluenza virus (PIV-3) and were significantly more frequent in the first 6 months of life. Clinical severity score of RSV infection was significantly higher than PIV-3 but not for RV or MPV. In multivariate analysis, RV infection was significantly associated with severity while RSV infection was not. Among RSV infections, neither viral load nor viral co-infections were significantly associated with severity. Young age and having fever at admission were significantly associated with both RSV and LRTI severity. A shift in RSV subgroup predominance was observed during two consecutive rainy seasons but was not associated with severity.ConclusionWe report etiologies, the epidemiological and clinical characteristics of LRTI among hospitalized children under two years of age and risk factors of RSV and LRTI severity.

Highlights

This study aims to describe the viral etiologies, the demographic, epidemiological, and clinical characteristics of children under two years of age who were hospitalized with a lower respiratory tract infections (LRTI), focusing on Respiratory syncytial virus (RSV) and its association with disease severity
The epidemiological and clinical characteristics of LRTI among hospitalized children under two years of age and risk factors of RSV and LRTI severity
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections (LRTIs) in young children. 50% of children are infected by RSV during their first year of life, and by 3 years of age, 100% have experienced at least one infection [1]

Summary

Introduction

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections (LRTIs) in young children. 50% of children are infected by RSV during their first year of life, and by 3 years of age, 100% have experienced at least one infection [1]. Information on detailed clinical, epidemiological features and virological characteristics of RSV infections (e.g. disease burden, demographics, seasonal variations of RSV and other viral infections, circulating genotypes and subgroups, viral load) or on the frequency / impact of other respiratory viruses among Vietnamese children under two years old are limited [6]. We aimed to describe the viral etiologies and the demographic, epidemiological, and clinical characteristics of children under two years of age who were hospitalized with a LRTI, focusing on RSV (prevalence, seasonality, subgroups, viral load) and its association with disease severity. This study aims to describe the viral etiologies, the demographic, epidemiological, and clinical characteristics of children under two years of age who were hospitalized with a lower respiratory tract infections (LRTI), focusing on RSV (prevalence, seasonality, subgroups, viral load) and its association with disease severity

Objectives

Methods

Conclusion