Abstract
BackgroundThere is little information that describe the burden of respiratory syncytial virus (RSV) associated disease in the tropical African outpatient setting.MethodsWe studied a systematic sample of children aged <5 years presenting to a rural district hospital in Kenya with acute respiratory infection (ARI) between May 2002 and April 2004. We collected clinical data and screened nasal wash samples for RSV antigen by immunofluorescence. We used a linked demographic surveillance system to estimate disease incidence.ResultsAmong 2143 children tested, 166 (8%) were RSV positive (6% among children with upper respiratory tract infection and 12% among children with lower respiratory tract infection (LRTI). RSV was more likely in LRTI than URTI (p<0.001). 51% of RSV cases were aged 1 year or over. RSV cases represented 3.4% of hospital outpatient presentations. Relative to RSV negative cases, RSV positive cases were more likely to have crackles (RR = 1.63; 95% CI 1.34–1.97), nasal flaring (RR = 2.66; 95% CI 1.40–5.04), in-drawing (RR = 2.24; 95% CI 1.47–3.40), fast breathing for age (RR = 1.34; 95% CI 1.03–1.75) and fever (RR = 1.54; 95% CI 1.33–1.80). The estimated incidence of RSV-ARI and RSV-LRTI, per 100,000 child years, among those aged <5 years was 767 and 283, respectively.ConclusionThe burden of childhood RSV-associated URTI and LRTI presenting to outpatients in this setting is considerable. The clinical features of cases associated with an RSV infection were more severe than cases without an RSV diagnosis.
Highlights
In the developing world pneumonia represents the major public health disease burden [1,2,3]
Most of the information that is available on the clinical characteristics and epidemiology of respiratory syncytial virus (RSV) is derived from studies of paediatric patients admitted to hospital with severe respiratory illness
12,295 (45%) had a diagnosis of acute respiratory infection (ARI) and were eligible for recruitment, 140 (0.5%) had no diagnosis record
Summary
In the developing world pneumonia represents the major public health disease burden [1,2,3]. Most of the information that is available on the clinical characteristics and epidemiology of RSV is derived from studies of paediatric patients admitted to hospital with severe respiratory illness These data do not present the full extent of the health burden in the community since they exclude children with disease not severe enough to require hospital admission, which has social, morbid and economic costs [10]. Such data are important in support of estimates of the effectiveness and costs associated with vaccine intervention. There is little information that describe the burden of respiratory syncytial virus (RSV) associated disease in the tropical African outpatient setting
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call