Respiratory syncytial virus infection: denominator-based studies in Indonesia, Mozambique, Nigeria and South Africa

• Published in: Bulletin of the World Health Organization 2004-12, Vol.82 (12), p.914-922
• Main Authors: ROBERTSON, Susan E, ROCA, Anna, WRIGHT, Peter F, ALONSO, Pedro, SIMOES, Eric A. F, KARTASASMITA, Cissy B, OLALEYE, David O, ODAIBO, Georgina N, COLLINSON, Mark, VENTER, Marietjie, YUWEI ZHU
• Format: Article
• Language: English
• Subjects: Age; Age Distribution; Biological and medical sciences; Burden; Care and treatment; Child, Preschool; Children & youth; Clinics; Community health care; Crossnational studies; Developing Countries; Diagnosis; Epidemiology; General aspects; Health care; Health Policy & Services; Hospitals; Households; Human infectious diseases. Experimental studies and models; Humans; Incidence; Indice de severidad de la enfermedad; Indonesia; Indonesia - epidemiology; Infant; Infant, Newborn; Infecciones por virus sincitial del tracto respiratorio; Infections; Infectious diseases; Lactante; LDCs; Medical research; Medical sciences; Medicine; Mozambique; Mozambique - epidemiology; Nigeria; Nigeria - epidemiology; Nurses; Population; Population Surveillance; Preescolar; Preschool children; Private sector; Respiratory syncytial virus; Respiratory syncytial virus infection; Respiratory Syncytial Viruses - immunology; Respiratory Syncytial Viruses - pathogenicity; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - prevention & control; Respiratory Tract Infections - virology; Risk factors; Rural areas; South Africa - epidemiology; Sudáfrica; Surveillance; Viral Vaccines; Virology; Viruses
• ISSN: 0042-9686; 1564-0604
• DOI: 10.1590/S0042-96862004001200007

To assess the burden of respiratory syncytial virus (RSV)-associated lower respiratory infections (LRI) in children in four developing countries. A WHO protocol for prospective population-based surveillance of acute respiratory infections in children aged less than 5 years was used at sites in Indonesia, Mozambique, Nigeria and South Africa. RSV antigen was identified by enzyme-linked immunosorbent assay performed on nasopharyngeal specimens from children meeting clinical case definitions. Among children aged < 5 years, the incidence of RSV-associated LRI per 1000 child-years was 34 in Indonesia and 94 in Nigeria. The incidence of RSV-associated severe LRI per 1000 child-years was 5 in Mozambique, 10 in Indonesia, and 9 in South Africa. At all study sites, the majority of RSV cases occurred in infants. These studies demonstrate that RSV contributes to a substantial but quite variable burden of LRI in children aged < 5 years in four developing countries. The possible explanations for this variation include social factors, such as family size and patterns of seeking health care; the proportion of children infected by human immunodeficiency syndrome (HIV); and differences in clinical definitions used for obtaining samples. The age distribution of cases indicates the need for an RSV vaccine that can protect children early in life.