Respiratory syncytial virus infection: denominator-based studies in Indonesia, Mozambique, Nigeria and South Africa |
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Authors: | Robertson Susan E Roca Anna Alonso Pedro Simoes Eric A F Kartasasmita Cissy B Olaleye David O Odaibo Georgina N Collinson Mark Venter Marietjie Zhu Yuwei Wright Peter F |
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Institution: | Vaccines and Biologicals, Department of Immunization, World Health Organization, 1211 Geneva 27, Switzerland. robertsons@who.int |
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Abstract: | OBJECTIVE: To assess the burden of respiratory syncytial virus (RSV)-associated lower respiratory infections (LRI) in children in four developing countries. METHODS: 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. FINDINGS: 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. CONCLUSION: 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. |
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