[Impact of a respiratory disease prevention program in high-risk preterm infants: a prospective, multicentric study]

Abstract

Respiratory tract infections (RTI), especially those caused by Respiratory Syncytial Virus (RSV), are of central concern in high-risk preterm infant care. Prevention programs including new and costly interventions should be evaluated in terms of effectiveness and impact.

Objectives: To evaluate feasibility and results of a National Health Ministry pilot program for severe RTI prevention in high-risk infants.

Methods: Seven high-risk follow-up clinics from the public healthcare system were selected for a prospective, multicentric study. Between May and September 2007, a pilot program comprising healthcare team training, parental education, RSV passive immunoprophylaxis, RTI patient care end results evaluation was implemented. Indicators were used to evaluate feasibility; effectiveness was estimated comparing study results with two historical controls.

Results: 183 infants were incorporated, 5 were lost and 1 died from cardiac disease. A RTI management guideline was elaborated among participating centers; parents assisted to educational workshops; palivizumab was given to participating infants up to three doses. RTI hospital admission rate for the study group was 20% (7% RSV-related), compared to 42% (26% RSV-related) and 37% (29% RSV-related) in control groups (p< 0.0001 and p= 0.02, respectively).

Conclusions: Program implementation was feasible and readily accepted by healthcare teams. RTI hospital admissions rates, in general and RSV-related, were significatively lower than local previous studies.