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. 2017 Jul;89(7):1151-1157.
doi: 10.1002/jmv.24768. Epub 2017 Feb 24.

RSV associated hospitalizations in children in Karachi, Pakistan: Implications for vaccine prevention strategies

Asad Ali  1 , Mohammad Tahir Yousafzai  1 , Rabbia Waris  1 , Fatima Jafri  1 , Fatima Aziz  1 , Imran Naeem Abbasi  1 , Anita Zaidi  1
Affiliations

RSV associated hospitalizations in children in Karachi, Pakistan: Implications for vaccine prevention strategies

Asad Ali et al. J Med Virol. 2017 Jul.

Abstract

Major progress is being made in vaccines against Respiratory Syncytial Virus (RSV), with multiple vaccine candidates currently in the clinical phase of development. Making an investment case for public sector financing of RSV vaccine will require estimation of burden, cost-effectiveness, and impact. The aim of this study is to determine the proportion, age distribution and clinical spectrum of RSV associated hospitalizations in children in Karachi, Pakistan. A three years prospective study was conducted at the Aga Khan University Hospital in Karachi, a city of 20 million in south Pakistan, from August 2009 to June 2012. Children less than five years old admitted with acute respiratory infections (ARI) were enrolled. Throat swabs were collected and tested for RSV using real-time PCR. Multivariable log binomial regression analysis was performed to identify the associated factors of RSV infection. Out of 1150 children enrolled, RSV was detected among 223 (19%). Highest rate of RSV detection was in young infants less than 3 months of age (48/168, 29%), which accounted for 22% of all RSV detected. Most common diagnosis in RSV positive infants (<12 months of age) was bronchiolitis followed by pneumonia, while in older children between the ages of one and 5 years of age, pneumonia and asthma were the most common diagnosis. Although identified year-round, RSV was most prevalent from August to October with peak in September, coinciding with the rainy season. This study identified RSV to be independently associated with younger age (P = 0.036), rainy season (P < 0.001), post-tussive emesis (P = 0.008), intubation (P = 0.003), and discharge diagnosis of bronchiolitis (P = 0.004). Vaccines against RSV that target this age group are likely to yield remarkable benefit.

Keywords: ARI; Karachi; Pakistan; RSV; asthma; bronchiolitis; log binomial regression; pneumonia; respiratory syncytial virus.

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Figures

Figure 1
Figure 1
Monthly number of cases for each diagnosis among the total admissions at Aga Khan University Karachi
Figure 2
Figure 2
Percentage of RSV infection among children less than 5 years of age across months of enrollment during Aug 2009 to July 2012 (Bar chart)
Figure 3
Figure 3
Percentage distribution of ARI attributed to RSV infection among children less than 5 years of age across the months of enrollment during Aug 2009 to July 2012. (Bar chart)
See this image and copyright information in PMC

References

    1. Ali SA, Khowaja AR, Bashir MZ, Aziz F, Mustafa S, Zaidi A. Role of Human Metapneumovirus, Influenza A Virus and Respiratory Syncytial Virus in Causing WHO-Defined Severe Pneumonia in Children in a Developing Country. Plos One. 2013;8(9):e74756. Doi:10.1371/journal.pone.0074756. - PMC - PubMed
    1. Breiman RF, Van Beneden CA, Farnon EC. Surveillance for respiratory infections in low- and middle-income countries: experience from the Centers for Disease Control and Prevention's Global Disease Detection International Emerging Infections Program. J Infect Dis. 2013;208(Suppl 3):S167–172. - PMC - PubMed
    1. Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet. 2005;365(9465):1147–1152. - PubMed
    1. Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, Auinger P, Griffin MR, Poehling KA, Erdman D, Grijalva CG, Zhu Y, Szilagyi P. The burden of respiratory syncytial virus infection in young children. N Engl J Med. 2009;360(6):588–598. - PMC - PubMed
    1. John TJ, Cherian T, Steinhoff MC, Simoes EA, John M. Etiology of acute respiratory infections in children in tropical southern India. Rev Infect Dis. 1991;13(Suppl 6):S463–469. - PubMed

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