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. 2023 Jun 26:14:1173842.
doi: 10.3389/fmicb.2023.1173842. eCollection 2023.

Epidemiology and risk factors of respiratory syncytial virus associated acute respiratory tract infection in hospitalized children younger than 5 years from Sri Lanka

Maduja V M Divarathna  1 , Rukshan A M Rafeek  1 , Adrian J Morel  2 , Chathuri Aththanayake  3 , Faseeha Noordeen  1
Affiliations

Epidemiology and risk factors of respiratory syncytial virus associated acute respiratory tract infection in hospitalized children younger than 5 years from Sri Lanka

Maduja V M Divarathna et al. Front Microbiol. .

Abstract

Background: Respiratory syncytial virus (RSV) is the leading cause of acute respiratory tract infections (ARTI) and a major cause of morbidity and mortality in children worldwide.

Aim: This study aimed to describe the prevalence and seasonal patterns of RSV and to determine the actual and predictive association of RSV-associated ARTI and clinical, socio-demographic, and climatic risk factors in children < 5 years.

Methods: Nasopharyngeal aspirates were collected from 500 children < 5 years admitted to the Kegalle General Hospital, Sri Lanka between May 2016 to July 2018. RSV and RSV subtypes were detected using immunofluorescence assay and real time RT-PCR, respectively. Descriptive and inferential statistics were done for the data analysis using Chi-square, Fisher's exact, Kruskal-Wallis test, and multiple binary logistic regression in the statistical package for social sciences (SPSS), version 16.0.

Results: Prevalence of RSV-associated ARTI was 28% in children < 5 years. Both RSV subtypes were detected throughout the study period. RSV-B was the dominant subtype detected with a prevalence of 72.14%. RSV infection in general caused severe respiratory disease leading to hypoxemia. Compared to RSV-B, RSV-A infection had more symptoms leading to hypoxemia. Factors increasing the risk of contracting RSV infection included number of people living (n > 6), having pets at home and inhaling toxic fumes. The inferential analysis predicts RSV infection in children < 5 years with ARTI, with a 75.4% probability with clinical and socio-demographic characteristics like age < 1 year, fever for > 4 days, cough, conjunctivitis, stuffiness, fatigue, six or more people at home, having pets at home and inhaling toxic fumes. Climatic factors like increases in temperature (°C), wind speed (Km/h), wind gust (Km/h), rainfall (mm) and atmospheric pressure (mb) showed a strong correlation with the RSV infection in children.

Keywords: Sri Lanka; acute respiratory tract infections; children; epidemiology; respiratory syncytial virus; risk factors.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Monthly distribution of the RSV-A and RSV subtypes during the study period. RSV-B was detected throughout the study period with peak incidence from June to August 2016, March to June 2017 and April to June 2018. RSV-A was also detected throughout the year with a lesser incidence than RSV-B. RSV-A peaked from March to July 2017 and April to June 2018. RSV-A incidence during the 2018 outbreak (April–June 2018) was significantly higher compared to the 2016 and 2017 outbreaks. In 2018, the RSV-A incidence was more or less like the RSV-B incidence reported in that year. Co-infections between RSV-A and RSV-B were detected during the study period.
Figure 2
Figure 2
Predictive analysis of risk factors to get RSV infection. The predictive map developed using the data obtained from the study to identify how risk factors can be used to predict the probability (%) of getting infection with RSV, RSV-A, RSV-B and co-infections between RSV-A and-B in children <5 years in Sri Lanka.
Figure 3
Figure 3
Monthly distribution of RSV infection with rain fall, number of rainy days, temperature, wind speed and gust, atmospheric pressure and humidity from May 2016 to July 2018.
See this image and copyright information in PMC

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