TY - JOUR
T1 - RSV associated hospitalizations in children in Karachi, Pakistan
T2 - Implications for vaccine prevention strategies
AU - Ali, Asad
AU - Yousafzai, Mohammad Tahir
AU - Waris, Rabbia
AU - Jafri, Fatima
AU - Aziz, Fatima
AU - Abbasi, Imran Naeem
AU - Zaidi, Anita
N1 - Funding Information:
This study was supported by grant 1R01TW008126 from FIC/NIH, titled “Burden of Influenza and RSV in Children in Pakistan” (PI Asad Ali). Dr. Ali's training was partially supported by Fogarty training grants D43TW007585 and 2D43TW001035. Data were stored and managed using the REDCap electronic data capture tool, funded by an NIH grant UL1 TR000445 from NCATS/NIH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/7
Y1 - 2017/7
N2 - 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.
AB - 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.
KW - ARI
KW - Karachi
KW - Pakistan
KW - RSV
KW - asthma
KW - bronchiolitis
KW - log binomial regression
KW - pneumonia
KW - respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=85013774890&partnerID=8YFLogxK
U2 - 10.1002/jmv.24768
DO - 10.1002/jmv.24768
M3 - Article
C2 - 28092107
AN - SCOPUS:85013774890
SN - 0146-6615
VL - 89
SP - 1151
EP - 1157
JO - Journal of Medical Virology
JF - Journal of Medical Virology
IS - 7
ER -