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Njuma Libwea J, Esso L, Njoh AA, Ngwa CH, Ngomba Armelle V, Bilounga Ndongo C, Etoundi Mballa GA, Nwaru BI, Weinberger D, Njouom R, Koulla-Shiro S. Generating the evidence to support the establishment of a Respiratory Syncytial Virus surveillance system in Cameroon: A study protocol. PLoS One 2024; 19:e0303468. [PMID: 38861519 PMCID: PMC11166269 DOI: 10.1371/journal.pone.0303468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/25/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is one of the major pathogens frequently associated with severe respiratory tract infections in younger children and older adults globally. There is an unmet need with a lack of routine country-specific databases and/or RSV surveillance systems on RSV disease burden among adults in most low- and middle-income countries, including Cameroon. We aim to estimate the adult RSV burden needed to develop a framework for establishing an RSV surveillance database in Cameroon. METHODS AND ANALYSIS A two-phase study approach will be implemented, including a literature review and a review of medical records. First, a systematic review of available literature will provide insights into the current burden of RSV in adults in Cameroon, searching the following databases: Global Health, PubMed, CINAHL, Embase, African Journal Online Library, Scopus, Global Index Medicus, Cochrane databases, and grey literature search. Identified studies will be included if they reported on the RSV burden of disease among Cameroonian adults aged ≥18 years from 1st January 1990 to 31st December 2023. A narrative synthesis of the evidence will be provided. A meta-analysis will be conducted using a random effect model, when feasible. Two co-authors will independently perform data screening, extraction, and synthesis and will be reported according to the PRISMA-P guidelines for writing systematic review protocols. Secondly, a retrospective cohort design will permit data analysis on RSV among adults in the laboratory registers at the National Influenza Center. Medical records will be reviewed to link patients' files from emanating hospitals to capture relevant demographic, laboratory, and clinical data. The International Classification of Diseases and Clinical Modifications 10th revision (ICD-10-CM) codes will be used to classify the different RSV outcomes retrospectively. RESULTS The primary outcome is quantifying the RSV burden among the adult population, which can help inform policy on establishing an RSV surveillance database in Cameroon. The secondary outcomes include (i) estimates of RSV prevalence among Cameroonian adult age groups, (ii) RSV determinants, and (iii) clinical outcomes, including proportions of RSV-associated morbidity and/or death among age-stratified Cameroonian adults with medically attended acute respiratory tract infections. CONCLUSIONS The evidence generated from the two projects will be used for further engagement with relevant stakeholders, including policymakers, clinicians, and researchers, to develop a framework for systematically establishing an RSV surveillance database in Cameroon. This study proposal has been registered (CRD42023460616) with the University of York Center for Reviews and Dissemination of the International Prospective Register of Systematic Reviews (PROSPERO).
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Affiliation(s)
- John Njuma Libwea
- Directorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon
- Cameroon Academy of Sciences, Yaoundé, Cameroon
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- African Science Frontiers Initiatives [ASFI], Lagos, Nigeria
| | - Linda Esso
- Directorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon
| | - Andreas Ateke Njoh
- Central Coordination, Expanded Programme on Immunization, Yaoundé, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui, Central Africa Republic
| | - Che Henry Ngwa
- African Science Frontiers Initiatives [ASFI], Lagos, Nigeria
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Global Action for Public Health Services (GAPS), Buea, Cameroon
| | - Vivienne Ngomba Armelle
- Directorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon
| | | | | | - Bright I. Nwaru
- African Science Frontiers Initiatives [ASFI], Lagos, Nigeria
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Dan Weinberger
- Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Richard Njouom
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Centre Pasteur of Cameroon, Yaoundé, Cameroon
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Boattini M, Almeida A, Comini S, Bianco G, Cavallo R, Costa C. From Forgotten Pathogen to Target for New Vaccines: What Clinicians Need to Know about Respiratory Syncytial Virus Infection in Older Adults. Viruses 2024; 16:531. [PMID: 38675874 PMCID: PMC11053843 DOI: 10.3390/v16040531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Respiratory syncytial virus (RSV) is increasingly recognized as being implicated in acute illness in older adults, with a significant weight in hospitalizations for respiratory illness and death. By means of a best-evidence review, this paper aims to investigate whether RSV can be considered a forgotten pathogen in older patients, looking at trends in the literature volume and exploring possible epidemiological and clinical features underlying the focus given to it. We then present an assessment of its disease burden and present and future strategies for its reduction, particularly in light of the recent availability of new vaccines.
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Affiliation(s)
- Matteo Boattini
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
- Lisbon Academic Medical Centre, 1649-028 Lisbon, Portugal
| | - André Almeida
- Department of Internal Medicine 4, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa, 1169-024 Lisbon, Portugal;
- NOVA Medical School, Universidade Nova de Lisboa, Centro Clínico Académico de Lisboa, 1169-056 Lisbon, Portugal
| | - Sara Comini
- Operative Unit of Clinical Pathology, Carlo Urbani Hospital, 60035 Jesi, Italy
| | - Gabriele Bianco
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
- Department of Experimental Medicine, University of Salento, Via Provinciale Monteroni n. 165, 73100 Lecce, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
| | - Cristina Costa
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (G.B.)
- Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy
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3
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Correa RA, Arancibia F, De Ávila Kfouri R, Chebabo A, García G, Gutiérrez Robledo LM, Lopardo G, Nemerovsky J, Pérez CM, Rendon A, Ruiz-Palacios GM, Aggarwal B, Berzanskis A, Cintra O. Understanding the Burden of Respiratory Syncytial Virus in Older Adults in Latin America: An Expert Perspective on Knowledge Gaps. Pulm Ther 2024; 10:1-20. [PMID: 38358618 PMCID: PMC10881952 DOI: 10.1007/s41030-024-00253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024] Open
Abstract
Respiratory syncytial virus (RSV) is a significant global health concern and major cause of hospitalization, particularly among infants and older adults. The clinical impact of RSV is well characterized in infants; however, in many countries, the burden and risk of RSV in older populations are overlooked. In Latin America, there are limited data on RSV epidemiology and disease management in older adults. Therefore, the impact of RSV in this region needs to be addressed. Here, current insights on RSV infections in older populations in Latin America, including those with underlying health conditions, are discussed. We also outline the key challenges limiting our understanding of the burden of RSV in Latin America in a worldwide context and propose an expert consensus to improve our understanding of the burden of RSV in the region. By so doing, we aim to ultimately improve disease management and outcomes of those at risk and to alleviate the impact on healthcare systems.A graphical plain language summary is available with this article.
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Affiliation(s)
- Ricardo Amorim Correa
- Medical School, Pulmonology and Thoracic Surgery Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Arancibia
- Pulmonary Department, Instituto Nacional del Tórax and Clínica Santa María, Santiago de Chile, Chile
| | - Renato De Ávila Kfouri
- Pediatric Infectious Disease Specialist, Brazilian Pediatric Society and Brazilian Immunization, São Paulo, Brazil
| | - Alberto Chebabo
- University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luis Miguel Gutiérrez Robledo
- National Institute of Medical Sciences and Nutrition "S Zubiran" and National Institute of Geriatric Medicine, Mexico City, Mexico
| | - Gustavo Lopardo
- Infectious Diseases Department, Hospital Bernardo Houssay, Buenos Aires, Argentina
| | - Julio Nemerovsky
- Geriatrician Physician, Argentine Society of Gerontology and Geriatrics, Buenos Aires, Argentina
| | - Carlos M Pérez
- Faculty of Medicine and Science, Universidad San Sebastian, Santiago, Chile
| | - Adrian Rendon
- Universidad Autonoma de Nuevo León, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias (CIPTIR), Monterrey, Mexico
| | - Guillermo M Ruiz-Palacios
- Department of Infectious Diseases, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
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4
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Olson D, Calvimontes DM, Lamb MM, Guzman G, Barrios E, Chacon A, Rojop N, Arias K, Gomez M, Bolanos GA, Monzon J, Chard AN, Iwamoto C, Duca LM, Vuong N, Fineman M, Lesteberg K, Beckham D, Santiago ML, Quicke K, Ebel G, Gutierrez EZ, Azziz-Baumgartner E, Hayden FG, Mansour H, Edwards K, Newman LS, Asturias EJ. Clinical and Economic Impact of COVID-19 on Agricultural Workers, Guatemala 1. Emerg Infect Dis 2022; 28:S277-S287. [PMID: 36502430 DOI: 10.3201/eid2813.212303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We evaluated clinical and socioeconomic burdens of respiratory disease in banana farm workers in Guatemala. We offered all eligible workers enrollment during June 15-December 30, 2020, and annually, then tracked them for influenza-like illnesses (ILI) through self-reporting to study nurses, sentinel surveillance at health posts, and absenteeism. Workers who had ILI submitted nasopharyngeal swab specimens for testing for influenza virus, respiratory syncytial virus, and SARS-CoV-2, then completed surveys at days 0, 7, and 28. Through October 10, 2021, a total of 1,833 workers reported 169 ILIs (12.0 cases/100 person-years), and 43 (25.4%) were laboratory-confirmed infections with SARS-CoV-2 (3.1 cases/100 person-years). Workers who had SARS-CoV-2‒positive ILIs reported more frequent anosmia, dysgeusia, difficulty concentrating, and irritability and worse clinical and well-being severity scores than workers who had test result‒negative ILIs. Workers who had positive results also had greater absenteeism and lost income. These results support prioritization of farm workers in Guatemala for COVID-19 vaccination.
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Noble M, Khan RA, Walker B, Bennett E, Gent N. Respiratory syncytial virus-associated hospitalisation in children aged ≤5 years: a scoping review of literature from 2009 to 2021. ERJ Open Res 2022; 8:00593-2021. [PMID: 35651366 PMCID: PMC9149382 DOI: 10.1183/23120541.00593-2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/22/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Following the easing of COVID-19 restrictions in many countries, a surge in respiratory syncytial virus (RSV) hospitalisations was reported, surpassing yearly trends pre-pandemic. The changes to RSV epidemiology may have unforeseen effects on healthcare systems and populations globally, adding to the burden generated during the pandemic and placing increased demand on resources. Here we aim to identify recent global trends of RSV hospitalisation amongst children aged ≤5 years, to help inform policy makers in the planning of preventative interventions. Methods We conducted a scoping review of published literature between January 2009 and May 2021. Using keywords “Hospital admissions, Respiratory syncytial virus, RSV, Bronchiolitis, Children” we located studies using Medline, EMCARE, CINAHL and HMIC. Studies were eligible if they reported on trends/data for RSV hospitalisation amongst children aged ≤5 years. The articles were reviewed by two independent reviewers. Findings We assessed 3310 abstracts, reviewed 70 studies and included 56 studies in the final review. Findings were categorised into themes. The review highlighted that, although RSV incidence has been steadily increasing since 2009, the number of reported RSV hospitalisations decreased during lockdown. The highest numbers of hospitalisations were reported in children <1 year of age, particularly 0–2-month-old infants. Globally, RSV hospitalisations tend to peak in the winter months; however, since COVID-19 restrictions have eased, countries are reporting incidence peaks at different times, in contrast to the trends of previous years. Conclusion With greater physical interactions due to the relaxation of COVID-19 restriction measures, RSV-related hospitalisations can be seen to increase amongst children aged ≤5 years, possibly surpassing the numbers reported in previous RSV seasons. With #COVID19 restriction measures being eased globally, #RSV-related hospitalisation among children will increase, possibly surpassing pre-pandemic levelshttps://bit.ly/35lg4Iv
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Rahman AE, Hossain AT, Nair H, Chisti MJ, Dockrell D, Arifeen SE, Campbell H. Prevalence of hypoxaemia in children with pneumonia in low-income and middle-income countries: a systematic review and meta-analysis. THE LANCET GLOBAL HEALTH 2022; 10:e348-e359. [PMID: 35180418 PMCID: PMC8864303 DOI: 10.1016/s2214-109x(21)00586-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/31/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022] Open
Abstract
Background Pneumonia accounts for around 15% of all deaths of children younger than 5 years globally. Most happen in resource-constrained settings and are potentially preventable. Hypoxaemia is one of the strongest predictors of these deaths. We present an updated estimate of hypoxaemia prevalence among children with pneumonia in low-income and middle-income countries. Methods We conducted a systematic review using the following key concepts “children under five years of age” AND “pneumonia” AND “hypoxaemia” AND “low- and middle-income countries” by searching in 11 bibliographic databases and citation indices. We included all articles published between Nov 1, 2008, and Oct 8, 2021, based on observational studies and control arms of randomised and non-randomised controlled trials. We excluded protocol papers, articles reporting hypoxaemia prevalence based on less than 100 pneumonia cases, and articles published before 2008 from the review. Quality appraisal was done with the Joanna Briggs Institute tools. We reported pooled prevalence of hypoxaemia (SpO2 <90%) by classification of clinical severity and by clinical settings by use of the random-effects meta-analysis models. We combined our estimate of the pooled prevalence of pneumonia with a previously published estimate of the number of children admitted to hospital due to pneumonia annually to calculate the total annual number of children admitted to hospital with hypoxaemic pneumonia. Findings We identified 2825 unique records from the databases, of which 57 studies met the eligibility criteria: 26 from Africa, 23 from Asia, five from South America, and four from multiple continents. The prevalence of hypoxaemia was 31% (95% CI 26–36; 101 775 children) among all children with WHO-classified pneumonia, 41% (33–49; 30 483 children) among those with very severe or severe pneumonia, and 8% (3–16; 2395 children) among those with non-severe pneumonia. The prevalence was much higher in studies conducted in emergency and inpatient settings than in studies conducted in outpatient settings. In 2019, we estimated that over 7 million children (95% CI 5–8 million) were admitted to hospital with hypoxaemic pneumonia. The studies included in this systematic review had high τ2 (ie, 0·17), indicating a high level of heterogeneity between studies, and a high I2 value (ie, 99·6%), indicating that the heterogeneity was not due to chance. This study is registered with PROSPERO, CRD42019126207. Interpretation The high prevalence of hypoxaemia among children with severe pneumonia, particularly among children who have been admitted to hospital, emphasises the importance of overall oxygen security within the health systems of low-income and middle-income countries, particularly in the context of the COVID-19 pandemic. Even among children with non-severe pneumonia that is managed in outpatient and community settings, the high prevalence emphasises the importance of rapid identification of hypoxaemia at the first point of contact and referral for appropriate oxygen therapy. Funding UK National Institute for Health Research (Global Health Research Unit on Respiratory Health [RESPIRE]; 16/136/109).
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Affiliation(s)
- Ahmed Ehsanur Rahman
- The University of Edinburgh, Edinburgh, UK; International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - Aniqa Tasnim Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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7
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Olson D, Calvimontes DM, Lamb MM, Guzman G, Barrios E, Chacon A, Rojop N, Arias K, Gomez M, Bolanos GA, Monzon J, Chard AN, Iwamoto C, Duca LM, Vuong N, Fineman M, Lesteberg K, Beckham D, Santiago ML, Quicke K, Ebel G, Gutierrez EZ, Azziz-Baumgartner E, Hayden FG, Mansour H, Edwards K, Newman LS, Asturias EJ. Clinical and Economic Impact of COVID-19 on Plantation Workers: Preliminary Results from the Guatemala Agricultural Workers and Respiratory Illness Impact (AGRI) Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.02.07.22270274. [PMID: 35169807 PMCID: PMC8845422 DOI: 10.1101/2022.02.07.22270274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We evaluated the clinical and socioeconomic burdens of respiratory disease in a cohort of Guatemalan banana plantation workers. All eligible workers were offered enrollment from June 15-December 30, 2020, and annually, then followed for influenza-like illnesses (ILI) through: 1) self-reporting to study nurses, 2) sentinel surveillance at health posts, and 3) absenteeism. Workers with ILI submitted nasopharyngeal swabs for influenza, RSV, and SARS-CoV-2 testing, then completed surveys at days 0, 7, and 28. Through October 10, 2021, 1,833 workers developed 169 ILIs (12.0/100 person-years) and 43 (25.4%) of these ILIs were laboratory-confirmed SARS-CoV-2 (3.1/100 person-years). Workers with SARS-CoV-2-positive ILI reported more anosmia (p<0.01), dysgeusia (p<0.01), difficulty concentrating (p=0.01), and irritability (p=0.01), and greater clinical and well-being severity scores (Flu-iiQ) than test-negative ILIs; they also had greater absenteeism (p<0.01) and lost income (median US$127.1, p<0.01). These results support the prioritization of Guatemalan farm workers for COVID-19 vaccination.
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Affiliation(s)
- Daniel Olson
- University of Colorado School of Medicine, Aurora, CO, USA
- Colorado School of Public Health, Aurora
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Diva M. Calvimontes
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
- La Comisión Presidencial de Atención a la Emergencia COVID-19 (Coprecovid), Guatemala
| | | | - Gerber Guzman
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Edgar Barrios
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Andrea Chacon
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Neudy Rojop
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Kareen Arias
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Melissa Gomez
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | - Jose Monzon
- Centers for Disease Control and Prevention, Guatemala City, Guatemala
| | - Anna N. Chard
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chelsea Iwamoto
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lindsey M. Duca
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nga Vuong
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - David Beckham
- University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | | | | | | | | | | | - Kathryn Edwards
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Lee S. Newman
- University of Colorado School of Medicine, Aurora, CO, USA
- Colorado School of Public Health, Aurora
| | - Edwin J. Asturias
- University of Colorado School of Medicine, Aurora, CO, USA
- Colorado School of Public Health, Aurora
- Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
- La Comisión Presidencial de Atención a la Emergencia COVID-19 (Coprecovid), Guatemala
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Shi T, Denouel A, Tietjen AK, Campbell I, Moran E, Li X, Campbell H, Demont C, Nyawanda BO, Chu HY, Stoszek SK, Krishnan A, Openshaw P, Falsey AR, Nair H. Global Disease Burden Estimates of Respiratory Syncytial Virus-Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta-Analysis. J Infect Dis 2020; 222:S577-S583. [PMID: 30880339 DOI: 10.1093/infdis/jiz059] [Citation(s) in RCA: 215] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Respiratory syncytial virus-associated acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in older adults aged ≥65 years. We aimed to identify all studies worldwide investigating the disease burden of RSV-ARI in this population. We estimated the community incidence, hospitalization rate, and in-hospital case-fatality ratio (hCFR) of RSV-ARI in older adults, stratified by industrialized and developing regions, using data from a systematic review of studies published between January 1996 and April 2018 and 8 unpublished population-based studies. We applied these rate estimates to population estimates for 2015 to calculate the global and regional burdens in older adults with RSV-ARI in the community and in hospitals for that year. We estimated the number of in-hospital deaths due to RSV-ARI by combining hCFR data with hospital admission estimates from hospital-based studies. In 2015, there were about 1.5 million episodes (95% confidence interval [CI], .3 million-6.9 million) of RSV-ARI in older adults in industrialized countries (data for developing countries were missing), and of these, approximately 14.5% (214 000 episodes; 95% CI, 100 000-459 000) were admitted to hospitals. The global number of hospital admissions for RSV-ARI in older adults was estimated at 336 000 hospitalizations (uncertainty range [UR], 186 000-614 000). We further estimated about 14 000 in-hospital deaths (UR, 5000-50 000) related to RSV-ARI globally. The hospital admission rate and hCFR were higher for those aged ≥65 years than for those aged 50-64 years. The disease burden of RSV-ARI among older adults is substantial, with limited data from developing countries. Appropriate prevention and management strategies are needed to reduce this burden.
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Affiliation(s)
- Ting Shi
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Angeline Denouel
- Global Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - Anna K Tietjen
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Iain Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Emily Moran
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Xue Li
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Clarisse Demont
- Global Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | | | - Helen Y Chu
- Department of Medicine, University of Washington, Seattle
| | | | - Anand Krishnan
- All India Institute of Medical Sciences, New Delhi, India
| | - Peter Openshaw
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ann R Falsey
- University of Rochester School of Medicine, New York
- ReSViNET Foundation, Zeist, the Netherlands
| | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
- ReSViNET Foundation, Zeist, the Netherlands
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9
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Ali A, Lopardo G, Scarpellini B, Stein RT, Ribeiro D. Systematic review on respiratory syncytial virus epidemiology in adults and the elderly in Latin America. Int J Infect Dis 2020; 90:170-180. [PMID: 31669592 PMCID: PMC7110494 DOI: 10.1016/j.ijid.2019.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The present study provides a comprehensive review of the recently published data on RSV epidemiology in adults and the elderly in Latin America. METHODS A systematic literature search was carried out in Medline, Scielo, Lilacs, and Cochrane Library. The search strategy aimed at retrieving studies focusing on RSV prevalence, burden, risk factors, and the routine clinical practice in the prevention and management of RSV infections in Latin American countries. Only articles published between January 2011 and December 2017 were considered. RESULTS Eighteen studies were included. Percentages of RSV detection varied highly across included studies for adult subjects with respiratory infections (0% to 77.9%), influenza-like illness (1.0% to 16.4%) and community-acquired pneumonia (1.3% to 13.5%). Considerable percentages of hospitalization were reported for RSV-infected adults with influenza-like illness (40.9% and 69.9%) and community-acquired pneumonia (91.7%). CONCLUSIONS Recent RSV data regarding adult populations in Latin America are scarce. RSV was documented as a cause of illness in adults and the elderly, being identified in patients with acute respiratory infections, influenza-like illness and community-acquired pneumonia. The studies suggest that RSV infections may be a significant cause of hospitalization in adult populations in Latin America, including younger adults.
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Affiliation(s)
- Abraham Ali
- Fundación Neumológica Colombiana, Carrera 13B # 161- 85 Piso 2, Postal Code 110131, Bogotá, Colombia.
| | - Gustavo Lopardo
- Department of Infectious Diseases at FUNCEI and Hospital Bernardo Houssay, French 3085, (1425) Buenos Aires, Argentina.
| | - Bruno Scarpellini
- Real World Evidence Department, Medical Affairs Latin America, Janssen Cilag Farmacêutica, Avenida Presidente Juscelino Kubitschek, 2041 - Vila Nova Conceição, 04543-011, São Paulo, Brazil.
| | - Renato T. Stein
- Pontifícia Universidade Católica do RGS (PUCRS), ReSViNET Executive Committee member, Centro Clinico PUCRS, Av. Ipiranga, 6690, conj.420. Porto Alegre, RS, CEP 90610-000, Brazil
| | - Diogo Ribeiro
- CTI Clinical Trial & Consulting Services, Rua Tierno Galvan, Torre 3, Piso 16, 1070-274 Lisboa, Portugal.
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Detection of Common Respiratory Viruses in Patients with Acute Respiratory Infections Using Multiplex Real-Time RT-PCR. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.96513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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11
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González-Ortiz AM, Bernal-Silva S, Comas-García A, Vega-Morúa M, Garrocho-Rangel ME, Noyola DE. Severe Respiratory Syncytial Virus Infection in Hospitalized Children. Arch Med Res 2019; 50:377-383. [PMID: 31678896 DOI: 10.1016/j.arcmed.2019.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/30/2019] [Accepted: 10/18/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lower respiratory tract infections (LRTI) are one of the most common causes of death worldwide. Respiratory syncytial virus (RSV) is a leading cause of LRTI in children. Despite of its epidemiological importance, there is limited information regarding the impact of this virus in Latin America. AIMS OF THE STUDY We carried out a prospective study to establish the frequency and characteristics of RSV infections in hospitalized Mexican children. METHODS 1,252 children hospitalized between November, 2012 and December, 2015 because of LRTI were included in the study. A respiratory sample was obtained for RSV detection by RT-PCR and information regarding clinical presentation, hospital course, and outcome was recorded. RESULTS RSV was detected in 43.7% of children admitted with LRTI, in 43.3% of those admitted to the intensive care unit (ICU), and in 36.4% of those who died. Infants with RSV infection were younger, were diagnosed with bronchiolitis more frequently, and were less likely to have underlying disorders than those with RSV-negative LRTI. Among RSV-positive infants, admission to the ICU was associated with the presence of underlying conditions, pneumonia diagnosis, and young age. Four (0.73%) of the 547 infants with RSV infection died; death was more common in those with underlying disorders than previously healthy infants (3.8 vs. 0.2%, respectively; p = 0.02). CONCLUSION RSV contributes to a large proportion of LRTI hospital admissions. Most children admitted with RSV infection do not have underlying conditions. However, severe infection requiring ICU admission and death are more common in those with underlying disorders.
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Affiliation(s)
- Ana M González-Ortiz
- Hospital del Niño y la Mujer, Dr. Alberto López Hermosa, San Luis Potosí, México
| | - Sofía Bernal-Silva
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Andreu Comas-García
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - María Vega-Morúa
- Hospital del Niño y la Mujer, Dr. Alberto López Hermosa, San Luis Potosí, México
| | - María E Garrocho-Rangel
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Daniel E Noyola
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México.
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Ivey KS, Edwards KM, Talbot HK. Respiratory Syncytial Virus and Associations With Cardiovascular Disease in Adults. J Am Coll Cardiol 2019; 71:1574-1583. [PMID: 29622165 DOI: 10.1016/j.jacc.2018.02.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 02/02/2018] [Accepted: 02/07/2018] [Indexed: 12/31/2022]
Abstract
Respiratory syncytial virus (RSV) is historically known for causing respiratory illness in young children, but the appreciation of its impact on older adults is growing. Studies have shown that hospitalization for respiratory illness due to RSV is complicated by cardiovascular events in 14% to 22% of adult patients, including worsening congestive heart failure, acute coronary syndrome, and arrhythmias. Additionally, underlying cardiovascular disease is associated with hospitalization in 45% to 63% of adults with confirmed RSV. In summary, patients with cardiopulmonary disease have higher rates of health care utilization for RSV-related illness and worse outcomes. Patients with cardiovascular disease likely represent an important target population for the rapidly developing field of RSV vaccines.
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Affiliation(s)
- Kelsey S Ivey
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kathryn M Edwards
- Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee
| | - H Keipp Talbot
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Health Policy, Vanderbilt University, Nashville, Tennessee.
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13
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Acute Respiratory Illness in Rural Haiti. Int J Infect Dis 2019; 81:176-183. [PMID: 30772468 PMCID: PMC7173118 DOI: 10.1016/j.ijid.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 12/18/2022] Open
Abstract
Top viruses detected in Haitian children are Rhinovirus, Influenza A and Adenovirus. Top bacteria detected in Haitian children are S. pneumoniae and S. aureus. Younger children are more likely to have Influenza A and S. pneumoniae detected. Younger children are more likely to present with fever and diagnosed with pneumonia. These data support early use of Influenza A and S. pneumoniae vaccines in Haiti.
Objectives Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention. Methods Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015. Results Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3–5 years had more Influenza A (28% vs. 9%, p = 0.002) and Adenovirus detected (14% vs. 3%, p = 0.01). Similarly, S. pneumoniae was greatest in children 3–5 years old (71% 3–5yrs; 58% 6–15 years; 25% 16–20 years; p = 0.008). Children 3–10 years old presented with fever more than children 11–20 years old (22% vs 7%; p = 0.02) and were more often diagnosed with pneumonia (28% vs 4%, p < 0.001). Conclusions Younger children had increased fever, pneumonia, and detection of Influenza A and S. pneumoniae. These data support the need for influenza and pneumococcus vaccination in early childhood in Haiti.
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Rabarison JH, Tempia S, Harimanana A, Guillebaud J, Razanajatovo NH, Ratsitorahina M, Heraud JM. Burden and epidemiology of influenza- and respiratory syncytial virus-associated severe acute respiratory illness hospitalization in Madagascar, 2011-2016. Influenza Other Respir Viruses 2018; 13:138-147. [PMID: 30596225 PMCID: PMC6379640 DOI: 10.1111/irv.12557] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2018] [Indexed: 12/01/2022] Open
Abstract
Background Influenza and respiratory syncytial virus (RSV) infections are responsible for substantial global morbidity and mortality in young children and elderly individuals. Estimates of the burden of influenza‐ and RSV‐associated hospitalization are limited in Africa. Methods We conducted hospital‐based surveillance for laboratory‐confirmed influenza‐ and RSV‐associated severe acute respiratory illness (SARI) among patients of any age at one hospital and a retrospective review of SARI hospitalizations in five hospitals situated in Antananarivo during 2011‐2016. We estimated age‐specific rates (per 100 000 population) of influenza‐ and RSV‐associated SARI hospitalizations for the Antananarivo region and then extrapolated these rates to the national level. Results Overall, the mean annual national number of influenza‐associated SARI hospitalizations for all age groups was 6609 (95% CI: 5381‐7835‐rate: 30.0; 95% CI: 24.4‐35.6), 4468 (95% CI: 3796‐5102‐rate: 127.6; 95% CI: 108.4‐145.7), 2141 (95% CI: 1585‐2734‐rate: 11.6; 95% CI: 8.6‐14.8), and 339 (95% CI: 224‐459‐rate: 50.0; 95% CI: 36.3‐74.4) among individuals aged <5, ≥5, and ≥65 years, respectively. For these same age groups, the mean annual number of RSV‐associated SARI hospitalizations was 11 768 (95% CI: 10 553‐12 997‐rate: 53.4; 95% CI: 47.9‐59.0), 11 299 (95% CI: 10 350‐12 214‐rate: 322.7; 95% CI: 295.6‐348.8), 469 (95% CI: 203‐783‐rate: 2.5;95% CI: 1.1‐4.2), and 36 (95% CI: 0‐84‐rate: 5.8; 0.0‐13.5), respectively. Conclusion The burden of influenza‐ and RSV‐associated SARI hospitalization was high among children aged <5 years. These first estimates for Madagascar will enable government to make informed evidence‐based decisions when allocating scarce resources and planning intervention strategies to limit the impact and spread of these viruses.
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Affiliation(s)
| | - Stefano Tempia
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Centers for Disease Control and Prevention-South Africa, Pretoria, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Aina Harimanana
- Epidemiology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Julia Guillebaud
- National Influenza Centre, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Norosoa H Razanajatovo
- National Influenza Centre, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Maherisoa Ratsitorahina
- Direction de la Veille Sanitaire et de la Surveillance Epidemiologique, Ministry of Public Health, Antananarivo, Madagascar
| | - Jean-Michel Heraud
- National Influenza Centre, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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15
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Phadke VK, McCracken JP, Kriss JL, Lopez MR, Lindblade KA, Bryan JP, Garcia ME, Funes CE, Omer SB. Clinical Characteristics of Hospitalized Infants With Laboratory-Confirmed Pertussis in Guatemala. J Pediatric Infect Dis Soc 2018; 7:310-316. [PMID: 29045690 PMCID: PMC5899054 DOI: 10.1093/jpids/pix081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/28/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pertussis is an important cause of hospitalization and death in infants too young to be vaccinated (aged <2 months). Limited data on infant pertussis have been reported from Central America. The aim of this study was to characterize acute respiratory illnesses (ARIs) attributable to Bordetella pertussis among infants enrolled in an ongoing surveillance study in Guatemala. METHODS As part of a population-based surveillance study in Guatemala, infants aged <2 months who presented with ARI and required hospitalization were enrolled, and nasopharyngeal and oropharyngeal swab specimens were obtained. For this study, these specimens were tested for B pertussis using real-time polymerase chain reaction (PCR). RESULTS Among 301 infants hospitalized with ARI, we found 11 with pertussis confirmed by PCR (pertussis-positive infants). Compared to pertussis-negative infants, pertussis-positive infants had a higher mean admission white blood cell count (20900 vs 12579 cells/μl, respectively; P = .024), absolute lymphocyte count (11517 vs 5591 cells/μl, respectively; P < .001), rate of admission to the intensive care unit (64% vs 35%, respectively; P = .054), and case fatality rate (18% vs 3%, respectively; P = .014). Ten of the 11 pertussis-positive infants had cough at presentation; the majority (80%) of them had a cough duration of <7 days, and only 1 had a cough duration of >14 days. Fever (temperature ≥ 38°C) was documented in nearly half (45%) of the pertussis-positive infants (range, 38.0-38.4°C). CONCLUSIONS In this study of infants <2 months of age hospitalized with ARI in Guatemala, pertussis-positive infants had a high rate of intensive care unit admission and a higher case fatality rate than pertussis-negative infants.
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Affiliation(s)
- Varun K Phadke
- Division of Infectious Diseases, School of Medicine,Correspondence: V. K. Phadke, MD, 49 Jesse Hill Jr. Dr, Atlanta, GA 30303 ()
| | - John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City
| | - Jennifer L Kriss
- Department of Epidemiology, Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City, Guatemala
| | - Maria R Lopez
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City
| | - Kim A Lindblade
- Division of Global Health Protection, Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City, Guatemala
| | - Joe P Bryan
- Division of Global Health Protection, Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City, Guatemala,Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Miguel E Garcia
- Department of Pediatrics, Hospital Nacional de Cuilapa, Santa Rosa, Guatemala
| | - Carlos E Funes
- Department of Pediatrics, Hospital Regional de Occidente, Quetzaltenango, Guatemala
| | - Saad B Omer
- Department of Epidemiology, Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City, Guatemala,Hubert Department of Global Health, Rollins School of Public Health,Emory Vaccine Center, Emory University, Atlanta, Georgia
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16
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Belongia EA, King JP, Kieke BA, Pluta J, Al-Hilli A, Meece JK, Shinde V. Clinical Features, Severity, and Incidence of RSV Illness During 12 Consecutive Seasons in a Community Cohort of Adults ≥60 Years Old. Open Forum Infect Dis 2018; 5:ofy316. [PMID: 30619907 PMCID: PMC6306566 DOI: 10.1093/ofid/ofy316] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/23/2018] [Indexed: 01/15/2023] Open
Abstract
Background The epidemiology and burden of respiratory syncytial virus (RSV) illness are not well defined in older adults. Methods Adults ≥60 years old seeking outpatient care for acute respiratory illness were recruited from 2004–2005 through 2015–2016 during the winter seasons. RSV was identified from respiratory swabs by multiplex polymerase chain reaction. Clinical characteristics and outcomes were ascertained by interview and medical record abstraction. The incidence of medically attended RSV was estimated for each seasonal cohort. Results RSV was identified in 243 (11%) of 2257 enrollments (241 of 1832 individuals), including 121 RSV type A and 122 RSV type B. The RSV clinical outcome was serious in 47 (19%), moderate in 155 (64%), and mild in 41 (17%). Serious outcomes included hospital admission (n = 29), emergency department visit (n = 13), and pneumonia (n = 23) and were associated with lower respiratory tract symptoms during the enrollment visit. Moderate outcomes included receipt of a new antibiotic prescription (n = 144; 59%), bronchodilator/nebulizer (n = 45; 19%), or systemic corticosteroids (n = 28; 12%). The relative risk of a serious outcome was significantly increased in persons aged ≥75 years (vs 60–64 years) and in those with chronic obstructive pulmonary disease or congestive heart failure. The average seasonal incidence was 139 cases/10 000, and it was significantly higher in persons with cardiopulmonary disease compared with others (rate ratio, 1.89; 95% confidence interval, 1.44–2.48). Conclusions RSV causes substantial outpatient illness with lower respiratory tract involvement. Serious outcomes are common in older patients and those with cardiopulmonary disease.
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Affiliation(s)
| | | | - Burney A Kieke
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | - Joanna Pluta
- Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Ali Al-Hilli
- Marshfield Clinic Health System, Marshfield, Wisconsin
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Kim HJ, Choi SM, Lee J, Park YS, Lee CH, Yim JJ, Yoo CG, Kim YW, Han SK, Lee SM. Respiratory virus of severe pneumonia in South Korea: Prevalence and clinical implications. PLoS One 2018; 13:e0198902. [PMID: 29912989 PMCID: PMC6005478 DOI: 10.1371/journal.pone.0198902] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 05/28/2018] [Indexed: 01/30/2023] Open
Abstract
Background Severe viral pneumonia is associated with a high mortality rate. However, due to the vulnerability of critically ill patients, invasive diagnostic methods should be performed with caution in the intensive care unit (ICU). It would be helpful if the prevalence, risk factors, and clinical impact of virus detection are elucidated. Methods We evaluated patients with severe pneumonia between January 1st 2008 and December 31st 2015. Reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed for 8 respiratory viruses when viral pathogen could not be excluded as the origin of severe pneumonia. The baseline characteristics, laboratory results, microbiological findings, and clinical outcomes of the patients were analyzed. Results Of the 2,347 patients admitted to the medical ICU, 515 underwent RT-PCR for respiratory viruses, 69 of whom had positive results. The detection rate was higher during the winter, with a community onset, in patients with history of recent chemotherapy, and low platelet count. Additional bronchoscopic sampling along with upper respiratory specimen increased the yield of viral detection. Respiratory syncytial virus was the most common pathogen detected, while influenza A was the most common virus with bacterial coinfection. Respiratory virus detection led to changes in clinical management in one-third of the patients. Conclusions The detection of viral pathogens in patients with severe pneumonia is not rare, and can be more common in certain group of patients. Invasive sampling for RT-PCR can be helpful, and such detection can lead to positive changes in clinical management.
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Affiliation(s)
- Hyung-Jun Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Mi Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jinwoo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Sik Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chang-Hoon Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Joon Yim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul-Gyu Yoo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Whan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Koo Han
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang-Min Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Rao CY, Goryoka GW, Henao OL, Clarke KR, Salyer SJ, Montgomery JM. Global Disease Detection-Achievements in Applied Public Health Research, Capacity Building, and Public Health Diplomacy, 2001-2016. Emerg Infect Dis 2018; 23. [PMID: 29155662 PMCID: PMC5711302 DOI: 10.3201/eid2313.170859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Centers for Disease Control and Prevention has established 10 Global Disease Detection (GDD) Program regional centers around the world that serve as centers of excellence for public health research on emerging and reemerging infectious diseases. The core activities of the GDD Program focus on applied public health research, surveillance, laboratory, public health informatics, and technical capacity building. During 2015-2016, program staff conducted 205 discrete projects on a range of topics, including acute respiratory illnesses, health systems strengthening, infectious diseases at the human-animal interface, and emerging infectious diseases. Projects incorporated multiple core activities, with technical capacity building being most prevalent. Collaborating with host countries to implement such projects promotes public health diplomacy. The GDD Program continues to work with countries to strengthen core capacities so that emerging diseases can be detected and stopped faster and closer to the source, thereby enhancing global health security.
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Scheltema NM, Gentile A, Lucion F, Nokes DJ, Munywoki PK, Madhi SA, Groome MJ, Cohen C, Moyes J, Thorburn K, Thamthitiwat S, Oshitani H, Lupisan SP, Gordon A, Sánchez JF, O'Brien KL, Gessner BD, Sutanto A, Mejias A, Ramilo O, Khuri-Bulos N, Halasa N, de-Paris F, Pires MR, Spaeder MC, Paes BA, Simões EAF, Leung TF, da Costa Oliveira MT, de Freitas Lázaro Emediato CC, Bassat Q, Butt W, Chi H, Aamir UB, Ali A, Lucero MG, Fasce RA, Lopez O, Rath BA, Polack FP, Papenburg J, Roglić S, Ito H, Goka EA, Grobbee DE, Nair H, Bont LJ. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series. LANCET GLOBAL HEALTH 2018; 5:e984-e991. [PMID: 28911764 PMCID: PMC5599304 DOI: 10.1016/s2214-109x(17)30344-3] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/11/2017] [Accepted: 08/16/2017] [Indexed: 01/08/2023]
Abstract
Background Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data for fatal RSV infection are scarce. We aimed to identify clinical and socioeconomic characteristics of children aged younger than 5 years with RSV-related mortality using individual patient data. Methods In this retrospective case series, we developed an online questionnaire to obtain individual patient data for clinical and socioeconomic characteristics of children aged younger than 5 years who died with community-acquired RSV infection between Jan 1, 1995, and Oct 31, 2015, through leading research groups for child pneumonia identified through a comprehensive literature search and existing research networks. For the literature search, we searched PubMed for articles published up to Feb 3, 2015, using the key terms “RSV”, “respiratory syncytial virus”, or “respiratory syncytial viral” combined with “mortality”, “fatality”, “death”, “died”, “deaths”, or “CFR” for articles published in English. We invited researchers and clinicians identified to participate between Nov 1, 2014, and Oct 31, 2015. We calculated descriptive statistics for all variables. Findings We studied 358 children with RSV-related in-hospital death from 23 countries across the world, with data contributed from 31 research groups. 117 (33%) children were from low-income or lower middle-income countries, 77 (22%) were from upper middle-income countries, and 164 (46%) were from high-income countries. 190 (53%) were male. Data for comorbidities were missing for some children in low-income and middle-income countries. Available data showed that comorbidities were present in at least 33 (28%) children from low-income or lower middle-income countries, 36 (47%) from upper middle-income countries, and 114 (70%) from high-income countries. Median age for RSV-related deaths was 5·0 months (IQR 2·3–11·0) in low-income or lower middle-income countries, 4·0 years (2·0–10·0) in upper middle-income countries, and 7·0 years (3·6–16·8) in high-income countries. Interpretation This study is the first large case series of children who died with community-acquired RSV infection. A substantial proportion of children with RSV-related death had comorbidities. Our results show that perinatal immunisation strategies for children aged younger than 6 months could have a substantial impact on RSV-related child mortality in low-income and middle-income countries. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- Nienke M Scheltema
- Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Angela Gentile
- Department of Epidemiology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina
| | - Florencia Lucion
- Department of Epidemiology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina
| | - D James Nokes
- Kenya Medical Research Institute, Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya; School of Life Sciences, University of Warwick, Coventry, UK
| | - Patrick K Munywoki
- Kenya Medical Research Institute, Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya; Department of Nursing Sciences, Pwani University, Kilifi, Kenya
| | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle J Groome
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Kentigern Thorburn
- Department of Paediatric Intensive Care, Alder Hey Children's Hospital, Liverpool, UK
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Socorro P Lupisan
- Research Institute for Tropical Medicine, Alabang Muntinlupa City, Metro Manila Philippines
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, MI, USA
| | - José F Sánchez
- Department of Medicine, Hospital Infantil Manuel de Jesus Rivera, Managua, Nicaragua
| | - Katherine L O'Brien
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Asuncion Mejias
- Department of Pediatrics, Division of Infectious Diseases, Ohio State University, Columbus, OH, USA; Center for Vaccines and Immunity at Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA
| | - Octavio Ramilo
- Department of Pediatrics, Division of Infectious Diseases, Ohio State University, Columbus, OH, USA; Center for Vaccines and Immunity at Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA
| | - Najwa Khuri-Bulos
- Department of Pediatrics, University of Jordan, Aljubeiha, Amman, Jordan
| | - Natasha Halasa
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fernanda de-Paris
- Molecular Biology Laboratory, Hospital de Clínicas de Porto Alegre, Bairro Santa Cecília, Porto Alegre, Brazil
| | - Márcia Rosane Pires
- Infection Control Commission, Hospital de Clínicas de Porto Alegre, Bairro Santa Cecília, Porto Alegre, Brazil
| | - Michael C Spaeder
- Division of Pediatric Critical Care, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Bosco A Paes
- Neonatal Division, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Eric A F Simões
- Department of Pediatrics and Center for Global Health, University of Colorado, Aurora, CO, USA
| | - Ting F Leung
- Department of Paediatrics, Faculty of Medicine and Chinese University of Hong Kong-University Medical Center Utrecht Joint Research Laboratory of Respiratory Virus and Immunobiology, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China
| | | | | | - Quique Bassat
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; ICREA, Catalan Institution for Research and Advanced Studies, Barcelona, Spain; Department of Pediatrics, Hospital Sant Joan de Déu, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Faculty of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Warwick Butt
- Department of Intensive Care, Royal Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Hsin Chi
- Department of Pediatric Infectious Disease, MacKay Children's Hospital, Taipei, Taiwan
| | - Uzma Bashir Aamir
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | - Asad Ali
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Marilla G Lucero
- Research Institute for Tropical Medicine, Alabang Muntinlupa City, Metro Manila Philippines
| | | | - Olga Lopez
- Hospital Dr. Ernesto Torres Galdames, Iquique, Chile
| | - Barbara A Rath
- Vienna Vaccine Safety Initiative, Berlin, Germany; University of Nottingham School of Medicine, Nottingham, UK
| | | | - Jesse Papenburg
- Department of Microbiology, Division of Pediatric Infectious Diseases, McGill University Health Centre, Montreal, QC, Canada
| | - Srđan Roglić
- Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia
| | - Hisato Ito
- Department of Pediatrics, Nantan General Hospital, Ueno, Yagichoyagi, Nantan-shi, Kyoto, Japan
| | - Edward A Goka
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Julius Clinical Science, Zeist, Netherlands
| | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Louis J Bont
- Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands; ReSViNET Respiratory Syncytial Virus Network, Utrecht, Netherlands.
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Moyes J, Walaza S, Pretorius M, Groome M, von Gottberg A, Wolter N, Haffejee S, Variava E, Cohen AL, Tempia S, Kahn K, Dawood H, Venter M, Cohen C, Madhi SA. Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting. J Infect 2017; 75:346-355. [PMID: 28676408 PMCID: PMC5712433 DOI: 10.1016/j.jinf.2017.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 06/22/2017] [Accepted: 06/24/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND There are limited data on the epidemiology of respiratory syncytial virus (RSV) illness in HIV-infected adults or the elderly in Africa. We studied the epidemiology of RSV-associated severe acute respiratory illness (SARI) hospitalizations in adults in South Africa from 2009 through 2013. METHODS Individuals admitted to sentinel surveillance hospitals were investigated by respiratory tract swabs for RSV, using a multiplex real-time polymerase chain reaction assay. The incidence of RSV-associated SARI was calculated for the one site with population denominators. RESULTS Of 7796 participants investigated, 329 (4%) tested positive for RSV. On multivariable analysis, HIV-infected individuals with RSV-associated SARI had greater odds of being in the age groups 18-44 and 45-64 years (odd ratios (OR) 26.3; 95% confidence interval (CI) 6.2-112.1 and OR 11.4; 95% CI 2.6-50.0) compared with those ≥65 years and being female (OR 2.7; 95% CI 1.4-5.4). The relative risk of hospitalization with RSV-associated SARI was 12-18 times higher in HIV infected individual compared to that of HIV-uninfected. CONCLUSION The incidence of RSV-associated SARI was higher in HIV-infected individuals and those aged 65 years and older. Further studies are warranted to describe the disease association of RSV detected in adults with SARI.
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Affiliation(s)
- Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Health Sciences Faculty, University of the Witwatersrand, Johannesburg, South Africa.
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Health Sciences Faculty, University of the Witwatersrand, Johannesburg, South Africa
| | - Marthi Pretorius
- Department of Medical Virology, University of Pretoria, South Africa
| | - Michelle Groome
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Ebrahim Variava
- Klerksdorp-Tshepong Hospital Complex, South Africa; The University of the Witwatersrand, South Africa
| | - Adam L Cohen
- Strategic Information Group, Expanded Programme on Immunization, Department of Immunization, Vaccines and Biologicals, World Health Organization, Switzerland
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Global Health Research and Umeå University, Umeå, Sweden; INDEPTH Network Accra, Ghana
| | - Halima Dawood
- Pietermaritzburg Hospital Complex and University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Marietjie Venter
- Department of Medical Virology, University of Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Health Sciences Faculty, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
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One‐year observational study of palivizumab prophylaxis on infants at risk for respiratory syncytial virus infection in Latin America. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Castillo LM, Bugarin G, Arias JC, Barajas Rangel JI, Serra ME, Vain N. One-year observational study of palivizumab prophylaxis on infants at risk for respiratory syncytial virus infection in Latin America. J Pediatr (Rio J) 2017; 93:467-474. [PMID: 28236418 DOI: 10.1016/j.jped.2016.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/08/2016] [Accepted: 11/09/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aims to describe real world palivizumab use and effectiveness in high-risk Latin American infants and young children. METHOD Prospective, multicenter observational study with infants at risk for severe RSV infection who received palivizumab according to routine clinical practice. Subjects were followed for one year with monthly visits after the first dose of palivizumab. An infant was considered adherent if receiving all the expected injections or five or fewer injections within appropriate inter-dose intervals. Annual incidence rates and risk factors of lower respiratory tract infection (LRTI) hospitalization were determined through Poisson regression models (α=0.05). RESULTS The study enrolled 458 children from seven countries in Latin America, from February 2011 to September 2012. The majority (98%) were born <36 weeks gestation. Overall, patients received 83.7% of their expected injections and 86.7% completed one year of follow-up. Of the 61 LRTI hospitalizations, 12 episodes were due to RSV infection. The RSV-associated hospitalization rate was 2.9 per 100 patient-years. Bronchopulmonary dysplasia was identified as an independent risk factor for LRTI hospitalization. A total of 1165 adverse events were recorded during one year of follow-up. One hundred and two patients (22.3%) had a total of 135 serious adverse events, but no events were considered to be related to palivizumab. CONCLUSIONS The rate of RSV hospitalization in high-risk infants in Latin America was low and aligned with those observed in randomized control trials and observational studies. Palivizumab prophylaxis appeared effective and had a good safety profile in this population.
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Affiliation(s)
| | | | | | | | - Maria Elina Serra
- FUNDASAMIN Fundación para la Salud Materno Infantil, Buenos Aires, Argentina
| | - Nestor Vain
- FUNDASAMIN Fundación para la Salud Materno Infantil, Buenos Aires, Argentina; Sanatorio de la Trinidad Palermo, Buenos Aires, Argentina
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Colosia AD, Yang J, Hillson E, Mauskopf J, Copley-Merriman C, Shinde V, Stoddard J. The epidemiology of medically attended respiratory syncytial virus in older adults in the United States: A systematic review. PLoS One 2017; 12:e0182321. [PMID: 28797053 PMCID: PMC5552193 DOI: 10.1371/journal.pone.0182321] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 07/17/2017] [Indexed: 11/23/2022] Open
Abstract
Objective This review was undertaken to assess the historical evidence of the disease incidence and burden of laboratory-confirmed respiratory syncytial virus (RSV) in medically attended older adults. Design A qualitative systematic literature review was performed; no statistical synthesis of the data was planned, in anticipation of expected heterogeneity across studies in this population. Methods A literature search of PubMed, Embase, and the Cochrane Library was conducted for studies of medically attended RSV in older adults (≥ 50 years) published in the last 15 years. Two independent reviewers screened titles and abstracts based on predefined inclusion and exclusion criteria. Results From 10 studies reporting incidence proportions, RSV may be the causative agent in up to 12% of medically attended acute respiratory illness in older adults unselected for comorbidities, with variations in clinical setting and by year. In multiple studies, medically attended–RSV incidence among older adults not selected for having underlying health conditions increased with increasing age. Of prospectively followed lung transplant recipients, 16% tested positive for RSV. In hospitalized adults with chronic cardiopulmonary diseases, 8% to 13% were infected with RSV during winter seasons (8%-13%) or metapneumovirus season (8%). Hospitalizations for RSV in older adults typically lasted 3 to 6 days, with substantial proportions requiring intensive care unit admission and mechanical ventilation. Among older adults hospitalized with RSV, the mortality rate was 6% to 8%. Conclusions Protection of older adults against RSV could reduce respiratory-related burden, especially as age increases and the prevalence of comorbidities (especially cardiopulmonary comorbidities) grows.
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Affiliation(s)
- Ann D. Colosia
- RTI Health Solutions, Research Triangle Park, North Carolina, United States
- * E-mail:
| | - Jin Yang
- RTI Health Solutions, Research Triangle Park, North Carolina, United States
| | | | - Josephine Mauskopf
- RTI Health Solutions, Research Triangle Park, North Carolina, United States
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Ábrego LE, Delfraro A, Franco D, Castillo J, Castillo M, Moreno B, López-Vergès S, Pascale JM, Arbiza J. Genetic variability of human respiratory syncytial virus group B in Panama reveals a novel genotype BA14. J Med Virol 2017; 89:1734-1742. [PMID: 28464479 DOI: 10.1002/jmv.24838] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/24/2017] [Accepted: 04/17/2017] [Indexed: 11/10/2022]
Abstract
In Panama, human respiratory syncytial virus (HRSV) is responsible of 20-40% of acute respiratory infections in children under 5 years old. Currently, little is known about the genetic variability of HRSV in Central America and the Caribbean. Recently, we reported the genetic variability of HRSV-A, however; no studies on HRSV-B in Panama have been described yet. In this study, 24 sequences of Panamanian HRSV-B, from children (<5 years) with acute respiratory infections (ARI), collected from July 2008 to November 2012 were analyzed. All sequences share the characteristic 60-nt duplication of the BA strains. Six Panamanian strains grouped with the BA10 genotype and 12 samples clustered together in a separate monophyletic clade with an aLRT support value of 0.92 and an intra-group p-distance less than 0.07. This fulfills the criteria to consider a new genotype in HRSV, which we named BA14 genotype. Another six strains remain unclassified, but closely related to BA9, BA11, or the new BA14 genotypes, according to their genetic p-distance. Different amino acid substitutions in the Panamanian HRSV-B strains were observed, some previously described and others found only on Panamanian strains. This study contributes to the knowledge of the genetic variability and evolution of HRSV in Central America.
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Affiliation(s)
- Leyda E Ábrego
- Deparment of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Adriana Delfraro
- Virology Section, School of Sciences, University of the Republic, Montevideo, Uruguay
| | - Danilo Franco
- Deparment of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama.,School of Medicine, University of Panama, Panama City, Panama
| | - Juan Castillo
- Department of Genomic and Proteomic, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Marlene Castillo
- Deparment of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Brechla Moreno
- Deparment of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Sandra López-Vergès
- Deparment of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Juan M Pascale
- School of Medicine, University of Panama, Panama City, Panama.,Department of Genomic and Proteomic, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Juan Arbiza
- Virology Section, School of Sciences, University of the Republic, Montevideo, Uruguay
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Stein RT, Bont LJ, Zar H, Polack FP, Park C, Claxton A, Borok G, Butylkova Y, Wegzyn C. Respiratory syncytial virus hospitalization and mortality: Systematic review and meta-analysis. Pediatr Pulmonol 2017; 52:556-569. [PMID: 27740723 PMCID: PMC5396299 DOI: 10.1002/ppul.23570] [Citation(s) in RCA: 205] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/24/2016] [Accepted: 07/18/2016] [Indexed: 10/31/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major public health burden worldwide. We aimed to review the current literature on the incidence and mortality of severe RSV in children globally. METHODS Systematic literature review and meta-analysis of published data from 2000 onwards, reporting on burden of acute respiratory infection (ARI) due to RSV in children. Main outcomes were hospitalization for severe RSV-ARI and death. RESULTS Five thousand two hundred and seventy-four references were identified. Fifty-five studies were included from 32 countries. The global RSV-ARI hospitalization estimates, reported per 1,000 children per year (95% Credible Interval (CrI), were 4.37 (2.98, 6.42) among children <5 years, 19.19 (15.04, 24.48) among children <1 year, 20.01 (9.65, 41.31) among children <6 months and 63.85 (37.52, 109.70) among premature children <1 year. The RSV-ARI global case-fatality estimates, reported per 1,000 children, (95% Crl) were 6.21 (2.64, 13.73) among children <5 years, 6.60 (1.85, 16.93) for children <1 year, and 1.04 (0.17, 12.06) among preterm children <1 year. CONCLUSIONS A substantial proportion of RSV-associated morbidity occurs in the first year of life, especially in children born prematurely. These data affirm the importance of RSV disease in the causation of hospitalization and as a significant contributor to pediatric mortality and further demonstrate gestational age as a critical determinant of disease severity. An important limitation of case-fatality ratios is the absence of individual patient characteristics of non-surviving patients. Moreover, case-fatality ratios cannot be translated to population-based mortality. Pediatr Pulmonol. 2017;52:556-569. © 2016 The Authors. Pediatric Pulmonology. Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Renato T Stein
- Department of Pediatrics, Hospital da PUCRS & Biomedical Research Institute, Porto Alegre, Brazil
| | - Louis J Bont
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Heather Zar
- Department of Paediatrics and Child Health, Red Cross Childrens Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Fernando P Polack
- Fundacion INFANT, Buenos Aires, Argentina.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Ami Claxton
- Doctor Evidence, LLC, Santa Monica, California
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Bouzas ML, Oliveira JR, Fukutani KF, Borges IC, Barral A, Van der Gucht W, Wollants E, Van Ranst M, de Oliveira CI, Van Weyenbergh J, Nascimento-Carvalho CM. Respiratory syncytial virus a and b display different temporal patterns in a 4-year prospective cross-sectional study among children with acute respiratory infection in a tropical city. Medicine (Baltimore) 2016; 95:e5142. [PMID: 27741144 PMCID: PMC5072971 DOI: 10.1097/md.0000000000005142] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common etiological agents of childhood respiratory infections globally. Information on seasonality of different antigenic groups is scarce. We aimed to describe the frequency, seasonality, and age of children infected by RSV antigenic groups A (RSVA) and B (RSVB) among children with ARI in a 4-year period.Children (6-23 months old) with respiratory infection for ≤7 days were enrolled in a prospective cross-sectional study, from September, 2009 to October, 2013, in Salvador, in a tropical region of Brazil. Upon recruitment, demographic, clinical data, and nasopharyngeal aspirates (NPA) were collected. A multiplex quantitative real-time polymerase chain reaction (RT-PCR) with a group-specific primer and probeset for RSVA and RSVB was used. Seasonal distribution of infection by RSV different antigenic groups was evaluated by Prais-Wisten regression.Of 560 cases, the mean age was 11.4 ± 4.5 months and there were 287 (51.3%) girls. Overall, RSV was detected in 139 (24.8%; 95% CI: 21.4%-28.5%) cases, RSVA in 74 (13.2%; 95% CI: 10.6%-16.2%) cases, and RSVB in 67 (12.0%; 95% CI: 9.5%-14.9%) cases. Two (0.4%; 95% CI: 0.06%-1.2%) cases had coinfection. RSVA frequency was 9.6%, 18.4%, 21.6%, and 3.1% in 2010, 2011, 2012, and 2013, respectively. RSVB frequency was 19.2%, 0.7%, 1.4%, and 35.4% in the same years. RSVA was more frequently found from August to January than February to July (18.2% vs. 6.4%, P < 0.001). RSVB was more frequently found (P < 0.001) between March and June (36.0%) than July to October (1.0%) or November to February (1.6%). RSVB infection showed seasonal distribution and positive association with humidity (P = 0.02) whereas RSVA did not. RSVA was more common among children ≥1-year-old (17.8% vs. 1.8%; P = 0.02), as opposed to RSVB (11.5% vs. 12.2%; P = 0.8).One quarter of patients had RSV infection. RSVA compromised more frequently children aged ≥1 year. RSVA predominated in 2011 and 2012 whereas RSVB predominated in 2010 and 2013. In regard to months, RSVA was more frequent from August to January whereas RSVB was more often detected between March and June. Markedly different monthly as well as yearly patterns for RSVA and RSVB reveal independent RSV antigenic groups' epidemics.
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Affiliation(s)
- Maiara L Bouzas
- Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Bahia, Brazil Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brazil Department of Pathology, Federal University of Bahia School of Medicine, Salvador, Bahia, Brazil Department of Microbiology and Immunology, Laboratory for Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU, Leuven, Belgium Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Bahia, Brazil
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Tempia S, Walaza S, Viboud C, Cohen AL, Madhi SA, Venter M, von Mollendorf C, Moyes J, McAnerney JM, Cohen C. Deaths associated with respiratory syncytial and influenza viruses among persons ≥5 years of age in HIV-prevalent area, South Africa, 1998-2009(1). Emerg Infect Dis 2015; 21:600-8. [PMID: 25811455 PMCID: PMC4378466 DOI: 10.3201/eid2104.141033] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We estimated deaths attributable to influenza and respiratory syncytial virus (RSV) among persons >5 years of age in South Africa during 1998-2009 by applying regression models to monthly deaths and laboratory surveillance data. Rates were expressed per 100,000 person-years. The mean annual number of seasonal influenza-associated deaths was 9,093 (rate 21.6). Persons >65 years of age and HIV-positive persons accounted for 50% (n = 4,552) and 28% (n = 2,564) of overall seasonal influenza-associated deaths, respectively. In 2009, we estimated 4,113 (rate 9.2) influenza A(H1N1)pdm09-associated deaths. The mean of annual RSV-associated deaths during the study period was 511 (rate 1.2); no RSV-associated deaths were estimated in persons >45 years of age. Our findings support the recommendation for influenza vaccination of older persons and HIV-positive persons. Surveillance for RSV should be strengthened to clarify the public health implications and severity of illness associated with RSV infection in South Africa.
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Contreras CL, Verani JR, Lopez MR, Paredes A, Bernart C, Moscoso F, Roldan A, Arvelo W, Lindblade KA, McCracken JP. Incidence of Hospitalized Pneumococcal Pneumonia among Adults in Guatemala, 2008-2012. PLoS One 2015; 10:e0140939. [PMID: 26488871 PMCID: PMC4619266 DOI: 10.1371/journal.pone.0140939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/30/2015] [Indexed: 11/21/2022] Open
Abstract
Background Streptococcus pneumoniae is a leading cause of pneumonia worldwide. However, the burden of pneumococcal pneumonia among adults in low- and middle-income countries is not well described. Methods Data from 2008–2012 was analyzed from two surveillance sites in Guatemala to describe the incidence of pneumococcal pneumonia in adults. A case of hospitalized pneumococcal pneumonia was defined as a positive pneumococcal urinary antigen test or blood culture in persons aged ≥ 18 years hospitalized with an acute respiratory infection (ARI). Results Among 1595 adults admitted with ARI, 1363 (82%) had either urine testing (n = 1286) or blood culture (n = 338) performed. Of these, 188 (14%) had pneumococcal pneumonia, including 173 detected by urine only, 8 by blood culture only, and 7 by both methods. Incidence rates increased with age, with the lowest rate among 18–24 year-olds (2.75/100,000) and the highest among ≥65 year-olds (31.3/100,000). The adjusted incidence of hospitalized pneumococcal pneumonia was 18.6/100,000 overall, with in-hospital mortality of 5%. Conclusions An important burden of hospitalized pneumococcal pneumonia in adults was described, particularly for the elderly. However, even adjusted rates likely underestimate the true burden of pneumococcal pneumonia in the community. These data provide a baseline against which to measure the indirect effects of the 2013 introduction of the pneumococcal conjugate vaccine in children in Guatemala.
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Affiliation(s)
- Carmen Lucía Contreras
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- * E-mail:
| | - Jennifer R. Verani
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States of America
| | - María Renee Lopez
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Antonio Paredes
- National Center for Epidemiology, Ministry of Public Health and Social Welfare (MSPAS), Guatemala City, Guatemala
| | - Chris Bernart
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Fabiola Moscoso
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Aleida Roldan
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Wences Arvelo
- Division of Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention (CDC), Atlanta GA, United States of America
| | - Kim A. Lindblade
- Division of Global Disease Detection and Emergency Response, Centers for Disease Control and Prevention (CDC), Atlanta GA, United States of America
| | - John P. McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
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Hospitalizations associated with influenza and respiratory syncytial virus among patients attending a network of private hospitals in South Africa, 2007-2012. BMC Infect Dis 2014; 14:694. [PMID: 25510622 PMCID: PMC4278267 DOI: 10.1186/s12879-014-0694-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/10/2014] [Indexed: 11/20/2022] Open
Abstract
Background Influenza and respiratory syncytial virus (RSV) infection are common causes of lower respiratory tract illness. Data on their burden in low and middle-income settings and from Africa are scarce. We aimed to estimate age-specific rates of hospitalization attributable to influenza and RSV among patients attending private hospitals in South Africa during 2007–2012. Methods We estimated annual age-specific rates of influenza- and RSV-associated hospitalization (that is respiratory hospitalizations likely due to influenza or RSV infection) by applying regression models to monthly administrative hospitalization data from a national private hospital group, using influenza and RSV surveillance data as covariates. Results Estimated mean hospitalization rates associated with seasonal influenza were 75 (95% confidence interval (CI), 41–108) and 3 (95% CI, 2–5) per 100,000 person-years for all-respiratory and all-circulatory causes, respectively. Children <1 year and adults ≥75 years were the most affected, with influenza-associated all-respiratory hospitalization rates estimated at 255 (95% CI, 143–358) and 380 (95% CI, 227–506) per 100,000 person-years, respectively. Excess all-circulatory hospitalizations associated with seasonal influenza were only observed in adults ≥65 years. Annual hospitalization rates associated with RSV averaged an estimate of 223 (95% CI, 128–317) per 100,000 person-years for all-respiratory causes. Among children <1 year, RSV-associated all-respiratory hospitalization rate of 7,601 (95% CI, 4,312-10,817) per 100,000 person-years was estimated. Conclusions Influenza and RSV substantially contributed to hospitalizations over the study period. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0694-x) contains supplementary material, which is available to authorized users.
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