Incidence and Severity of Respiratory Syncytial Virus Pneumonia in Rural Kenyan Children Identified through Hospital Surveillance

作者：D. James Nokes, Mwanajuma Ngama, Ann Bett, John Abwao, Patrick K. Munywoki, Mike English, J. Anthony G. Scott, Patricia A. Cane, Graham Francis Medley · 发表于：Clinical Infectious Diseases · 年份：2009 · DOI：10.1086/606055 · 被引用次数：159 · 研究领域：Respiratory viral infections research、Virology and Viral Diseases、Pneumonia and Respiratory Infections

Background.Although necessary for developing a rationale for vaccination, the burden of severe respiratory syncytial virus (RSV) disease in children in resource-poor settings remains poorly defined. Methods.We conducted prospective surveillance of severe and very severe pneumonia in children aged !5 years admitted from 2002 through 2007 to Kilifi district hospital in coastal Kenya.Nasal specimens were screened for RSV antigen by immunofluorescence.Incidence rates were estimated for the well-defined population.Results.Of 25,149 hospital admissions, 7359 patients (29%) had severe or very severe pneumonia, of whom 6026 (82%) were enrolled.RSV prevalence was 15% (20% among infants) and 27% during epidemics (32% among infants).The proportion of case patients aged у3 months was 65%, and the proportion aged у6 months was 43%.Average annual hospitalization rates were 293 hospitalizations per 100,000 children aged !5 years (95% confidence interval, 271-371 hospitalizations per 100,000 children aged !5 years) and 1107 hospitalizations per 100,000 infants (95% confidence interval, 1012-1211 hospitalizations per 100,000 infants).Hospital admission rates were double in the region close to the hospital.Few patients with RSV infection had life-threatening clinical features or concurrent serious illnesses, and the associated mortality was 2.2%. Conclusions.In this low-income setting, rates of hospital admission with RSV-associated pneumonia are substantial; they are comparable to estimates f...