The Incidence and Clinical Burden of Respiratory Syncytial Virus Disease Identified through Hospital Outpatient Presentations in Kenyan ChildrenReportar como inadecuado




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Background

There is little information that describe the burden of respiratory syncytial virus RSV associated disease in the tropical African outpatient setting.

Methods

We studied a systematic sample of children aged <5 years presenting to a rural district hospital in Kenya with acute respiratory infection ARI between May 2002 and April 2004. We collected clinical data and screened nasal wash samples for RSV antigen by immunofluorescence. We used a linked demographic surveillance system to estimate disease incidence.

Results

Among 2143 children tested, 166 8% were RSV positive 6% among children with upper respiratory tract infection and 12% among children with lower respiratory tract infection LRTI. RSV was more likely in LRTI than URTI p<0.001. 51% of RSV cases were aged 1 year or over. RSV cases represented 3.4% of hospital outpatient presentations. Relative to RSV negative cases, RSV positive cases were more likely to have crackles RR = 1.63; 95% CI 1.34–1.97, nasal flaring RR = 2.66; 95% CI 1.40–5.04, in-drawing RR = 2.24; 95% CI 1.47–3.40, fast breathing for age RR = 1.34; 95% CI 1.03–1.75 and fever RR = 1.54; 95% CI 1.33–1.80. The estimated incidence of RSV-ARI and RSV-LRTI, per 100,000 child years, among those aged <5 years was 767 and 283, respectively.

Conclusion

The burden of childhood RSV-associated URTI and LRTI presenting to outpatients in this setting is considerable. The clinical features of cases associated with an RSV infection were more severe than cases without an RSV diagnosis.



Autor: Emelda A. Okiro , Mwanajuma Ngama, Ann Bett, D. James Nokes

Fuente: http://plos.srce.hr/



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