Epidemiology and Virology of Acute Respiratory Infections During the First Year of Life: A Birth Cohort Study in Vietnam

BACKGROUND:Understanding viral etiology and age-specific incidence of acute respiratory infections in infants can help identify risk groups and inform vaccine delivery, but community-based data is lacking from tropical settings. METHODS:One thousand four hundred and seventy-eight infants in urban Ho...

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Veröffentlicht in:The Pediatric infectious disease journal 2015-04, Vol.34 (4), p.361-370
Hauptverfasser: Anders, Katherine L, Nguyen, Hoa L, Nguyen, Nguyet Minh, Van Thuy, Nguyen Thi, Hong Van, Nguyen Thi, Hieu, Nguyen Trong, Hong Tham, Nguyen Thi, Thanh Ha, Phan Thi, Lien, Le Bich, Vinh Chau, Nguyen Van, Ty Hang, Vu Thi, van Doorn, H Rogier, Simmons, Cameron P
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container_end_page 370
container_issue 4
container_start_page 361
container_title The Pediatric infectious disease journal
container_volume 34
creator Anders, Katherine L
Nguyen, Hoa L
Nguyen, Nguyet Minh
Van Thuy, Nguyen Thi
Hong Van, Nguyen Thi
Hieu, Nguyen Trong
Hong Tham, Nguyen Thi
Thanh Ha, Phan Thi
Lien, Le Bich
Vinh Chau, Nguyen Van
Ty Hang, Vu Thi
van Doorn, H Rogier
Simmons, Cameron P
description BACKGROUND:Understanding viral etiology and age-specific incidence of acute respiratory infections in infants can help identify risk groups and inform vaccine delivery, but community-based data is lacking from tropical settings. METHODS:One thousand four hundred and seventy-eight infants in urban Ho Chi Minh City and 981 infants in a semi-rural district in southern Vietnam were enrolled at birth and followed to 1 year of age. Acute respiratory infection (ARI) episodes were identified through clinic-based illness surveillance, hospital admissions and self-reports. Nasopharyngeal swabs were collected from infants with respiratory symptoms and tested for 14 respiratory pathogens using multiplex reverse transcription-polymerase chain reaction. RESULTS:Estimated incidence of ARI was 542 and 2691 per 1000 infant-years, and hospitalization rates for ARI were 81 and 138 per 1000 infant-years, in urban and semi-rural cohorts, respectively, from clinic- and hospital-based surveillance. However self-reported ARI episodes were just 1.5-fold higher in the semi-rural versus urban cohort, indicating that part of the urban–rural difference was explained by under-ascertainment in the urban cohort. Incidence was higher in infants ≥6 months of age than
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METHODS:One thousand four hundred and seventy-eight infants in urban Ho Chi Minh City and 981 infants in a semi-rural district in southern Vietnam were enrolled at birth and followed to 1 year of age. Acute respiratory infection (ARI) episodes were identified through clinic-based illness surveillance, hospital admissions and self-reports. Nasopharyngeal swabs were collected from infants with respiratory symptoms and tested for 14 respiratory pathogens using multiplex reverse transcription-polymerase chain reaction. RESULTS:Estimated incidence of ARI was 542 and 2691 per 1000 infant-years, and hospitalization rates for ARI were 81 and 138 per 1000 infant-years, in urban and semi-rural cohorts, respectively, from clinic- and hospital-based surveillance. However self-reported ARI episodes were just 1.5-fold higher in the semi-rural versus urban cohort, indicating that part of the urban–rural difference was explained by under-ascertainment in the urban cohort. Incidence was higher in infants ≥6 months of age than &lt;6 months, but this was pathogen-specific. One or more viruses were detected in 53% (urban) and 64% (semi-rural) of samples from outpatients with ARI and in 78% and 66% of samples from hospitalized ARI patients, respectively. The most frequently detected viruses were rhinovirus, respiratory syncytial virus, influenza virus A and bocavirus. ARI-associated hospitalizations were associated with longer stays and more frequent ICU admission than other infections. CONCLUSIONS:ARI is a significant cause of morbidity in Vietnamese infants and influenza virus A is an under-appreciated cause of vaccine-preventable disease and hospitalizations in this tropical setting. Public health strategies to reduce infant ARI incidence and hospitalization rates are needed.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0000000000000643</identifier><identifier>PMID: 25674708</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Cohort Studies ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Multiplex Polymerase Chain Reaction ; Nasopharynx - virology ; Original Studies ; Pregnancy ; Respiratory Syncytial Viruses ; Respiratory Tract Infections - epidemiology ; Respiratory Tract Infections - virology ; Reverse Transcriptase Polymerase Chain Reaction ; Vietnam - epidemiology ; Virus Diseases - epidemiology ; Virus Diseases - virology ; Viruses - isolation &amp; purification ; Young Adult</subject><ispartof>The Pediatric infectious disease journal, 2015-04, Vol.34 (4), p.361-370</ispartof><rights>Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2015 by Wolters Kluwer Health, Inc. All rights reserved. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3603-d047a08c321d4e68b9fb44dbd1b01cc26cb3febb4c941ec114541b41fca4acfd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25674708$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anders, Katherine L</creatorcontrib><creatorcontrib>Nguyen, Hoa L</creatorcontrib><creatorcontrib>Nguyen, Nguyet Minh</creatorcontrib><creatorcontrib>Van Thuy, Nguyen Thi</creatorcontrib><creatorcontrib>Hong Van, Nguyen Thi</creatorcontrib><creatorcontrib>Hieu, Nguyen Trong</creatorcontrib><creatorcontrib>Hong Tham, Nguyen Thi</creatorcontrib><creatorcontrib>Thanh Ha, Phan Thi</creatorcontrib><creatorcontrib>Lien, Le Bich</creatorcontrib><creatorcontrib>Vinh Chau, Nguyen Van</creatorcontrib><creatorcontrib>Ty Hang, Vu Thi</creatorcontrib><creatorcontrib>van Doorn, H Rogier</creatorcontrib><creatorcontrib>Simmons, Cameron P</creatorcontrib><title>Epidemiology and Virology of Acute Respiratory Infections During the First Year of Life: A Birth Cohort Study in Vietnam</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>BACKGROUND:Understanding viral etiology and age-specific incidence of acute respiratory infections in infants can help identify risk groups and inform vaccine delivery, but community-based data is lacking from tropical settings. METHODS:One thousand four hundred and seventy-eight infants in urban Ho Chi Minh City and 981 infants in a semi-rural district in southern Vietnam were enrolled at birth and followed to 1 year of age. Acute respiratory infection (ARI) episodes were identified through clinic-based illness surveillance, hospital admissions and self-reports. Nasopharyngeal swabs were collected from infants with respiratory symptoms and tested for 14 respiratory pathogens using multiplex reverse transcription-polymerase chain reaction. RESULTS:Estimated incidence of ARI was 542 and 2691 per 1000 infant-years, and hospitalization rates for ARI were 81 and 138 per 1000 infant-years, in urban and semi-rural cohorts, respectively, from clinic- and hospital-based surveillance. However self-reported ARI episodes were just 1.5-fold higher in the semi-rural versus urban cohort, indicating that part of the urban–rural difference was explained by under-ascertainment in the urban cohort. Incidence was higher in infants ≥6 months of age than &lt;6 months, but this was pathogen-specific. One or more viruses were detected in 53% (urban) and 64% (semi-rural) of samples from outpatients with ARI and in 78% and 66% of samples from hospitalized ARI patients, respectively. The most frequently detected viruses were rhinovirus, respiratory syncytial virus, influenza virus A and bocavirus. ARI-associated hospitalizations were associated with longer stays and more frequent ICU admission than other infections. CONCLUSIONS:ARI is a significant cause of morbidity in Vietnamese infants and influenza virus A is an under-appreciated cause of vaccine-preventable disease and hospitalizations in this tropical setting. Public health strategies to reduce infant ARI incidence and hospitalization rates are needed.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Multiplex Polymerase Chain Reaction</subject><subject>Nasopharynx - virology</subject><subject>Original Studies</subject><subject>Pregnancy</subject><subject>Respiratory Syncytial Viruses</subject><subject>Respiratory Tract Infections - epidemiology</subject><subject>Respiratory Tract Infections - virology</subject><subject>Reverse Transcriptase Polymerase Chain Reaction</subject><subject>Vietnam - epidemiology</subject><subject>Virus Diseases - epidemiology</subject><subject>Virus Diseases - virology</subject><subject>Viruses - isolation &amp; purification</subject><subject>Young Adult</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV1v0zAUhi3ExMrgHyDkS24y7NpxHC6QurKOStWQ-JK4shz7uDEkcbEdtv57MnWbNi7wzZF1nvexpRehV5ScUlJXb9eXq1Py8AjOnqAZLdm8ILWsnqIZkTUtmBDyGD1P6efEME7JM3Q8L0XFKyJn6Pp85y30PnRhu8d6sPi7j4dLcHhhxgz4M6SdjzqHuMfrwYHJPgwJfxijH7Y4t4BXPqaMf4CON6mNd_AOL_CZj7nFy9CGmPGXPNo99sPkhzzo_gU6crpL8PJ2nqBvq_Ovy4_F5tPFernYFIYJwgpLeKWJNGxOLQchm9o1nNvG0oZQY-bCNMxB03BTcwqGUl5y2nDqjObaOMtO0PuDdzc2PVgDQ466U7voex33KmivHm8G36pt-KM4p7KSbBK8uRXE8HuElFXvk4Gu0wOEMSkqBBNlJctqQvkBNTGkFMHdP0OJuilNTaWpf0ubYq8ffvE-dNfSBMgDcBW6DDH96sYriKoF3eX2_-6_qxGl-Q</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Anders, Katherine L</creator><creator>Nguyen, Hoa L</creator><creator>Nguyen, Nguyet Minh</creator><creator>Van Thuy, Nguyen Thi</creator><creator>Hong Van, Nguyen Thi</creator><creator>Hieu, Nguyen Trong</creator><creator>Hong Tham, Nguyen Thi</creator><creator>Thanh Ha, Phan Thi</creator><creator>Lien, Le Bich</creator><creator>Vinh Chau, Nguyen Van</creator><creator>Ty Hang, Vu Thi</creator><creator>van Doorn, H Rogier</creator><creator>Simmons, Cameron P</creator><general>Copyright Wolters Kluwer Health, Inc. 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METHODS:One thousand four hundred and seventy-eight infants in urban Ho Chi Minh City and 981 infants in a semi-rural district in southern Vietnam were enrolled at birth and followed to 1 year of age. Acute respiratory infection (ARI) episodes were identified through clinic-based illness surveillance, hospital admissions and self-reports. Nasopharyngeal swabs were collected from infants with respiratory symptoms and tested for 14 respiratory pathogens using multiplex reverse transcription-polymerase chain reaction. RESULTS:Estimated incidence of ARI was 542 and 2691 per 1000 infant-years, and hospitalization rates for ARI were 81 and 138 per 1000 infant-years, in urban and semi-rural cohorts, respectively, from clinic- and hospital-based surveillance. However self-reported ARI episodes were just 1.5-fold higher in the semi-rural versus urban cohort, indicating that part of the urban–rural difference was explained by under-ascertainment in the urban cohort. Incidence was higher in infants ≥6 months of age than &lt;6 months, but this was pathogen-specific. One or more viruses were detected in 53% (urban) and 64% (semi-rural) of samples from outpatients with ARI and in 78% and 66% of samples from hospitalized ARI patients, respectively. The most frequently detected viruses were rhinovirus, respiratory syncytial virus, influenza virus A and bocavirus. ARI-associated hospitalizations were associated with longer stays and more frequent ICU admission than other infections. CONCLUSIONS:ARI is a significant cause of morbidity in Vietnamese infants and influenza virus A is an under-appreciated cause of vaccine-preventable disease and hospitalizations in this tropical setting. Public health strategies to reduce infant ARI incidence and hospitalization rates are needed.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>25674708</pmid><doi>10.1097/INF.0000000000000643</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Cohort Studies
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Multiplex Polymerase Chain Reaction
Nasopharynx - virology
Original Studies
Pregnancy
Respiratory Syncytial Viruses
Respiratory Tract Infections - epidemiology
Respiratory Tract Infections - virology
Reverse Transcriptase Polymerase Chain Reaction
Vietnam - epidemiology
Virus Diseases - epidemiology
Virus Diseases - virology
Viruses - isolation & purification
Young Adult
title Epidemiology and Virology of Acute Respiratory Infections During the First Year of Life: A Birth Cohort Study in Vietnam
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