Respiratory Syncytial Virus–Associated Mortality Among Young Infants in Karachi, Pakistan: A Prospective Postmortem Surveillance Study

Abstract Background Respiratory syncytial virus (RSV) is an important cause of infant morbidity and mortality and a potential target for maternal immunization strategies. However, data on the role of RSV in young infant deaths in developing countries are limited. Methods We conducted a community-bas...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Clinical infectious diseases 2021-09, Vol.73 (Supplement_3), p.S203-S209
Hauptverfasser: Kazi, Abdul Momin, Aguolu, Obianuju G, Mughis, Waliyah, Ahsan, Nazia, Jamal, Saima, Khan, Ayub, Qureshi, Hanya M, Yildirim, Inci, Malik, Fauzia A, Omer, Saad B
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Abstract Background Respiratory syncytial virus (RSV) is an important cause of infant morbidity and mortality and a potential target for maternal immunization strategies. However, data on the role of RSV in young infant deaths in developing countries are limited. Methods We conducted a community-based mortality surveillance from August 2018–March 2020 for infants ≤6 months in Karachi, Pakistan. We tested (reverse transcription–polymerase chain reaction) nasopharyngeal swabs from deceased infants for presence of RSV. We performed verbal autopsies and calculated odds of RSV-associated mortality with 95% CIs and used multivariable logistic regression to evaluate associations. Results We collected 490 nasopharyngeal specimens from 1280 eligible infant deaths. There were 377/490 (76.9%) live births and 14/377 (3.7%; 95% CI: 1.8–5.6) were RSV positive. Most deaths occurred in neonates (254/377; 67.4%), males (226/377; 59.9%), and respiratory illnesses (206/377; 54.6%). Postneonatal age (10/14, 71.4%; OR: 5.5; 95% CI: 1.7–18.0), respiratory symptoms (12/14, 85.7%; OR: 5.2; 1.2–23.7), and high RSV season (9/14, 64.3%; OR: 4.4; 1.4–13.3) were associated with RSV mortality. In multivariable logistic regression analysis, respiratory symptoms (OR: 6.6; 95% CI: 1.3–32.5), RSV seasonality (6.1; 1.8–20.4), and age (9.2; 2.6–33.1) were significant predictors of RSV-associated mortality. Conclusions RSV has a significant mortality burden in early infancy in Karachi, Pakistan. Age, RSV seasonality, and respiratory symptoms were significant predictors of RSV-associated mortality. Our findings have implications for clinical management of young infants with cold-like symptoms, policy development, and research regarding maternal immunization against RSV during pregnancy, in resource-constrained, low-income, and vaccine-hesitant populations. Respiratory syncytial virus is a potential target for maternal immunization with significant disease burden in young infants. Limited knowledge regarding RSV infant mortality in developing countries exists. We assessed the burden and determinants of RSV infant mortality in Karachi, Pakistan.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciab488