Association of Respiratory Syncytial Virus Infection and Underlying Risk Factors for Death Among Young Infants Who Died at University Teaching Hospital, Lusaka Zambia.

Autor:	Forman LS; Boston University School of Public Health, Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston, Massachusetts, USA., Macleod W; Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA., Mwananyanda L; Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA.; Right to Care-Zambia, Lusaka, Zambia., Kwenda G; School of Health Sciences, Department of Biomedical Sciences, University of Zambia, Lusaka, Zambia., Pieciak R; Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA., Mupila Z; Right to Care-Zambia, Lusaka, Zambia., Murphy C; Right to Care-Zambia, Lusaka, Zambia., Thea D; Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA., Chikoti C; Right to Care-Zambia, Lusaka, Zambia., Yankonde B; Right to Care-Zambia, Lusaka, Zambia., Ngoma B; Right to Care-Zambia, Lusaka, Zambia., Chimoga C; Right to Care-Zambia, Lusaka, Zambia., Gill CJ; Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Sep 02; Vol. 73 (Suppl_3), pp. S180-S186.
DOI:	10.1093/cid/ciab466
Abstrakt:	Background: Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections and child mortality. While RSV disease burden is highest in low- and middle-income countries, most knowledge about risk factors for fatal RSV disease comes from high-income settings. Methods: Among infants aged 4 days to <6 months who died at University Teaching Hospital in Lusaka, Zambia, we tested nasopharyngeal swabs obtained postmortem for RSV using reverse transcriptase-quantitative polymerase chain reaction. Through a systematic review of death certificates and hospital records, we identified 10 broad categories of underlying medical conditions associated with infant deaths. We used backward-selection models to calculate adjusted and unadjusted risk ratios (RRs) for the association between each underlying condition and RSV status. Results: From 720 infant deaths, 6% (44) were RSV-positive, 70% were <4 weeks old, and 54% were male. At least 1 underlying condition was found in 85% of infants, while 63% had ≥2. Prematurity/low birth weight (53% [384]) and complications of labor and delivery (32% [230]) were the most common conditions. Congenital cardiac conditions were significantly associated with an increased risk of RSV infection (4%, 32; adjusted RR: 3.57; 95% CI: 1.71-7.44). No other underlying conditions were significantly associated with RSV. Conclusions: Other than congenital cardiac conditions, we found a lack of association between RSV and underlying risk factors. This differs from high-income settings, where RSV mortality is concentrated among high-risk infants. In this population, birth-related outcomes are the highest mortality risk factors. Improved neonatal care remains crucial in the fight against neonatal mortality. (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu