title: Epidemiology and clinical presentation of respiratory syncytial virus infection in a rural area of southern Mozambique.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection (LRTI) in infants throughout most of the world, but little is known about RSV infection in Africa where LRTI are among the leading causes of infant and childhood death.
  
  
  METHODS
  The study took place in a rural district hospital in southern Mozambique between October, 1998, and May, 2000. From all children (n = 5635) <1 year of age presenting to an outpatient department with cough or nasal secretion and all children (n = 1307) <5 years of age admitted to hospital with a LRTI, a nasopharyngeal aspirate was collected and tested for RSV by enzyme-linked immunosorbent assay (Abbott).
  
  
  RESULTS
  RSV infection was found in 8.6% of study infants in the outpatient department and 10.6% of admitted children with LRTI. Cases presented in predictable yearly outbreaks during the warm and rainy season. Lower respiratory tract involvement was frequent (59.7%). Cough, chest indrawing and increased respiratory rate were all independently related to RSV infection. Wheezing was infrequent. Bacterial coinfection (4.6%) and the case-fatality rate (3.4%) were low.
  
  
  CONCLUSIONS
  There is a substantial burden of disease attributable to RSV infection in this rural African setting, with the highest incidence and severity occurring in young infants.
authors.affiliation: Centro de Investigaçao em Saúde da Manhiça, Ministerio de Saúde, Maputo, Mozambique.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Loscertales
authors.forename: Anna
authors.initials: A
authors.lastname: Roca
authors.forename: Pere J
authors.initials: PJ
authors.lastname: Ventura
authors.forename: Fátima
authors.initials: F
authors.lastname: Abacassamo
authors.forename: Francisco
authors.initials: F
authors.lastname: Dos Santos
authors.forename: Mariano
authors.initials: M
authors.lastname: Sitaube
authors.forename: Clara
authors.initials: C
authors.lastname: Men  ndez
authors.forename: Brian M
authors.initials: BM
authors.lastname: Greenwood
authors.forename: Juan C
authors.initials: JC
authors.lastname: Saiz
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
mesh_terms: D001424:Bacterial Infections; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D001239:Inhalation; D008297:Male; D009026:Mortality / Q000639:trends; D009073:Mozambique / Q000453:epidemiology; D009305:Nasopharynx / Q000473:pathology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D012136:Respiratory Syncytial Viruses / Q000276:immunology / Q000472:pathogenicity*; D012424:Rural Population; D012720:Severity of Illness Index