Incidence and clinical features of hospitalization because of respiratory syncytial virus lower respiratory illness among children less than two years of age in a rural Asian setting.
BACKGROUND
Lower respiratory illness is the leading cause of child death in the developing world. Despite this few reports on respiratory syncytial virus (RSV) lower respiratory illness disease burden exist from rural areas of the developing world, and none exist for Indonesia.


METHODS
We evaluated children living in any of 83 villages on Lombok Island, Indonesia who were <2 years of age when hospitalized for severe lower respiratory illness during 2000 and 2001. All hospitals on Lombok were included in the evaluation. We obtained the number of births and deaths that occurred within the study villages and time frame, allowing for incidence determination.


RESULTS
Of 2677 children hospitalized for severe lower respiratory illness whose RSV status was determined, 23% had a positive test; this percentage varied from 50% at the end of the rainy season to 0% shortly before the start of the rainy season. Among children <2 years of age, the confirmed and estimated incidences of severe RSV lower respiratory illness hospitalization were 10 and 14 per 1000 child-years, respectively; values for children <1 year of age were 17 and 25 per 1000 child-years. The confirmed case-fatality percentage among RSV-positive cases was 1.9%; however, 84% of children who died were dead before RSV status could be determined, suggesting the actual case fatality percentage was higher.


CONCLUSIONS
Lombok has a large burden of severe childhood RSV lower respiratory illness, and death occurs frequently. Novel RSV vaccines thus could have a substantial positive impact on lower respiratory illness morbidity and mortality.
Djelantik
I G
IG
Program for Appropriate Technology in Health, Seattle WA, USA.
Gessner
Bradford D
BD
Soewignjo
S
S
Steinhoff
Mark
M
Sutanto
Augustinis
A
Widjaya
Anton
A
Linehan
Mary
M
Moniaga
Vanda
V
Ingerani
D017677:Age Distribution; D002675:Child, Preschool; D016001:Confidence Intervals; D003906:Developing Countries; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000453:epidemiology*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D015996:Survival Rate