Respiratory syncytial virus infection: denominator-based studies in Indonesia, Mozambique, Nigeria and South Africa.
OBJECTIVE
To assess the burden of respiratory syncytial virus (RSV)-associated lower respiratory infections (LRI) in children in four developing countries.


METHODS
A WHO protocol for prospective population-based surveillance of acute respiratory infections in children aged less than 5 years was used at sites in Indonesia, Mozambique, Nigeria and South Africa. RSV antigen was identified by enzyme-linked immunosorbent assay performed on nasopharyngeal specimens from children meeting clinical case definitions.


RESULTS
Among children aged < 5 years, the incidence of RSV-associated LRI per 1000 child-years was 34 in Indonesia and 94 in Nigeria. The incidence of RSV-associated severe LRI per 1000 child-years was 5 in Mozambique, 10 in Indonesia, and 9 in South Africa. At all study sites, the majority of RSV cases occurred in infants.


CONCLUSIONS
These studies demonstrate that RSV contributes to a substantial but quite variable burden of LRI in children aged < 5 years in four developing countries. The possible explanations for this variation include social factors, such as family size and patterns of seeking health care; the proportion of children infected by human immunodeficiency syndrome (HIV); and differences in clinical definitions used for obtaining samples. The age distribution of cases indicates the need for an RSV vaccine that can protect children early in life.
Robertson
Susan E
SE
Vaccines and Biologicals, Department of Immunization, World Health Organization, 1211 Geneva 27, Switzerland. robertsons@who.int
Roca
Anna
A
Alonso
Pedro
P
Simoes
Eric A F
EA
Kartasasmita
Cissy B
CB
Olaleye
David O
DO
Odaibo
Georgina N
GN
Collinson
Mark
M
Venter
Marietjie
M
Zhu
Yuwei
Y
Wright
Peter F
PF
D017677:Age Distribution; D002675:Child, Preschool; D003906:Developing Countries; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D009073:Mozambique / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D011159:Population Surveillance; D012136:Respiratory Syncytial Viruses / Q000276:immunology / Q000472:pathogenicity*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D013019:South Africa / Q000453:epidemiology; D014765:Viral Vaccines
D014765:Viral Vaccines