title: Respiratory syncytial virus infection: denominator-based studies in Indonesia, Mozambique, Nigeria and South Africa.
abstract: 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.
authors.affiliation: Vaccines and Biologicals, Department of Immunization, World Health Organization, 1211 Geneva 27, Switzerland. robertsons@who.int
authors.forename: Susan E
authors.initials: SE
authors.lastname: Robertson
authors.forename: Anna
authors.initials: A
authors.lastname: Roca
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simoes
authors.forename: Cissy B
authors.initials: CB
authors.lastname: Kartasasmita
authors.forename: David O
authors.initials: DO
authors.lastname: Olaleye
authors.forename: Georgina N
authors.initials: GN
authors.lastname: Odaibo
authors.forename: Mark
authors.initials: M
authors.lastname: Collinson
authors.forename: Marietjie
authors.initials: M
authors.lastname: Venter
authors.forename: Yuwei
authors.initials: Y
authors.lastname: Zhu
authors.forename: Peter F
authors.initials: PF
authors.lastname: Wright
mesh_terms: 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
chemical_list: D014765:Viral Vaccines