title: Long-term consequences of respiratory syncytial virus acute lower respiratory tract infection in early childhood in Guinea-bissau.
abstract: OBJECTIVE
  The study aimed to investigate long-term consequences of respiratory syncytial virus (RSV) positive acute lower respiratory tract infection (ALRI) in a low-income country according to severity of the initial infection.
  
  
  METHODS
  The study was a 1:1 matched case-control study of 335 RSV case children and 335 control children. The mean age of RSV ALRI was 0.9 year and at follow-up, 6.8 years. Case children were identified at the hospital and in the community with an antigen and an IgM test to diagnose RSV. Severe RSV infection was defined when a child was treated at the hospital, whereas disease was assumed less severe when a child was diagnosed at home and received no care in the hospital.
  
  
  RESULTS
  At follow-up, forced expiratory volume in 1 second (FEV1) and peak flow were significantly lower in case children (odds ratio [OR] = 0.28; 95% confidence interval [CI] 0.10-0.79), the effect being particularly marked for children with severe RSV. Bronchitis at follow-up was reported more frequently among the case children with severe disease. Fewer case children had a positive skin-prick test for local allergens than control children (OR 0.64; 95% CI = 0.44-0.94). Specific IgE for dust mites and cockroach was elevated (52%) in both case and control children. However, specific IgE to peppertree was higher in the case children (OR 2.18; 95% CI = 1.17-4.07). All identified differences were particularly marked for children with severe RSV.
  
  
  CONCLUSIONS
  Severe RSV infection in infancy was associated with decreased lung function in preschool age in Guinea-Bissau. Children with severe RSV disease had more long-term health problems than children with less severe disease.
authors.affiliation: Projecto de Saude de Bandim, Guinea-Bissau, Copenhagen, Denmark. anja@dadlnet.dk
authors.forename: Anja
authors.initials: A
authors.lastname: Poulsen
authors.forename: Lone Graff
authors.initials: LG
authors.lastname: Stensballe
authors.forename: Jens
authors.initials: J
authors.lastname: Nielsen
authors.forename: Christine Stabell
authors.initials: CS
authors.lastname: Benn
authors.forename: Aliu
authors.initials: A
authors.lastname: Balde
authors.forename: Adam
authors.initials: A
authors.lastname: Roth
authors.forename: Ida Maria
authors.initials: IM
authors.lastname: Lisse
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D007223:Infant; D008297:Male; D012129:Respiratory Function Tests; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000472:pathogenicity*; D012141:Respiratory Tract Infections / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology* / Q000821:virology; D012720:Severity of Illness Index; D013997:Time Factors