title: Climatic, temporal, and geographic characteristics of respiratory syncytial virus disease in a tropical island population.
abstract: Respiratory syncytial virus (RSV) is an important cause of morbidity in children worldwide, although data from equatorial regions are limited. We analysed climatic, spatial, and temporal data for children presenting to hospitals in Lombok island, Indonesia with clinical pneumonia. During the study period, 2878 children presented and 741 RSV cases were identified. In multivariate analysis with an 8-day lag, occurrence of rain was associated with 64% higher incidence of RSV disease [incidence rate ratio (IRR) 1.64, 95% confidence interval (CI) 1.13-2.38]. A 1% rise in mean relative humidity and 1 degree C increase in mean air temperature was associated with a 6% (IRR 1.06, 95% CI 1.03-1.10) and 44% (IRR 1.44, 95% CI 1.24-1.66) increase in RSV cases, respectively. Four statistically significant local clusters of RSV pneumonia were identified within the annual island-wide epidemics. This study demonstrates statistical association of monsoon-associated weather in equatorial Indonesia with RSV. Moreover, within the island-wide epidemics, localized RSV outbreaks suggest local factors influence RSV disease.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. somer@jhsph.edu
authors.forename: S B
authors.initials: SB
authors.lastname: Omer
authors.forename: A
authors.initials: A
authors.lastname: Sutanto
authors.forename: H
authors.initials: H
authors.lastname: Sarwo
authors.forename: M
authors.initials: M
authors.lastname: Linehan
authors.forename: I G G
authors.initials: IG
authors.lastname: Djelantik
authors.forename: D
authors.initials: D
authors.lastname: Mercer
authors.forename: V
authors.initials: V
authors.lastname: Moniaga
authors.forename: L H
authors.initials: LH
authors.lastname: Moulton
authors.forename: A
authors.initials: A
authors.lastname: Widjaya
authors.forename: P
authors.initials: P
authors.lastname: Muljati
authors.forename: B D
authors.initials: BD
authors.lastname: Gessner
authors.forename: M C
authors.initials: MC
authors.lastname: Steinhoff
mesh_terms: D005843:Geography; D006801:Humans; D006813:Humidity; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D015999:Multivariate Analysis; D011024:Pneumonia, Viral / Q000453:epidemiology*; D011891:Rain; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D013223:Statistics as Topic; D013696:Temperature; D013997:Time Factors; D014329:Tropical Climate