[Impact of a respiratory disease prevention program in high-risk preterm infants: a prospective, multicentric study].
Respiratory tract infections (RTI), especially those caused by Respiratory Syncytial Virus (RSV), are of central concern in high-risk preterm infant care. Prevention programs including new and costly interventions should be evaluated in terms of effectiveness and impact.


OBJECTIVE
To evaluate feasibility and results of a National Health Ministry pilot program for severe RTI prevention in high-risk infants.


METHODS
Seven high-risk follow-up clinics from the public healthcare system were selected for a prospective, multicentric study. Between May and September 2007, a pilot program comprising healthcare team training, parental education, RSV passive immunoprophylaxis, RTI patient care end results evaluation was implemented. Indicators were used to evaluate feasibility; effectiveness was estimated comparing study results with two historical controls.


RESULTS
183 infants were incorporated, 5 were lost and 1 died from cardiac disease. A RTI management guideline was elaborated among participating centers; parents assisted to educational workshops; palivizumab was given to participating infants up to three doses. RTI hospital admission rate for the study group was 20% (7% RSV-related), compared to 42% (26% RSV-related) and 37% (29% RSV-related) in control groups (p< 0.0001 and p= 0.02, respectively).


CONCLUSIONS
Program implementation was feasible and readily accepted by healthcare teams. RTI hospital admissions rates, in general and RSV-related, were significatively lower than local previous studies.
Bauer
Gabriela
G
Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan. gababauer@gmail.com
Bossi
Lucrecia
L
Santoalla
Marisa
M
Rodríguez
Susana
S
Fariña
Diana
D
Speranza
Ana M
AM
D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D008297:Male; D015397:Program Evaluation; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000517:prevention & control; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D012307:Risk Factors