title: The burden of hospitalized lower respiratory tract infection due to respiratory syncytial virus in rural Thailand.
abstract: BACKGROUND
  We describe the epidemiology of hospitalized RSV infections for all age groups from population-based surveillance in two rural provinces in Thailand.
  
  
  METHODS
  From September 1, 2003 through December 31, 2007, we enrolled hospitalized patients with acute lower respiratory tract illness, who had a chest radiograph ordered by the physician, from all hospitals in SaKaeo and Nakhom Phanom Provinces. We tested nasopharyngeal specimens for RSV with reverse transcriptase polymerase chain reaction (RT-PCR) assays and paired-sera from a subset of patients with IgG enzyme immunoassay. Rates were adjusted for enrollment.
  
  
  RESULTS
  Among 11,097 enrolled patients, 987 (8.9%) had RSV infection. Rates of hospitalized RSV infection overall (and radiographically-confirmed pneumonia) were highest among children aged<1 year: 1,067/100,000 (534/100,000 radiographically-confirmed pneumonia) and 1-4 year: 403/100,000 (222/100,000), but low among enrolled adults aged≥65 years: 42/100,000. Age<1 year (adjusted odds ratio [aOR]=13.2, 95% confidence interval [CI] 7.7, 22.5) and 1-4 year (aOR=8.3, 95% CI 5.0, 13.9) were independent predictors of hospitalized RSV infection.
  
  
  CONCLUSIONS
  The incidence of hospitalized RSV lower respiratory tract illness among children<5 years was high in rural Thailand. Efforts to prevent RSV infection could substantially reduce the pneumonia burden in children aged<5 years.
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. agf1@cdc.gov
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Malinee
authors.initials: M
authors.lastname: Chittaganpitch
authors.forename: Henry C
authors.initials: HC
authors.lastname: Baggett
authors.forename: Teresa C T
authors.initials: TC
authors.lastname: Peret
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Dare
authors.forename: Pongpun
authors.initials: P
authors.lastname: Sawatwong
authors.forename: Somsak
authors.initials: S
authors.lastname: Thamthitiwat
authors.forename: Peera
authors.initials: P
authors.lastname: Areerat
authors.forename: Wichai
authors.initials: W
authors.lastname: Sanasuttipun
authors.forename: Julie
authors.initials: J
authors.lastname: Fischer
authors.forename: Susan A
authors.initials: SA
authors.lastname: Maloney
authors.forename: Dean D
authors.initials: DD
authors.lastname: Erdman
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Olsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology; D011159:Population Surveillance; D012367:RNA, Viral / Q000235:genetics; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012424:Rural Population / Q000706:statistics & numerical data*; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012367:RNA, Viral