title: The epidemiology of respiratory syncytial virus lower respiratory tract infections in children less than 5 years of age in Indonesia.
abstract: BACKGROUND
  Although the epidemiology of respiratory syncytial virus (RSV) lower respiratory tract infections (LRI) is well known in industrialized countries, the burden in developing Asian countries is not well studied.
  
  
  METHODS
  To define the burden of RSV disease in children <5 years of age in rural and urban Indonesia, infants and children were enrolled from peri-urban and rural subdistricts, in the following 2 cohorts: (a) a cross-sectional cohort of approximately 100 children from each of 2 subdistricts in the following 5 age groups: 3 to 5, 6 to 8, 9 to 11, 12 to 23, and 24 to 48 months; (b) a birth cohort of all newborns in both subdistricts during the 28 months of the study. All subjects were visited weekly at home. Children with World Health Organization-defined LRI or wheezing had a nasal wash for detection of RSV using an enzyme immunoassay and polymerase chain reaction.
  
  
  RESULTS
  Of the 2014 children studied, 1074 were in the cross-sectional and 940 in the newborn cohorts. Of the 802 episodes of LRI, 163 were caused by RSV. The RSV LRI incidence per 1000 child-years (C-Y) was higher in rural areas (57.25 vs. 38.54), P < 0.05. No RSV LRI occurred in the first 2 months of life and the peak incidence was in the 6- to 8-month-old infants (103/1000 C-Y). The rates were lowest in those <6 months, 16.5 per 1000 C-Y, compared with 83.1 per 1000 C-Y in those 6 to 11 months of age (P < 0.001), 66.99 in those 12 to 23 months of age, and 28.1 in 2- to 5-year-olds.
  
  
  CONCLUSIONS
  In Indonesia, the incidence of RSV LRI in the first 6 months of life is relatively low with most disease occurring in older children.
authors.affiliation: Section of Infectious Diseases, Department of Pediatrics, University of Colorado at Denver Health Sciences Center and The Children's Hospital, Denver, CO, USA. eric.simoes@ucdenver.edu
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simões
authors.forename: Kuswandewi
authors.initials: K
authors.lastname: Mutyara
authors.forename: Shirlena
authors.initials: S
authors.lastname: Soh
authors.forename: Dwi
authors.initials: D
authors.lastname: Agustian
authors.forename: Martin L
authors.initials: ML
authors.lastname: Hibberd
authors.forename: Cissy B
authors.initials: CB
authors.lastname: Kartasasmita
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D012621:Seasons