title: Incidence of respiratory virus-associated pneumonia in urban poor young children of Dhaka, Bangladesh, 2009-2011.
abstract: BACKGROUND
  Pneumonia is the leading cause of childhood death in Bangladesh. We conducted a longitudinal study to estimate the incidence of virus-associated pneumonia in children aged <2 years in a low-income urban community in Dhaka, Bangladesh.
  
  
  METHODS
  We followed a cohort of children for two years. We collected nasal washes when children presented with respiratory symptoms. Study physicians diagnosed children with cough and age-specific tachypnea and positive lung findings as pneumonia case-patients. We tested respiratory samples for respiratory syncytial virus (RSV), rhinoviruses, human metapneumovirus (HMPV), influenza viruses, human parainfluenza viruses (HPIV 1, 2, 3), and adenoviruses using real-time reverse transcription polymerase chain reaction assays.
  
  
  RESULTS
  Between April 2009-March 2011, we followed 515 children for 730 child-years. We identified a total of 378 pneumonia episodes, 77% of the episodes were associated with a respiratory viral pathogen. The overall incidence of pneumonia associated with a respiratory virus infection was 40/100 child-years. The annual incidence of pneumonia/100 child-years associated with a specific respiratory virus in children aged < 2 years was 12.5 for RSV, 6 for rhinoviruses, 6 for HMPV, 4 for influenza viruses, 3 for HPIV and 2 for adenoviruses.
  
  
  CONCLUSIONS
  Young children in Dhaka are at high risk of childhood pneumonia and the majority of these episodes are associated with viral pathogens. Developing effective low-cost strategies for prevention are a high priority.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. nhomaira@icddrb.org
authors.forename: Nusrat
authors.initials: N
authors.lastname: Homaira
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
authors.forename: Raija
authors.initials: R
authors.lastname: Vainionpaa
authors.forename: Mustafizur
authors.initials: M
authors.lastname: Rahman
authors.forename: Kamal
authors.initials: K
authors.lastname: Hossain
authors.forename: Cynthia B
authors.initials: CB
authors.lastname: Snider
authors.forename: Mahmudur
authors.initials: M
authors.lastname: Rahman
authors.forename: A S M
authors.initials: AS
authors.lastname: Alamgir
authors.forename: Farzina
authors.initials: F
authors.lastname: Zesmin
authors.forename: Masud
authors.initials: M
authors.lastname: Alam
authors.forename: Emily S
authors.initials: ES
authors.lastname: Gurley
authors.forename: Rashid Uz
authors.initials: RU
authors.lastname: Zaman
authors.forename: Tasnim
authors.initials: T
authors.lastname: Azim
authors.forename: Dean D
authors.initials: DD
authors.lastname: Erdman
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Joseph
authors.initials: J
authors.lastname: Bresee
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.forename: Eduardo
authors.initials: E
authors.lastname: Azziz-Baumgartner
mesh_terms: D000256:Adenoviridae / Q000235:genetics; D002648:Child; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D029121:Metapneumovirus / Q000235:genetics; D009975:Orthomyxoviridae / Q000235:genetics; D011024:Pneumonia, Viral / Q000453:epidemiology*; D011203:Poverty; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012136:Respiratory Syncytial Viruses / Q000235:genetics; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D018108:Respirovirus / Q000235:genetics; D012229:Rhinovirus / Q000235:genetics; D012307:Risk Factors; D014505:Urban Population