title: Epidemiology of respiratory syncytial virus infection in rural and urban Kenya.
abstract: BACKGROUND
  Information on the epidemiology of respiratory syncytial virus (RSV) infection in Africa is limited for crowded urban areas and for rural areas where the prevalence of malaria is high.
  
  
  METHODS
  At referral facilities in rural western Kenya and a Nairobi slum, we collected nasopharyngeal/oropharyngeal (NP/OP) swab specimens from patients with influenza-like illness (ILI) or severe acute respiratory illness (SARI) and from asymptomatic controls. Polymerase chain reaction assays were used for detection of viral pathogens. We calculated age-specific ratios of the odds of RSV detection among patients versus the odds among controls. Incidence was expressed as the number of episodes per 1000 person-years of observation.
  
  
  RESULTS
  Between March 2007 and February 2011, RSV was detected in 501 of 4012 NP/OP swab specimens (12.5%) from children and adults in the rural site and in 321 of 2744 NP/OP swab specimens (11.7%) from those in the urban site. Among children aged <5 years, RSV was detected more commonly among rural children with SARI (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.2-3.3), urban children with SARI (OR, 8.5; 95% CI, 3.1-23.6), and urban children with ILI (OR, 3.4; 95% CI, 1.2-9.6), compared with controls. The incidence of RSV disease was highest among infants with SARI aged <1 year (86.9 and 62.8 episodes per 1000 person-years of observation in rural and urban sites, respectively).
  
  
  CONCLUSIONS
  An effective RSV vaccine would likely substantially reduce the burden of respiratory illness among children in rural and urban areas in Africa.
authors.affiliation: International Emerging Infections Program.
authors.forename: Godfrey M
authors.initials: GM
authors.lastname: Bigogo
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Allan O
authors.initials: AO
authors.lastname: Audi
authors.forename: Barrack
authors.initials: B
authors.lastname: Aura
authors.forename: Leonard
authors.initials: L
authors.lastname: Cosmas
authors.forename: M Kariuki
authors.initials: MK
authors.lastname: Njenga
authors.forename: Barry S
authors.initials: BS
authors.lastname: Fields
authors.forename: Victor
authors.initials: V
authors.lastname: Omballa
authors.forename: Henry
authors.initials: H
authors.lastname: Njuguna
authors.forename: Peter M
authors.initials: PM
authors.lastname: Ochieng
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Mogeni
authors.forename: George O
authors.initials: GO
authors.lastname: Aol
authors.forename: Beatrice
authors.initials: B
authors.lastname: Olack
authors.forename: Mark A
authors.initials: MA
authors.lastname: Katz
authors.forename: Joel M
authors.initials: JM
authors.lastname: Montgomery
authors.forename: Deron C
authors.initials: DC
authors.lastname: Burton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance / Q000379:methods; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D012424:Rural Population / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Kenya; epidemiology; incidence; respiratory syncytial virus; rural; urban