title: Incidence and clinical features of respiratory syncytial virus infections in a population-based surveillance site in the Nile Delta Region.
abstract: BACKGROUND
  Most reports about respiratory syncytial virus (RSV) in developing countries rely on sentinel surveillance, from which population incidence is difficult to infer. We used the proportion of RSV infections from population-based surveillance with data from a healthcare utilization survey to produce estimates of RSV incidence in Damanhour district, Egypt.
  
  
  METHODS
  We conducted population-based surveillance in 3 hospitals (2009-2012) and 3 outpatient clinics (2011-2012) in Damanhour district. Nasopharyngeal and oropharyngeal specimens from hospitalized patients with acute respiratory illness and outpatients with influenza-like illness were tested by real-time reverse transcriptase polymerase chain reaction for RSV. We also conducted a healthcare utilization survey in 2011-2012 to determine the proportion of individuals who sought care for respiratory illness.
  
  
  RESULTS
  Among 5342 hospitalized patients and 771 outpatients, 12% and 5% tested positive for RSV, respectively. The incidence of RSV-associated hospitalization and outpatient visits was estimated at 24 and 608 (per 100 000 person-years), respectively. Children aged <1 year experienced the highest incidence of RSV-associated hospitalizations (1745/100 000 person-years).
  
  
  CONCLUSIONS
  This study demonstrates the utility of combining a healthcare utilization survey and population-based surveillance data to estimate disease incidence. Estimating incidence and outcomes of RSV disease is critical to establish the burden of RSV in Egypt.
authors.affiliation: Global Disease, Detection, and Response Program, US Naval Medical Research Unit 3, Cairo, Egypt.
authors.forename: Emily
authors.initials: E
authors.lastname: Rowlinson
authors.forename: Erica
authors.initials: E
authors.lastname: Dueger
authors.forename: Thomas
authors.initials: T
authors.lastname: Taylor
authors.forename: Adel
authors.initials: A
authors.lastname: Mansour
authors.forename: Chris
authors.initials: C
authors.lastname: Van Beneden
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abukela
authors.forename: Xingyou
authors.initials: X
authors.lastname: Zhang
authors.forename: Samir
authors.initials: S
authors.lastname: Refaey
authors.forename: Hesham
authors.initials: H
authors.lastname: Bastawy
authors.forename: Amr
authors.initials: A
authors.lastname: Kandeel
mesh_terms: D000328:Adult; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
keywords: incidence; population-based surveillance; respiratory syncytial virus