title: Population-based incidence of severe acute respiratory virus infections among children aged <5 years in rural Bangladesh, June-October 2010.
abstract: BACKGROUND
  Better understanding the etiology-specific incidence of severe acute respiratory infections (SARIs) in resource-poor, rural settings will help further develop and prioritize prevention strategies. To address this gap in knowledge, we conducted a longitudinal study to estimate the incidence of SARIs among children in rural Bangladesh.
  
  
  METHODS
  During June through October 2010, we followed children aged <5 years in 67 villages to identify those with cough, difficulty breathing, age-specific tachypnea and/or danger signs in the community or admitted to the local hospital. A study physician collected clinical information and obtained nasopharyngeal swabs from all SARI cases and blood for bacterial culture from those hospitalized. We tested swabs for respiratory syncytial virus (RSV), influenza viruses, human metapneumoviruses, adenoviruses and human parainfluenza viruses 1-3 (HPIV) by real-time reverse transcription polymerase chain reaction. We calculated virus-specific SARI incidence by dividing the number of new illnesses by the person-time each child contributed to the study.
  
  
  RESULTS
  We followed 12,850 children for 279,029 person-weeks (pw) and identified 141 SARI cases; 76 (54%) at their homes and 65 (46%) at the hospital. RSV was associated with 7.9 SARI hospitalizations per 100,000 pw, HPIV3 2.2 hospitalizations/100,000 pw, and influenza 1.1 hospitalizations/100,000 pw. Among non-hospitalized SARI cases, RSV was associated with 10.8 illnesses/100,000 pw, HPIV3 1.8/100,000 pw, influenza 1.4/100,000 pw, and adenoviruses 0.4/100,000 pw.
  
  
  CONCLUSIONS
  Respiratory viruses, particularly RSV, were commonly associated with SARI among children. It may be useful to explore the value of investing in prevention strategies, such as handwashing and respiratory hygiene, to reduce respiratory infections among young children in such settings.
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Sharifa
authors.initials: S
authors.lastname: Nasreen
authors.affiliation: icddr,b, Dhaka, Bangladesh ; Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: W Abdullah
authors.initials: WA
authors.lastname: Brooks
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Nusrat
authors.initials: N
authors.lastname: Homaira
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Mamun
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Mejbah Uddin
authors.initials: MU
authors.lastname: Bhuiyan
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Mustafizur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Dilruba
authors.initials: D
authors.lastname: Ahmed
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Jaynal
authors.initials: J
authors.lastname: Abedin
authors.affiliation: Institute of Epidemiology Disease Control and Research (IEDCR), Dhaka, Bangladesh.
authors.forename: Mahmudur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Institute of Epidemiology Disease Control and Research (IEDCR), Dhaka, Bangladesh.
authors.forename: A S M
authors.initials: AS
authors.lastname: Alamgir
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Peter Kim
authors.initials: PK
authors.lastname: Streatfield
authors.affiliation: icddr,b, Dhaka, Bangladesh.
authors.forename: Anisur
authors.initials: A
authors.lastname: Rahman
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bresee
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.affiliation: icddr,b, Dhaka, Bangladesh ; Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Azziz-Baumgartner
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000266:history*; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D009975:Orthomyxoviridae / Q000235:genetics; D010222:Parainfluenza Virus 1, Human / Q000235:genetics; D010223:Parainfluenza Virus 2, Human / Q000235:genetics; D010224:Parainfluenza Virus 3, Human / Q000235:genetics; D012327:RNA Virus Infections / Q000453:epidemiology* / Q000266:history; D060888:Real-Time Polymerase Chain Reaction; D012136:Respiratory Syncytial Viruses / Q000235:genetics; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000266:history / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric