title: Epidemiology, clinical characteristics, laboratory findings and severity of respiratory syncytial virus acute lower respiratory infection in Malaysian children, 2008-2013.
abstract: OBJECTIVE
  The aim of this study is to describe epidemiology, clinical features, laboratory data and severity of respiratory syncytial virus (RSV) acute lower respiratory infection (ALRI) in Malaysian children and to determine risk factors associated with prolonged hospital stay, paediatric intensive care unit (PICU) admission and mortality.
  
  
  METHODS
  Retrospective data on demographics, clinical presentation, outcomes and laboratory findings of 450 children admitted into Tuanku Jaafar Hospital in Seremban, Malaysia from 2008 to 2013 with documented diagnosis of RSV ALRI were collected and analysed.
  
  
  RESULTS
  Most admissions were children below 2 years old (85.8%; 386/450). Commonest symptoms were fever (84.2%; 379/450), cough (97.8%; 440/450) and rhinorrhea (83.6%; 376/450). The median age among febrile patients (n = 379) was 9.0 months with interquartile range (IQR) of 4.0-19.0 months whereas the median age among those who were apyrexial (n = 71) was 2 months with IQR of 1-6 months (P-value <0.001). 15.3% (69/450) needed intensive care and 1.6% (7/450) died. Young age, history of prematurity, chronic comorbidity and thrombocytosis were significantly associated with prolonged hospital stay, PICU admission and mortality.
  
  
  CONCLUSIONS
  Infants less than 6 months old with RSV ALRI tend to be afebrile at presentation. Younger age, history of prematurity, chronic comorbidity and thrombocytosis are predictors of severe RSV ALRI among Malaysian children. Case fatality rate for Malaysian children below 5 years of age with RSV ALRI in our centre is higher than what is seen in developed countries, suggesting that there is room for improvement.
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, Seremban, Malaysia.|Paediatric Infectious Disease and Immunology Department, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom.
authors.forename: Khuen F
authors.initials: KF
authors.lastname: Ng
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, Seremban, Malaysia.
authors.forename: Kah K
authors.initials: KK
authors.lastname: Tan
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, Seremban, Malaysia.|Paediatric Department, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Zhi H
authors.initials: ZH
authors.lastname: Sam
authors.affiliation: Pediatric Department, Tuanku Jaafar Hospital, Seremban, Malaysia.
authors.forename: Grace Ss
authors.initials: GS
authors.lastname: Ting
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia.
authors.forename: Wan Y
authors.initials: WY
authors.lastname: Gan
mesh_terms: D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008485:Medical Audit; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000503:physiopathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: children; clinical; respiratory infection; respiratory syncytial virus