PLoS ONE (Jan 2016)

Respiratory Syncytial Virus and Other Viral Infections among Children under Two Years Old in Southern Vietnam 2009-2010: Clinical Characteristics and Disease Severity.

  • Lien Anh Ha Do,
  • Juliet E Bryant,
  • Anh Tuan Tran,
  • Bach Hue Nguyen,
  • Thi Thu Loan Tran,
  • Quynh Huong Tran,
  • Quoc Bao Vo,
  • Nguyen Anh Tran Dac,
  • Hong Nhien Trinh,
  • Thi Thanh Hai Nguyen,
  • Bao Tinh Le Binh,
  • Khanh Le,
  • Minh Tien Nguyen,
  • Quang Tung Thai,
  • Thanh Vu Vo,
  • Ngoc Quang Minh Ngo,
  • Thi Kim Huyen Dang,
  • Ngoc Huong Cao,
  • Thu Van Tran,
  • Lu Viet Ho,
  • Jeremy Farrar,
  • Menno de Jong,
  • H Rogier van Doorn

DOI
https://doi.org/10.1371/journal.pone.0160606
Journal volume & issue
Vol. 11, no. 8
p. e0160606

Abstract

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BACKGROUND:Despite a high burden of respiratory syncytial virus (RSV) infections among children, data on demographic and clinical characteristics of RSV are scarce in low and middle income countries. This study aims to describe the viral etiologies, the demographic, epidemiological, and clinical characteristics of children under two years of age who were hospitalized with a lower respiratory tract infections (LRTI), focusing on RSV (prevalence, seasonality, subgroups, viral load) and its association with disease severity. METHODS:A prospective study among children under two years of age, hospitalized with LRTI was conducted in two referral pediatric hospitals in Ho Chi Minh City, Vietnam, from May 2009 to December 2010. Socio-demographic, clinical data and nasopharyngeal swabs were collected on enrolment and discharge. Multiplex real-time RT-PCR (13 viruses) and quantitative RSV RT-PCR were used to identify viral pathogens, RSV load and subgroups. RESULTS:Among 632 cases, 48% were RSV positive. RSV infections occurred at younger age than three other leading viral infections i.e rhinovirus (RV), metapneumovirus (MPV), parainfluenza virus (PIV-3) and were significantly more frequent in the first 6 months of life. Clinical severity score of RSV infection was significantly higher than PIV-3 but not for RV or MPV. In multivariate analysis, RV infection was significantly associated with severity while RSV infection was not. Among RSV infections, neither viral load nor viral co-infections were significantly associated with severity. Young age and having fever at admission were significantly associated with both RSV and LRTI severity. A shift in RSV subgroup predominance was observed during two consecutive rainy seasons but was not associated with severity. CONCLUSION:We report etiologies, the epidemiological and clinical characteristics of LRTI among hospitalized children under two years of age and risk factors of RSV and LRTI severity.