PLoS ONE (Jan 2012)

Incidence of respiratory virus-associated pneumonia in urban poor young children of Dhaka, Bangladesh, 2009-2011.

  • Nusrat Homaira,
  • Stephen P Luby,
  • William A Petri,
  • Raija Vainionpaa,
  • Mustafizur Rahman,
  • Kamal Hossain,
  • Cynthia B Snider,
  • Mahmudur Rahman,
  • A S M Alamgir,
  • Farzina Zesmin,
  • Masud Alam,
  • Emily S Gurley,
  • Rashid Uz Zaman,
  • Tasnim Azim,
  • Dean D Erdman,
  • Alicia M Fry,
  • Joseph Bresee,
  • Marc-Alain Widdowson,
  • Rashidul Haque,
  • Eduardo Azziz-Baumgartner

DOI
https://doi.org/10.1371/journal.pone.0032056
Journal volume & issue
Vol. 7, no. 2
p. e32056

Abstract

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Pneumonia is the leading cause of childhood death in Bangladesh. We conducted a longitudinal study to estimate the incidence of virus-associated pneumonia in children aged <2 years in a low-income urban community in Dhaka, Bangladesh.We followed a cohort of children for two years. We collected nasal washes when children presented with respiratory symptoms. Study physicians diagnosed children with cough and age-specific tachypnea and positive lung findings as pneumonia case-patients. We tested respiratory samples for respiratory syncytial virus (RSV), rhinoviruses, human metapneumovirus (HMPV), influenza viruses, human parainfluenza viruses (HPIV 1, 2, 3), and adenoviruses using real-time reverse transcription polymerase chain reaction assays.Between April 2009-March 2011, we followed 515 children for 730 child-years. We identified a total of 378 pneumonia episodes, 77% of the episodes were associated with a respiratory viral pathogen. The overall incidence of pneumonia associated with a respiratory virus infection was 40/100 child-years. The annual incidence of pneumonia/100 child-years associated with a specific respiratory virus in children aged < 2 years was 12.5 for RSV, 6 for rhinoviruses, 6 for HMPV, 4 for influenza viruses, 3 for HPIV and 2 for adenoviruses.Young children in Dhaka are at high risk of childhood pneumonia and the majority of these episodes are associated with viral pathogens. Developing effective low-cost strategies for prevention are a high priority.