Dataset Information

Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children.

ABSTRACT:

Background

In India, community-based acute lower respiratory infections (ALRI) burden studies are limited, hampering development of prevention and control strategies.

Methods

We surveyed children <10 years old at home weekly from August 2012-August 2014, for cough, sore throat, rhinorrhoea, ear discharge, and shortness of breath. Symptomatic children were assessed for ALRI using World Health Organization definitions. Nasal and throat swabs were obtained from all ALRI cases and asymptomatic controls and tested using polymerase chain reaction for respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza viruses (PIV), and influenza viruses (IV). We estimated adjusted odds ratios (aOR) using logistic regression to calculate etiologic fractions (EF). We multiplied agent-specific ALRI incidence rates by EF to calculate the adjusted incidence as episodes per child-year.

Results

ALRI incidence was 0.19 (95% confidence interval (CI)?=?0.18-0.20) episode per child-year. Association between virus and ALRI was strongest for RSV (aOR?=?15.9; 95% CI?=?7.3-34.7; EF?=?94%) and least for IV (aOR?=?4.6; 95% CI?=?2.0-10.6; EF?=?78%). Adjusted agent-specific ALRI incidences were RSV (0.03, 95% CI?=?0.02-0.03), hMPV (0.02, 95% CI?=?0.01-0.02), PIV (0.02, 95% CI?=?0.01-0.02), and IV (0.01, 95% CI?=?0.01-0.01) episode per child-year.

Conclusions

ALRI among children in rural India was high; RSV was a significant contributor.

SUBMITTER: Krishnan A

PROVIDER: S-EPMC6513504 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children.

Krishnan Anand A Kumar Rakesh R Broor Shobha S Gopal Giridara G Saha Siddhartha S Amarchand Ritvik R Choudekar Avinash A Purkayastha Debjani R DR Whitaker Brett B Pandey Bharti B Narayan Venkatesh Vinayak VV Kabra Sushil K SK Sreenivas Vishnubhatla V Widdowson Marc-Alain MA Lindstrom Stephen S Lafond Kathryn E KE Jain Seema S

Journal of global health 20190601 1

<h4>Background</h4>In India, community-based acute lower respiratory infections (ALRI) burden studies are limited, hampering development of prevention and control strategies.<h4>Methods</h4>We surveyed children <10 years old at home weekly from August 2012-August 2014, for cough, sore throat, rhinorrhoea, ear discharge, and shortness of breath. Symptomatic children were assessed for ALRI using World Health Organization definitions. Nasal and throat swabs were obtained from all ALRI cases and asy ...[more]

PMID: 31131104

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Project description:Viral lower respiratory tract infection (VLRTI) is the most common cause of hospital admission among small children in high-income countries. Guidelines to identify children in need of admission are lacking in the literature. In December 2012, our hospital introduced strict guidelines for admission. This study aims to retrospectively evaluate the safety and efficacy of the guidelines. We performed a single-center retrospective administrative database search and medical record review. ICD-10 codes identified children < 24 months assessed at the emergency department for VLRTI for a 10-year period. To identify adverse events related to admission guidelines implementation, we reviewed patient records for all those discharged on primary contact followed by readmission within 14 days. During the study period, 3227 children younger than 24 months old were assessed in the ED for VLRTI. The proportion of severe adverse events among children who were discharged on their initial emergency department contact was low both before (0.3%) and after the intervention (0.5%) (p=1.0). Admission rates before vs. after the intervention were for previously healthy children > 90 days 65.3% vs. 53.3% (p<0.001); for healthy children ≤ 90 days 85% vs. 68% (p<0.001); and for high-risk comorbidities 74% vs. 71% (p=0.5).Conclusion: After implementation of admission guidelines for VLRTI, there were few adverse events and a significant reduction in admissions to the hospital from the emergency department. Our admission guidelines may be a safe and helpful tool in the assessment of children with VLRTI. What is Known: • Viral lower respiratory tract infection, including bronchiolitis, is the most common cause of hospitalization for young children in the developed world. Treatment is mainly supportive, and hospitalization should be limited to the cases in need of therapeutic intervention. • Many countries have guidelines for the management of the disease, but the decision on whom to admit for inpatient treatment is often subjective and may vary even between physicians in the same hospital. What is New: • Implementation of admission criteria for viral lower respiratory tract infection may reduce the rate of hospital admissions without increasing adverse events.

Dataset Information

Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children.

Background

Methods

Results

Conclusions

Publications

Epidemiology of viral acute lower respiratory infections in a community-based cohort of rural north Indian children.

Similar Datasets

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