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Epidemiology, Risk Factors, and Outcomes of Respiratory Syncytial Virus Infections in Newborns in Bamako, Mali.

ABSTRACT: BACKGROUND:Few studies describe the respiratory syncytial virus (RSV) burden in African populations, and most have utilized hospital-based surveillance. In Mali, no community-based studies exist of the incidence or epidemiology of RSV infection. This study provides the first estimates of RSV incidence in Mali. METHODS:In a cohort of infants enrolled in a clinical trial of maternal influenza vaccination, we estimate incidence of RSV-associated febrile illness in the first 6 months of life and identify risk factors for RSV infection and progression to severe disease. Infants (N = 1871) were followed from birth to 6 months of age and visited weekly to detect pneumonia and influenza-like illness. Baseline covariates were explored as risk factors for RSV febrile illness and RSV pneumonia or hospitalization. RESULTS:Incidence of RSV illness was estimated at 536.8 per 1000 person-years, and 86% (131/153) of RSV illness episodes were positive for RSV-B. RSV illness was most frequent in the fifth month of life and associated with having older mothers and with lower parity. The incidence of RSV-associated hospitalizations was 45.6 per 1000 person-years. Among infants with RSV illness, males were more likely to be hospitalized. The incidence of RSV pneumonia was 29 cases per 1000 person-years. CONCLUSIONS:In the first 6 months of life, Malian infants have a high incidence of RSV illness, primarily caused by RSV-B. Prevention of early RSV will require passive protection via maternal immunization in pregnancy. Mali is the first country where RSV-B has been identified as the dominant subtype, with potential implications for vaccine development.

SUBMITTER: Buchwald AG

PROVIDER: S-EPMC6912158 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Epidemiology, Risk Factors, and Outcomes of Respiratory Syncytial Virus Infections in Newborns in Bamako, Mali.

Buchwald Andrea G AG Tamboura Boubou B Tennant Sharon M SM Haidara Fadima C FC Coulibaly Flanon F Doumbia Moussa M Diallo Fatoumata F Keita Adama M AM Sow Samba O SO Kotloff Karen L KL Levine Myron M MM Tapia Milagritos D MD

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20200101 1

<h4>Background</h4>Few studies describe the respiratory syncytial virus (RSV) burden in African populations, and most have utilized hospital-based surveillance. In Mali, no community-based studies exist of the incidence or epidemiology of RSV infection. This study provides the first estimates of RSV incidence in Mali.<h4>Methods</h4>In a cohort of infants enrolled in a clinical trial of maternal influenza vaccination, we estimate incidence of RSV-associated febrile illness in the first 6 months ...[more]

PMID: 30810160

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Project description:BackgroundSchistosomiasis is classically described as a rural disease that occurs in areas with poor sanitary conditions. However, over recent decades, there has been an expansion of schistosomiasis foci towards urban areas faced with a rapid and disordered urbanization. In Bamako, Mali, the impact of environmental change on vector-borne diseases such as schistosomiasis is not well known. This study sought to identify the presence of schistosomiasis transmission hotspots in Bamako. Using this perspective, we aimed to describe the risk factors of the endemization and maintenance of schistosomiasis.Materials and methodsA cross-sectional study was carried out in the six municipalities (communes) in Bamako. Environmental information was obtained from earth observation satellites in order to maximize ecological contrasts. Twenty-nine blocks of 200 m x 200 m were identified. We selected a school inside or nearest to each block for urine and stool samples examination. The study cohort was school children aged between eight and 15 years. The Kato-Katz technique and filtration were used for Schistosoma mansoni and S. haematobium ova research in stools and urine, respectively. The schools and snail breeding sites were georeferenced. Four malacological surveys were conducted between October 2011 and February 2012. Bivariate analysis was used to identify independent predictors of being infected with schistosomiasis.ResultsThe prevalence rate of S. haematobium was 14.7% (n = 1,761) and that of S. mansoni 1.5% (n = 1,491). Overall, the urinary form was endemic in 76.6% of schools. The infection significantly varied between the municipalities (p < 0.001). It was also more prevalent on the left side of the Niger River than the right side (17.4% vs. 9.5% respectively; p < 0.001). The vicinity to snail breeding sites (OR = 3.677; 95% IC [2.765-4.889]; p < 10 (-3) ) and parents' occupations (OR = 7.647; 95% IC [2.406-24.305]; p < 0.001) were the most important risk factors associated with S. haematobium infection exposure. Biomphalaria pfeifferi, Bulinus truncatus, and B. globosus were the intermediate hosts captured. The schistosome natural infection rates (SNIRs), which were low or nil in October and November, rose to 2.8% in January and 8.3% in February for B. pfeifferi and B. truncatus, respectively.ConclusionOur findings show that there is a high transmission risk for schistosomiasis in Bamako. Appropriate integrated control measures need to be introduced to control the transmission of this disease in the study area.

Dataset Information

Epidemiology, Risk Factors, and Outcomes of Respiratory Syncytial Virus Infections in Newborns in Bamako, Mali.

Publications

Epidemiology, Risk Factors, and Outcomes of Respiratory Syncytial Virus Infections in Newborns in Bamako, Mali.

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