Okiro, Emelda A., Ngama, Mwanajuma, Bett, Ann, Cane, Patricia, Medley, Graham and Nokes, D. James. (2008) Factors associated with increased risk of progression to respiratory syncytial virus-associated pneumonia in young Kenyan children. Tropical Medicine & International Health, Vol.13 (No.7). pp. 914-926. ISSN 1360-2276

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Abstract

OBJECTIVES To identify factors associated with developing severe respiratory syncytial virus (RSV) pneumonia and their commonality with all-cause lower respiratory tract infection (LRTI), in order to isolate those risk factors specifically associated with RSV-LRTI and identify targets for control. METHODS A birth cohort of rural Kenyan children was intensively monitored for acute respiratory infection (ARI) over three RSV epidemics. RSV was diagnosed by immunofluorescence of nasal washings collected at each ARI episode. Cox regression was used to determine the relative risk of disease for a range of co-factors. RESULTS A total of 469 children provided 937 years of follow-up, and experienced 857 all-cause LRTI, 362 RSV-ARI and 92 RSV-LRTI episodes. Factors associated with RSV-LRTI, but not RSV-ARI, were severe stunting (z-score <=-2, RR 1.7 95%CI 1.1-2.8), crowding (increased number of children, RR 2.6, 1.0-6.5) and number of siblings under 6 years (RR 2.0, 1.2-3.4). Moderate and severe stunting (z-score <=-1), crowding and a sibling aged over 5 years sleeping in the same room as the index child were associated with increased risk of all-cause LRTI, whereas higher educational level of the primary caretaker was associated with protection. CONCLUSION We identify factors related to host nutritional status (stunting) and contact intensity (crowding, siblings) which are distinguishable in their association with RSV severe disease in infant and young child. These factors are broadly in common with those associated with all-cause LRTI. The results support targeted strategies for prevention.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine
Divisions:	Faculty of Science > Life Sciences (2010- )
Journal or Publication Title:	Tropical Medicine & International Health
Publisher:	Wiley-Blackwell Publishing Ltd.
ISSN:	1360-2276
Date:	July 2008
Volume:	Vol.13
Number:	No.7
Number of Pages:	13
Page Range:	pp. 914-926
Identification Number:	10.1111/j.1365-3156.2008.02092.x
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/29884

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