Incidence of respiratory syncytial virus-associated lower respiratory tract illness in infants in low- and middle-income regions during the Coronavirus disease 2019 pandemic

Fry, SamanthaChokephaibulkit, KulkanyaPallem, SrideviHenry, OuzamaPu, YongjiaAkawung, AgnesKim, Joon HyungYanni, EmadTullio, Antonella NadiaAurpibul, LindaLee, Christine Mui FongCeballos, AnaZaman, KhalequAbadia de Regalado, IvonneAhmed, KhatijaArias Fernandez, Diana AndreaTaher, Sri WahyuCaccavo, JulianaCoutinho, Conrado MilaniD'Andrea Nores, UlisesDe Leon, TirzaD'Silva, Emily ChristineDe Bernardi, MaraDieser, PabloFalaschi, AndreaFlores Acosta, Clara del CarmenGentile, AngelaTeo, Ik HuiKotze, SheenaLopez-Medina, EduardoLuca, RubenLucion, Maria FlorenciaMantaring, Jacinto Blas V., IIIMarin, BladimirMoelo, MalahlehaMussi-Pinhata, Marisa MarciaPinto, JorgePuthanakit, ThanyaweeReyes, OsvaldoRoa, Maria FernandaRodriguez Brieschke, Maria TeresaRodriguez, Camilo EnriqueRodriguez Nino, Juan NicolasSchwarzbold, Alexandre VargasSierra Garcia, AlexandraSivapatham, LavithaSoon, RueyTinoco, Juan CarlosVelasquez Penagos, Jesus ArnulfoDos Santos, Gael2024-02-142024-02-142023-12Fry, S., Chokephaibulkit, K., Pallem, S. et al. 2023, 'Incidence of respiratory syncytial virus-associated lower respiratory tract illness in infants in low- and middle-income regions during the Coronavirus disease 2019 pandemic', Open Forum Infectious Diseases, vol. 10, no. 12, art. ofad553, pp. 1-11, doi : 10.1093/ofid/ofad553.2328-8957 (online)10.1093/ofid/ofad553http://hdl.handle.net/2263/94568DATA AVAILABILITY : Study data and documents can be requested for further research from www.clinicalstudydatarequest.com.BACKGROUND : Incidence data of respiratory syncytial virus–associated lower respiratory tract illness (RSV-LRTI) are sparse in low- and middle-income countries (LMICs). We estimated RSV-LRTI incidence rates (IRs) in infants in LMICs using World Health Organization case definitions. METHODS : This prospective cohort study, conducted in 10 LMICs from May 2019 to October 2021 (largely overlapping with the coronavirus disease 2019 [COVID-19] pandemic), followed infants born to women with low-risk pregnancies for 1 year from birth using active and passive surveillance to detect potential LRTIs, and quantitative reverse-transcription polymerase chain reaction on nasal swabs to detect RSV. RESULTS : Among 2094 infants, 32 (1.5%) experienced an RSV-LRTI (8 during their first 6 months of life, 24 thereafter). Seventeen (0.8%) infants had severe RSV-LRTI and 168 (8.0%) had all-cause LRTI. IRs (95% confidence intervals [CIs]) of first RSV-LRTI episode were 1.0 (.3–2.3), 0.8 (.3–1.5), and 1.6 (1.1–2.2) per 100 person-years for infants aged 0–2, 0–5, and 0–11 months, respectively. IRs (95% CIs) of the first all-cause LRTI episode were 10.7 (8.1–14.0), 11.7 (9.6–14.0), and 8.7 (7.5–10.2) per 100 person-years, respectively. IRs varied by country (RSV-LRTI: 0.0–8.3, all-cause LRTI: 0.0–49.6 per 100 person-years for 0- to 11-month-olds). CONCLUSIONS : RSV-LRTI IRs in infants in this study were relatively low, likely due to reduced viral circulation caused by COVID-19–related nonpharmaceutical interventions. CLINICAL TRIALS REGISTRATION : NCT03614676.en© GSK 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.Low- and middle-income countries (LMICs)EpidemiologyIncidenceInfantsLower respiratory tract infection (LRTI)Respiratory syncytial virus (RSV)Developing countriesCOVID-19 pandemicCoronavirus disease 2019 (COVID-19)SDG-03: Good health and well-beingIncidence of respiratory syncytial virus-associated lower respiratory tract illness in infants in low- and middle-income regions during the Coronavirus disease 2019 pandemicArticle