Natural history and epidemiology of respiratory syncytial virus infection in the Middle East: Hospital surveillance for children under age two in Jordan

Halasa, Natasha; Williams, John V.; Faouri, Samir; Shehabi, Asem A.; Vermund, Sten H.; Wang, Li; Fonnesbeck, Christopher; Khuri‐Bulos, Najwa

doi:10.1016/j.vaccine.2015.08.048

Cited by 60 publications

(101 citation statements)

References 63 publications

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“…Despite the year-round presence of the virus, we found that circulation in Egypt peaks during November-February and the seasonal surge of influenza infection is expected to be observed during this period. In some tropical countries such as Thailand (11) and Pakistan (12) similar increased influenza activity was observed during the winter season. Unfortunately, we found no relevant studies on influenza in the Middle East to compare our findings with.…”

Section: Discussionmentioning

confidence: 74%

“…Among these countries, Kenya, Niger, Pakistan and Thailand have a temperate climate similar to that of Egypt. In Thailand, during 2004-2010, the influenza positive rates for ILI and SARI patients from 7 years of sentinel-based surveillance was slightly higher, 20% and 21% respectively (11). In Niger, according to data from the sentinel based surveillance system collected over 2009-2013, 12% of ILI case-patients and 6% of SARI casepatients were influenza-positive (10).…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Influenza virus positivity nd circulating subtypes among cases of influenza-like illness nd severe acute respiratory infection, Egypt, 2012-2015

Refaey¹,

Amin²,

Labib³

et al. 2016

East Mediterr Health J

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Information on the prevalence of influenza, circulating virus subtypes and seasonality is essential for selecting strains for annual vaccines and for planning immunization programmes. Data were obtained from the 13 sentinel surveillance sites throughout Egypt during 2012-2015. Laboratory-confirmed influenza was found in 13% of cases of influenza-like illness (ILI) and 18% of cases of severe acute respiratory infection (SARI); positivity for influenza was similar in cases of ILI and SARI in patients up to 15 years of age but increased for SARI and decreased for ILI in people aged ≥ 15 years. The most commonly observed influenza virus subtypes were B followed by A/ H3 in ILI cases, and A/H1N1 followed by B in SARI cases. The seasonality of influenza in ILI cases was NovemberFebruary, and that in SARI cases was November-March, peaking in January. RÉSUMÉ Les informations sur la prévalence de la grippe, les sous-types circulants du virus et la saisonnalité sont essentielles pour la sélection des souches destinées aux vaccins annuels, ainsi que pour la planification des programmes de vaccination. Les données sont issues des 13 sites sentinelles de surveillance à travers l'Égypte pour la période 2012-2015. La présence de la grippe a été confirmée en laboratoire pour 13 % des cas ‫واألمــراض‬ ‫باإلنفلونــزا‬ ‫الشــبيهة‬ ‫األمــراض‬ ‫حــاالت‬ ‫لــدى‬ ‫اجلوالــة‬ ‫الفرعيــة‬ ‫واألنــواع‬ ‫اإلنفلونــزا‬ ‫فريوســات‬ ‫إجيابيــة‬

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 98%

Influenza virus positivity nd circulating subtypes among cases of influenza-like illness nd severe acute respiratory infection, Egypt, 2012-2015

Refaey¹,

Amin²,

Labib³

et al. 2016

East Mediterr Health J

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“…The 47 eligible publications are listed in Table . One quarter of these studies included children aged 0 to 5 years, and 6.4% and 12.8% of studies recruited children aged 0 to 3 years and aged 0 to 2 years, respectively.…”

Section: Resultsmentioning

confidence: 99%

Can we distinguish respiratory viral infections based on clinical features? A prospective pediatric cohort compared to systematic literature review

Conrad

Alchikh

et al. 2018

Reviews in Medical Virology

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Studies have shown that the predictive value of "clinical diagnoses" of influenza and other respiratory viral infections is low, especially in children. In routine care, pediatricians often resort to clinical diagnoses, even in the absence of robust evidence-based criteria. We used a dual approach to identify clinical characteristics that may help to differentiate infections with common pathogens including influenza, respiratory syncytial virus, adenovirus, metapneumovirus, rhinovirus, bocavirus-1, coronaviruses, or parainfluenza virus: (a) systematic review and meta-analysis of 47 clinical studies published in Medline (June 1996 to March 2017, PROSPERO registration number: CRD42017059557) comprising 49 858 individuals and (b) data-driven analysis of an inception cohort of 6073 children with ILI (aged 0-18 years, 56% male, December 2009 to March 2015) examined at the point of care in addition to blinded PCR testing. We determined pooled odds ratios for the literature analysis and compared these to odds ratios based on the clinical cohort dataset. This combined analysis suggested significant associations between influenza and fever or headache, as well as between respiratory syncytial virus infection and cough, dyspnea, and wheezing. Similarly, literature and cohort data agreed on significant associations between HMPV infection and cough, as well as adenovirus infection and fever. Importantly, none of the abovementioned features were unique to any particular pathogen but were also observed in association with other respiratory viruses. In summary, our "real-world" dataset confirmed published literature trends, but no individual feature allows any particular type of viral infection to be ruled in or ruled out. For the time being, laboratory confirmation remains essential. More research is needed to develop scientifically validated decision models to inform best practice guidelines and targeted diagnostic algorithms.

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“…In this prospective surveillance study, we enrolled children under 2 years old who were hospitalised with fever and/or respiratory symptoms between 16 March 2010 and 31 March 2013 at Al-Bashir Hospital in Amman, Jordan (detailed inclusion/exclusion criteria previously reported). 12 Subjects were recruited 5 days a week (Sunday through Thursday) within 48 hours of hospital admission. 12 Children with chemotherapy-associated neutropenia and newborns who had never been discharged after birth were excluded from the study.…”

Section: Methods Study Design and Participantsmentioning

confidence: 99%

“…12 Subjects were recruited 5 days a week (Sunday through Thursday) within 48 hours of hospital admission. 12 Children with chemotherapy-associated neutropenia and newborns who had never been discharged after birth were excluded from the study.…”

Section: Methods Study Design and Participantsmentioning

confidence: 99%

Severe outcomes associated with respiratory viruses in newborns and infants: a prospective viral surveillance study in Jordan

et al. 2018

Self Cite

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ObjectiveTo assess virus-specific hospitalisation rates, risk factors for illness severity and seasonal trends in children hospitalised with acute respiratory infections (ARI).DesignProspective cohort study.SettingA government hospital serving low-income and middle-income population in Amman, Jordan.ParticipantsChildren under 2 years of age hospitalised with fever and/or respiratory symptoms (n=3168) from 16 March 2010 to 31 March 2013. Children with chemotherapy-associated neutropenia and newborns who had never been discharged after birth were excluded from the study.Outcome measuresHospitalisation rates and markers of illness severity: admission to intensive care unit (ICU), mechanical ventilation (MV), oxygen therapy, length of stay (LOS) and death.ResultsOf the 3168 subjects, 2581 (82%) had at least one respiratory virus detected, with respiratory syncytial virus (RSV) being the most predominant pathogen isolated. During admission, 1013 (32%) received oxygen therapy, 284 (9%) were admitted to ICU, 111 (4%) were placed on MV and 31 (1%) children died. Oxygen therapy was higher in RSV-only subjects compared with human rhinovirus-only (42%vs29%, p<0.001), adenovirus-only (42%vs21%, p<0.001) and human parainfluenza virus-only (42%vs23%, p<0.001) subjects. The presence of an underlying medical condition was associated with oxygen therapy (adjusted OR (aOR) 1.95, 95% CI 1.49 to 2.56), ICU admission (aOR 2.51, 95% CI 1.71 to 3.68), MV (aOR 1.91, 95% CI 1.11 to 3.28) and longer LOS (aOR1.71, 95% CI 1.37 to 2.13). Similarly, younger age was associated with oxygen therapy (0.23, 95% CI 0.17 to 0.31), ICU admission (aOR 0.47, 95% CI 0.30 to 0.74), MV (0.28, 95% CI 0.15 to 0.53) and longer LOS (aOR 0.47, 95% CI 0.38 to 0.59). Pneumonia was strongly associated with longer LOS (aOR 2.07, 95% CI 1.65 to 2.60), oxygen therapy (aOR 2.94, 95% CI 2.22 to 3.89), ICU admission (aOR 3.12, 95% CI 2.16 to 4.50) and MV (aOR 3.33, 95% CI 1.85 to 6.00). Virus-specific hospitalisation rates ranged from 0.5 to 10.5 per 1000 children.ConclusionRespiratory viruses are associated with severe illness in Jordanian children hospitalised with ARI. Prevention strategies such as extended breast feeding, increased access to palivizumab and RSV vaccine development could help decrease hospitalisation rates and illness severity, particularly in young children with underlying medical conditions.

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Natural history and epidemiology of respiratory syncytial virus infection in the Middle East: Hospital surveillance for children under age two in Jordan

Abstract: RSV is a major cause of illness in hospitalized Jordanian children and is associated with increased severity compared to other respiratory viruses. Children with RSV in the Middle East would benefit from future RSV vaccines and antiviral therapy.

Cited by 60 publications

References 63 publications

Influenza virus positivity nd circulating subtypes among cases of influenza-like illness nd severe acute respiratory infection, Egypt, 2012-2015

Influenza virus positivity nd circulating subtypes among cases of influenza-like illness nd severe acute respiratory infection, Egypt, 2012-2015

Can we distinguish respiratory viral infections based on clinical features? A prospective pediatric cohort compared to systematic literature review

Severe outcomes associated with respiratory viruses in newborns and infants: a prospective viral surveillance study in Jordan

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