Respiratory syncytial virus infection in tropical and developing countries

Abstract

SummaryLittle is known about the epidemiology of respiratory syncytial virus (RSV) infection in tropical and developing countries; the data currently available have been reviewed. In most studies, RSV was found to be the predominant viral cause of acute lower respiratory tract infections (ALRI) in childhood, being responsible for 27-96% of hospitalised cases (mean 65%) in which a virus was found. RSV infection is seasonal in most countries; outbreaks occur most frequently in the cold season in areas with temperate and Mediterranean climates and in the wet season in tropical countries with seasonal rainfall. The situation on islands and in areas of the inner tropics with perennial high rainfall is less clear-cut. The age group mainly affected by RSV in developing countries is children under 6 months of age (mean 39% of hospital patients with RSV). RSV-ALRI is slightly more common in boys than in girls. Very little information is available about the mortality of children infected with RSV, the frequency of bacterial co-infection, or the incidence of further wheezing after RSV. Further studies on RSV should address these questions in more detail. RSV is an important pathogen in young children in tropical and developing countries and a frequent cause of hospital admission. Prevention of RSV infection by vaccination would have a significant impact on the incidence of ALRI in children in developing countries.

Short report: seasonal pattern of respiratory syncytial virus in a region with a tropical climate in southeastern Brazil.

“…In regions with tropical and sub-tropical climates, the disease appears to be more prevalent in the rainy seasons. 3,14 Although uncommon, the yearly distribution of RSV found in our study has also been described in two other studies. 15,16 Similarly, the beginning of an epidemic during the summer was also reported in the border state of Rio de Janeiro 10 and in Louisiana in the United States.…”

Sunshine, rainfall, humidity and child pneumonia in the tropics: time-series analyses

“…Singapore is a well known exception to the general finding that peak RSV incidence occurs in the rainy season in tropical settings 4,22 , and consistent with this, both of Singapore studies found a negative association between RSV incidence and relative humidity. More detailed examination of such exceptions would be useful to investigate different environmental and behavioural factors that influence RSV incidence.…”

Treatment guided by rapid diagnostic tests for malaria in Tanzanian children: safety and alternative bacterial diagnoses

“…Even of the true pneumonias some will be viral, including the vaccine-preventable RSV pneumonias, where antibiotics will make little positive impact on outcome [23,24]. In addition, studies of the quality of care suggest that IMCI procedures to diagnose pneumonia, in particular examining the chest and recording respiratory rate, are not well undertaken outside research settings [25,26].…”