Document Type
Article
Department
Paediatrics and Child Health
Abstract
Background: Respiratory syncytial virus (RSV) is an important cause of infant morbidity and mortality and a potential target for maternal immunization strategies. However, data on the role of RSV in young infant deaths in developing countries are limited.
Methods: We conducted a community-based mortality surveillance from August 2018-March 2020 for infants ≤6 months in Karachi, Pakistan. We tested (reverse transcription-polymerase chain reaction) nasopharyngeal swabs from deceased infants for presence of RSV. We performed verbal autopsies and calculated odds of RSV-associated mortality with 95% CIs and used multivariable logistic regression to evaluate associations.
Results: We collected 490 nasopharyngeal specimens from 1280 eligible infant deaths. There were 377/490 (76.9%) live births and 14/377 (3.7%; 95% CI: 1.8-5.6) were RSV positive. Most deaths occurred in neonates (254/377; 67.4%), males (226/377; 59.9%), and respiratory illnesses (206/377; 54.6%). Postneonatal age (10/14, 71.4%; OR: 5.5; 95% CI: 1.7-18.0), respiratory symptoms (12/14, 85.7%; OR: 5.2; 1.2-23.7), and high RSV season (9/14, 64.3%; OR: 4.4; 1.4-13.3) were associated with RSV mortality. In multivariable logistic regression analysis, respiratory symptoms (OR: 6.6; 95% CI: 1.3-32.5), RSV seasonality (6.1; 1.8-20.4), and age (9.2; 2.6-33.1) were significant predictors of RSV-associated mortality.
Conclusions: RSV has a significant mortality burden in early infancy in Karachi, Pakistan. Age, RSV seasonality, and respiratory symptoms were significant predictors of RSV-associated mortality. Our findings have implications for clinical management of young infants with cold-like symptoms, policy development, and research regarding maternal immunization against RSV during pregnancy, in resource-constrained, low-income, and vaccine-hesitant populations.
Publication (Name of Journal)
Clinical Infectious Diseases
Recommended Citation
Kazi, A.,
Aguolu, O. G.,
Mughis, W.,
Ahsan, N.,
Jamal, S.,
Khan, A.,
QureshI, H. M.,
Yildirim, I.,
Malik, F. A.,
Omer, S. B.
(2021). Respiratory syncytial virus-associated mortality among young infants in Karachi, Pakistan: A prospective postmortem surveillance study. Clinical Infectious Diseases, 73(Suppl_3), S203-S209.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/1071
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Included in
Influenza Virus Vaccines Commons, Maternal and Child Health Commons, Pediatrics Commons, Respiratory Tract Diseases Commons