Respiratory Syncytial Virus-Related Severe Acute Lower Respiratory Tract
Infection Among Under-Fives at a Public Tertiary Hospital in
Northwestern Nigeria: Epidemiology and Seasonality.
Abstract
Abstract: Background- Globally, 33 million cases of Respiratory
Syncytial Virus (RSV) infections occur annually among under-fives.
Ninety-nine percent of deaths from RSV occur in low- and middle-income
countries. Under-five pneumonia mortality in Nigeria was estimated at
140,520 in 2017, but RSV epidemiological data is scant due to poor
awareness and limited testing. Vaccines for RSV are currently under
development and RSV mortality data from this high-mortality low resource
setting are essential to maximizing the potential benefit of vaccination
as well as promoting vaccine uptake. This study aimed to describe the
epidemiology and seasonality of RSV-ALRTI in children younger than 5
years in Zaria, Northwestern Nigeria. Methods-A prospective cohort study
was conducted among children aged 1 month to 5 years who were
hospitalized with acute lower respiratory tract infection (ALRTI) in the
Emergency Pediatric Unit of Ahmadu Bello University Teaching Hospital
from November 2018 to November 2019. Naso-pharyngeal swabs were obtained
for RSV testing using a point-of-care immunoassay technique. Results-
Thirty-three percent (35/106) of the children had RSV-related ALRTI. The
median age of RSV-positive cases was 8 months (IQR 3-14). Two-thirds of
children (68.6%, 24/35) were below 12 months. The RSV mortality rate
was 5.7% (2/35). RSV occurred in 10 months of the year with peaks in
March and July. conclusions- A third of admitted children with ALRTI
were positive for RSV. RSV significantly contributes to childhood
pneumonia and testing will raise awareness of this important pathogen.
The dual seasonal peak observed in our study may have implications for
vaccine implementation.