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一项前瞻性三年队列研究,研究印度农村地区儿童急性呼吸道感染的流行病学和病毒学。

A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India.

机构信息

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

PLoS One. 2007 Jun 6;2(6):e491. doi: 10.1371/journal.pone.0000491.

Abstract

BACKGROUND

Acute respiratory infection (ARI) is a major killer of children in developing countries. Although the frequency of ARI is similar in both developed and developing countries, mortality due to ARI is 10-50 times higher in developing countries. Viruses are common causes of ARI among such children, yet the disease burden of these infections in rural communities is unknown.

METHODOLOGY/PRINCIPAL FINDINGS: A prospective longitudinal study was carried out in children enrolled from two rural Indian villages at birth and followed weekly for the development of ARI, classified as upper respiratory infection, acute lower respiratory infection (ALRI), or severe ALRI. Respiratory syncytial virus (RSV), influenza, parainfluenza viruses and adenoviruses in nasopharyngeal aspirates were detected by direct fluorescent antibody testing (DFA) and, in addition, centrifugation enhanced culture for RSV was done. 281 infants enrolled in 39 months and followed until 42 months. During 440 child years of follow-up there were 1307 ARIs, including 236 ALRIs and 19 severe ALRIs. Virus specific incidence rates per 1000 child years for RSV were total ARI 234, ALRI 39, and severe ALRI 9; for influenza A total ARI 141, ALRI 39; for INF B total ARI 37; for PIV1 total ARI 23, for PIV2 total ARI 28, ALRI 5; for parainfluenza virus 3 total ARI 229, ALRI 48, and severe ALRI 5 and for adenovirus total ARI 18, ALRI 5. Repeat infections with RSV were seen in 18 children.

CONCLUSIONS/SIGNIFICANCE: RSV, influenza A and parainfluenza virus 3 were important causes of ARI among children in rural communities in India. These data will be useful for vaccine design, development and implementation purposes.

摘要

背景

急性呼吸道感染(ARI)是发展中国家儿童的主要杀手。尽管发达国家和发展中国家的 ARI 发病率相似,但发展中国家因 ARI 导致的死亡率要高 10-50 倍。病毒是发展中国家此类儿童患 ARI 的常见原因,但农村社区这些感染的疾病负担尚不清楚。

方法/主要发现:对出生时在两个印度农村村庄登记的儿童进行了前瞻性纵向研究,并每周对其进行 ARI 发展情况的跟踪,将 ARI 分类为上呼吸道感染、急性下呼吸道感染(ALRI)或严重 ALRI。通过直接荧光抗体检测(DFA)检测鼻咽抽吸物中的呼吸道合胞病毒(RSV)、流感病毒、副流感病毒和腺病毒,此外,还进行了 RSV 的离心增强培养。281 名婴儿入组,随访至 42 个月。在 440 个儿童年的随访期间,发生了 1307 例 ARI,包括 236 例 ALRI 和 19 例严重 ALRI。每 1000 个儿童年病毒特异性发病率,RSV 为总 ARI 234、ALRI 39 和严重 ALRI 9;流感 A 为总 ARI 141、ALRI 39;INF B 为总 ARI 37;PIV1 为总 ARI 23、PIV2 为总 ARI 28、ALRI 5;副流感病毒 3 为总 ARI 229、ALRI 48 和严重 ALRI 5,腺病毒为总 ARI 18、ALRI 5。18 名儿童出现了 RSV 的重复感染。

结论/意义:RSV、流感 A 和副流感病毒 3 是印度农村社区儿童 ARI 的重要病因。这些数据将有助于疫苗的设计、开发和实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce5d/1876256/44ea6b5f09fc/pone.0000491.g001.jpg

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