Sitthikarnkha Phanthila, Uppala Rattapon, Niamsanit Sirapoom, Sutra Sumitr, Thepsuthammarat Kaewjai, Techasatian Leelawadee, Niyomkarn Watit, Teeratakulpisarn Jamaree
Department of Pediatrics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang, Khon Kaen 40002, Thailand.
Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Children (Basel). 2022 Dec 17;9(12):1990. doi: 10.3390/children9121990.
Objectives: This study sought to determine the epidemiology, seasonal variations, morbidity, and mortality of respiratory syncytial virus (RSV) infection among hospitalized children with lower respiratory tract infection in Thailand. In addition, we assessed the risk factors associated with severe RSV lower respiratory tract infection (LRTI)-related morbidity and mortality. Methods: The data were reviewed retrospectively from the National Health Security Office for hospitalized children younger than 18 years old diagnosed with RSV-related LRTI in Thailand, between the fiscal years of 2015 to 2020. The RSV-related LRTIs were identified using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification. ICD-10-TM codes J12.1, J20.5, and J21.0, which represent respiratory syncytial virus pneumonia, acute bronchitis due to respiratory syncytial virus, and acute bronchiolitis due to respiratory syncytial virus, respectively, were studied. Results: During the study period, RSV-related LRTI accounted for 19,340 of the 1,610,160 hospital admissions due to LRTI. RSV pneumonia was the leading cause of hospitalization (13,684/19,340; 70.76%), followed by bronchiolitis (2849/19,340; 14.73%) and bronchitis (2807/19,340; 14.51%), respectively. The highest peak incidence of 73.55 percent occurred during Thailand’s rainy season, from August to October. The mortality rate of RSV-related LRTI in infants younger than 1 year of age was 1.75 per 100,000 person years, which was significantly higher than that of children 1 to younger than 5 years old and children 5 to younger than 18 years old (0.21 per 100,000 person years and 0.01 per 100,000 person years, respectively, p-value < 0.001). Factors associated with mortality were congenital heart disease, hematologic malignancy, malnutrition, and neurological disease. Conclusions: In children with RSV LRTI, pneumonia was the leading cause of hospitalization. The admission rate was highest during the rainy season. Mortality from RSV-related LRTI was higher in children under 1 year old and in children with underlying illnesses; future preventive interventions should target these groups of patients.
本研究旨在确定泰国住院的下呼吸道感染儿童中呼吸道合胞病毒（RSV）感染的流行病学、季节性变化、发病率和死亡率。此外，我们评估了与严重RSV下呼吸道感染（LRTI）相关的发病率和死亡率的危险因素。方法：回顾性分析泰国国家卫生安全办公室2015财年至2020财年期间18岁以下诊断为RSV相关LRTI的住院儿童的数据。使用《疾病和相关健康问题国际统计分类》第10次修订版泰国修改版确定RSV相关的LRTI。研究了分别代表呼吸道合胞病毒肺炎、呼吸道合胞病毒引起的急性支气管炎和呼吸道合胞病毒引起的急性细支气管炎的ICD-10-TM编码J12.1、J20.5和J21.0。结果：在研究期间，RSV相关的LRTI占因LRTI住院的1,610,160例中的19,340例。RSV肺炎是住院的主要原因（13,684/19,340；70.76%），其次是细支气管炎（2,849/19,340；14.73%）和支气管炎（2,807/19,340；14.51%）。最高发病率峰值为73.55%，发生在泰国的雨季，即8月至10月。1岁以下婴儿中RSV相关LRTI的死亡率为每10万人年1.75例，显著高于1至5岁儿童和5至18岁儿童（分别为每10万人年0.21例和0.01例，p值<0.001）。与死亡率相关的因素包括先天性心脏病、血液系统恶性肿瘤、营养不良和神经系统疾病。结论：在患有RSV LRTI的儿童中，肺炎是住院的主要原因。雨季入院率最高。1岁以下儿童和患有基础疾病的儿童中RSV相关LRTI的死亡率更高；未来的预防干预措施应针对这些患者群体。
