Health Protection, Public Health Ontario, Toronto, Ontario, Canada.
Populations and Public Health, ICES, Toronto, Ontario, Canada.
J Pediatric Infect Dis Soc. 2023 Jul 31;12(7):421-430. doi: 10.1093/jpids/piad045.
Respiratory syncytial virus (RSV) contributes significantly to morbidity in children, placing substantial burdens on health systems, thus RSV vaccine development and program implementation are a public health priority. More data on burden are needed by policymakers to identify priority populations and formulate prevention strategies as vaccines are developed and licensed.
Using health administrative data, we calculated incidence rates of RSV hospitalization in a population-based birth cohort of all children born over a six-year period (May 2009 to June 2015) in Ontario, Canada. Children were followed until their first RSV hospitalization, death, 5th birthday, or the end of the study period (June 2016). RSV hospitalizations were identified using a validated algorithm based on International Classification of Diseases, 10th Revision, and/or laboratory-confirmed outcomes. We calculated hospitalization rates by various characteristics of interest, including calendar month, age groups, sex, comorbidities, and gestational age.
The overall RSV hospitalization rate for children <5 years was 4.2 per 1000 person-years (PY) with a wide range across age groups (from 29.6 to 0.52 per 1000 PY in children aged 1 month and 36-59 months, respectively). Rates were higher in children born at a younger gestational age (23.2 per 1000 PY for those born at <28 weeks versus 3.9 per 1000 PY born at ≥37 weeks); this increased risk persisted as age increased. While the majority of children in our study had no comorbidities, rates were higher in children with comorbidities. For all age groups, rates were highest between December and March.
Our results confirm the high burden of RSV hospitalization and highlight young infants are at additional risk, namely premature infants. These results can inform prevention efforts.
呼吸道合胞病毒（RSV）会导致儿童发病和住院，给卫生系统带来沉重负担，因此 RSV 疫苗的开发和应用是公共卫生的重点。随着疫苗的开发和许可，政策制定者需要更多关于负担的数据，以确定重点人群并制定预防策略。
利用健康管理数据，我们计算了加拿大安大略省一个基于人群的出生队列中所有儿童（2009 年 5 月至 2015 年 6 月出生）在六年期间内 RSV 住院的发病率。儿童在首次 RSV 住院、死亡、5 岁生日或研究期结束（2016 年 6 月）之前一直处于随访中。使用基于国际疾病分类第 10 版和/或实验室确诊结果的验证算法确定 RSV 住院。我们按各种感兴趣的特征（包括日历月份、年龄组、性别、合并症和胎龄）计算住院率。
5 岁以下儿童的总体 RSV 住院率为每 1000 人年 4.2 例（1 个月龄和 36-59 月龄儿童的住院率分别为每 1000 人年 29.6 例和 0.52 例），年龄组之间差异较大。胎龄较小的儿童（胎龄<28 周的儿童每 1000 人年为 23.2 例，胎龄≥37 周的儿童每 1000 人年为 3.9 例）的住院率更高；随着年龄的增长，这种风险持续增加。尽管我们研究中的大多数儿童没有合并症，但有合并症的儿童的住院率更高。对于所有年龄组，住院率在 12 月至 3 月之间最高。
我们的结果证实了 RSV 住院的高负担，并强调了小婴儿（尤其是早产儿）的额外风险。这些结果可以为预防工作提供信息。
