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Estimating respiratory syncytial virus (RSV) mortality among children < 5 years in Bangladesh

Dhaka, Bangladesh


RSV is believed to be the single most important cause of serious acute lower respiratory tract illness (ALRI) in infants and young children in developed countries and is an important contributor to ALRI hospitalizations in developing countries. At present there are no treatment or preventive measures available for RSV in developing countries. Although RSV immunoprophylaxis is available for high-risk infants, its cost is too high for use in developing countries. The data on RSV associated mortality are very limited for developing countries. Extrapolating from RSV hospitalizations, some have estimated that RSV is associated with approximately 500,000 deaths each year in developing countries. However, in developing countries many ALRI deaths occur in non-hospitalized children in the community and there are insufficient data to estimate how many of these deaths may be attributable to RSV.

Our objectives are to describe the seasonality of RSV detections/outbreaks in Bangladesh and to determine the relationship between RSV seasonality patterns and deaths with preceding ALRI. By completing these objectives, we will estimate the proportion of ALRI deaths that are associated with RSV infection. This information will help establish priorities for RSV vaccine development for use in developing countries to reduce mortality due to ALRI.

The ICDDR,B virology laboratory will test, by RT-PCR, approximately 2600 nasopharyngeal wash and paired serum specimens that have already been collected from March 2004 through February 2008. These specimens will be tested for the respiratory pathogens RSV, human metapneumovirus, human parainfluenza virus types 1, 2, and 3, and influenza. Existing data for ALRI deaths among children under 5 years of age will be obtained from the Health and Demographic Surveillance System (HDSS) modular Verbal Autopsy (VA) questionnaires. We will combine these two sources of data, describe the spatial and temporal patterns of RSV community outbreaks, and determine the relationship between RSV outbreaks and ALRI deaths in Bangladesh for the study period.


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