Risk factors for severe respiratory syncytial virus-associated respiratory tract infection in a high HIV prevalence setting, South Africa, 2012 - 2018

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 1128 - 10
• Main Authors: Moyes, Jocelyn, Tempia, Stefano, Walaza, Sibongile, Cohen, Adam L, Treurnicht, Florette, Hellferscee, Orienka, Wolter, Nicole, von Gottberg, Anne, Dawood, Halima, Variava, Ebrahim, Kahn, Kathleen, Madhi, Shabir A, Cohen, Cheryl
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 09.10.2024; BioMed Central; BMC
• Subjects: Adolescent; Adult; Age groups; Aged; Care and treatment; Child; Child, Preschool; Clinics; Consent; Diagnosis; Disease; Female; Fever; Health aspects; HIV; HIV infection; HIV Infections - complications; HIV Infections - epidemiology; Hospitalization; Hospitals; Human immunodeficiency virus; Humans; Illnesses; Immunization; Infant; Infant, Newborn; Infections; Influenza; Lower respiraptry tract infection; Male; Malnutrition; Medical referrals; Middle Aged; Older people; Patients; Pneumonia; Prevalence; Public health; Respiratory syncytial virus; Respiratory Syncytial Virus Infections - epidemiology; Respiratory Syncytial Virus, Human; Respiratory tract; Respiratory tract infection; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - virology; Risk Factors; RSV; Severe acute respiratory syndrome; South Africa - epidemiology; Standard scores; Surveillance; Urban areas; Viruses; Young Adult; South Africa; Lower respiraptry tract infection; Respiratory syncytial virus; RSV; HIV infection; Risk factors
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-10024-9

Identifying risk factors for respiratory syncytial virus (RSV)-associated severe acute respiratory illness (SARI) will assist with targeting vaccine interventions. Using surveillance data from South Africa (2012-2018), we compared the characteristics of individuals with RSV-associated influenza-like illness (ILI) (reference group) to those with RSV-associated SARI to describe factors associated with SARI using a multivariable analysis. RSV was detected in 6% (483/7792) of ILI cases and 15% (844/5672) of SARI cases. Factors associated with SARI in children included age < 2 months, compared to age 2-4 years (adjusted odds ratio (aOR) 54.4; 95% confidence interval (CI) 23.5-125.8), malnutrition (aOR 1.9; 95% CI 1.2-3.2), prematurity (aOR 2.4; 95% CI 1.3-4.6) and living with HIV (LWH) (aOR 22.5; 95% CI 2.9-174.3). In individuals ≥ 5 years, factors associated with SARI included age ≥ 65 years compared to age 5-24 years (aOR 10.7; 95% CI 1.1-107.5), symptom duration ≥ 5 days (aOR 2.7; 95% CI 1.1-6.3), underlying illness (aOR 2.7; 95% CI 1.5-26.1) and LWH (aOR 16.8, 95% CI: 4.8-58.2). Individuals at the extremes of age and those with identified risk factors might benefit most from RSV prevention interventions. Not applicable, this is not a clinical trial.