Related Experiment Videos
Respiratory syncytial virus infection in Navajo and White Mountain Apache children
Jana Bockova1, Katherine L O'Brien, Jane Oski
1Johns Hopkins University School of Medicine, Division of Pediatric Infectious Diseases, Baltimore, Maryland, USA.
Insights
Native American children under 2 years old, specifically Navajo and White Mountain Apache, face high rates of hospitalization due to respiratory syncytial virus (RSV) infection. These findings highlight a significant health disparity requiring further attention and intervention strategies.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Native American Health
Background:
- Bronchiolitis hospitalization rates in US children under 1 year are 31.2 per 1000.
- Respiratory syncytial virus (RSV) specific hospitalization data is lacking for high-risk Native American populations, except Alaska Natives.
- Previous estimates show RSV hospitalization incidence at 150 per 1000 for Alaska Native infants under 1 year.
Purpose of the Study:
- To estimate respiratory syncytial virus (RSV) hospitalization rates among Navajo and White Mountain Apache children.
- To assess RSV-specific disease burden in these vulnerable pediatric populations.
Main Methods:
- Prospective, population-level, hospital-based surveillance was conducted from 1997 to 2000.
- Nasopharyngeal aspirates were collected from children under 2 years admitted for acute lower respiratory tract infection during RSV season (October-March).
- RSV infection was confirmed using commercial enzyme immunoassay kits, and disease severity was assessed via chart review.
Main Results:
- RSV accounted for 51.3% of 1837 admissions for acute lower respiratory tract infection in children under 2 years.
- The overall seasonal RSV hospitalization rate was 63.6 per 1000 children under 2 years, and 91.3 per 1000 for those under 1 year.
- Infants younger than 6 months had a significantly higher risk of severe RSV disease (relative risk: 6.8).
Conclusions:
- Navajo and White Mountain Apache children exhibit a high risk for RSV-related hospitalizations.
- The high hospitalization rates are unlikely due to a lower threshold for admission or predisposing chronic conditions.
- These findings underscore a critical need for targeted public health interventions for RSV prevention and management in these communities.
Objective:
The hospitalization rate for bronchiolitis of any cause among US children younger than 1 year is estimated at 31.2 per 1000. No data exist on respiratory syncytial virus (RSV)-specific hospitalization rates among high-risk Native Americans other than Alaska Natives, for whom the incidence of RSV hospitalization was estimated at 150 per 1000 among infants younger than 1 year. We aimed to estimate RSV hospitalization rates among Navajo and White Mountain Apache children younger than 2 years.
Methods:
We conducted prospective population-level hospital-based surveillance to determine RSV hospitalization rates among Navajo and White Mountain Apache children younger than 2 years. From 1997 to 2000, all children who were admitted for acute lower respiratory tract infection between October 1 and March 31 had a nasopharyngeal aspirate obtained and tested for RSV by commercial enzyme immunoassay kits. We reviewed charts of children who tested positive for RSV antigen to determine disease severity.
Results:
During 3 RSV seasons (1997-2000), 51.3% of 1837 admissions for acute lower respiratory tract infection among children younger than 2 years were attributed to RSV infection. The overall seasonal RSV hospitalization rate among children younger than 2 years was 63.6 per 1000 and 91.3 per 1000 among children younger than 1 year. In a univariate analysis, predictors of severity included age <6 months (relative risk: 6.8; 95% confidence interval: 3.1-17.0).
Conclusions:
Navajo and White Mountain Apache children are at high risk for RSV disease requiring hospitalization. A lower threshold for hospitalization or underlying chronic conditions that predispose to severe RSV disease do not seem to explain high RSV hospitalization rates in this population.