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Published on: December 10, 2013
Clinical Epidemiological Characteristics and Risk Factors for Severe Bronchiolitis Caused by Respiratory Syncytial
Sang Ngoc Nguyen1, Thuy Ngoc Thi Nguyen1, Lam Tung Vu1
1Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam.
Insights
Respiratory syncytial virus (RSV) bronchiolitis is common in infants, with severe cases linked to specific risk factors. Identifying these factors is crucial for timely diagnosis and treatment of severe RSV bronchiolitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Bronchiolitis, primarily caused by respiratory syncytial virus (RSV), is a leading cause of infant hospitalization.
- RSV infection can lead to severe respiratory distress and failure, necessitating prompt diagnosis and treatment.
- Understanding risk factors for severe bronchiolitis is critical for effective clinical management.
Purpose of the Study:
- To describe the epidemiological and clinical characteristics of acute bronchiolitis caused by RSV.
- To identify and assess factors associated with severe acute bronchiolitis in hospitalized infants.
- To inform strategies for early detection and intervention in at-risk infants.
Main Methods:
- A descriptive, cross-sectional study conducted over one year at Haiphong Children's Hospital, Vietnam.
- Inclusion criteria: all infants under two years of age admitted with bronchiolitis.
- Data collection focused on patient demographics, clinical presentation, and outcomes.
Main Results:
- 377 infants were evaluated; 12.5% had severe disease.
- Common symptoms included wheezing, cough, tachypnea, and runny nose; RSV bronchiolitis cases peaked in winter-spring.
- Identified risk factors for severe disease: age ≤6 months, low birth weight, preterm birth, non-breastfeeding, early weaning, and exposure to cigarette smoke.
Conclusions:
- Hospitalizations for RSV bronchiolitis increase during the winter-spring season.
- Ten significant risk factors for severe RSV bronchiolitis were confirmed, including prematurity, low birth weight, and environmental exposures.
- These findings highlight the importance of targeted interventions for high-risk infants.
Introduction:
Bronchiolitis is the most prevalent cause of hospitalization in infants under the age of 12 months. The disease is caused by respiratory syncytial virus (RSV) infection, which can cause breathing difficulties and respiratory failure. Therefore, it is necessary to discover the risk factors of severe bronchiolitis to diagnose and treat promptly. This study is aimed at describing the epidemiological characteristics and clinical features of acute bronchiolitis caused by RSV and assessing the related factors to severe acute bronchiolitis in studied patients.
Methods:
A descriptive cross-sectional study was carried out in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from October 1, 2016, to September 30, 2017. All bronchiolitis admissions < 2 years were included.
Results:
377 children were evaluated, including 261 boys and 116 girls; children under 6 months accounted for the highest proportion (57%), and 47 (12.5%) of all patients had severe disease. Wheezing was the main reason to be taken to the hospital 261 (69.2%). Clinical symptoms of acute bronchiolitis such as cough, tachypnea, and runny nose were found in all patients. Bronchiolitis cases increased in the winter-spring season, and the highest registered number of patients was 42 in March. Image of bronchiolitis on chest X-ray was found in all patients, and air trapping lung was found in 124 (32.9%) patients. The risk factors included age (≤6 months), low birth weight, preterm birth, nonbreastfeeding for the first six months, early weaning, and exposition to cigarette smoke increased the severe disease (p < 0.05).
Conclusion:
The number of hospitalized infants with bronchiolitis caused by RSV has an upward trend during the winter-spring season (from October to March). This study confirms that age, preterm birth, breastfeeding under 6 months, history of exposure to cigarette smoking, low birth weight, having sibling(s) under five years old going to kindergarten, history of undergoing cesarean section, history of mechanical ventilation, poor living condition, and maternal education are 10 risk factors of severe bronchiolitis caused by RSV.
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