Risk factors and patterns of household clusters of respiratory viruses in rural Nepal
Emily M Scotta, Amalia Magareta, Jane M. Kuypersa, James M. Tielschb, Joanne Katzc, Subarna K. Khatryd e, Laveta M. Stewartc, Laxman Shresthaf, S. C. LeClerqc d e, Janet A. Englundg, Helen Y. Chua✉
- aSchool of Medicine, University of Washington, Seattle, WA, USA
- bDepartment of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- cDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- dNepal Nutrition Intervention Project - Sarlahi, Kathmandu, Nepal
- eNepal Nutrition Intervention Project – Sarlahi, Kathmandu, Nepal
- fDepartment of Paediatrics and Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- gSeattle Children's Hospital and Research Institute, University of Washington, Seattle, WA, USA
- ✉Corresponding author
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Abstract
Viral pneumonia is an important cause of death and morbidity among infants worldwide. Transmission of non-influenza respiratory viruses in households can inform preventative interventions and has not been well-characterised in South Asia. From April 2011 to April 2012, household members of pregnant women enrolled in a randomised trial of influenza vaccine in rural Nepal were surveyed weekly for respiratory illness until 180 days after birth. Nasal swabs were tested by polymerase chain reaction for respiratory viruses in symptomatic individuals. A transmission event was defined as a secondary case of the same virus within 14 days of initial infection within a household. From 555 households, 825 initial viral illness episodes occurred, resulting in 79 transmission events. The overall incidence of transmission was 1.14 events per 100 person-weeks. Risk of transmission incidence was associated with an index case age 1-4 years (incidence rate ratio (IRR) 2.35; 95% confidence interval (CI) 1.40-3.96), coinfection as initial infection (IRR 1.94; 95% CI 1.05-3.61) and no electricity in household (IRR 2.70; 95% CI 1.41-5.00). Preventive interventions targeting preschool-age children in households in resource-limited settings may decrease the risk of transmission to vulnerable household members, such as young infants.
TL;DRPreventive interventions targeting preschool-age children in households in resource-limited settings may decrease the risk of transmission to vulnerable household members, such as young infants. (Semantic Scholar)