{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:43:04Z","timestamp":1784266984909,"version":"3.55.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1163027"],"award-info":[{"award-number":["OPP1163027"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections and child mortality. While RSV disease burden is highest in low- and middle-income countries, most knowledge about risk factors for fatal RSV disease comes from high-income settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Among infants aged 4 days to &amp;lt;6 months who died at University Teaching Hospital in Lusaka, Zambia, we tested nasopharyngeal swabs obtained postmortem for RSV using reverse transcriptase\u2013quantitative polymerase chain reaction. Through a systematic review of death certificates and hospital records, we identified 10 broad categories of underlying medical conditions associated with infant deaths. We used backward-selection models to calculate adjusted and unadjusted risk ratios (RRs) for the association between each underlying condition and RSV status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 720 infant deaths, 6% (44) were RSV-positive, 70% were &amp;lt;4 weeks old, and 54% were male. At least 1 underlying condition was found in 85% of infants, while 63% had \u22652. Prematurity\/low birth weight (53% [384]) and complications of labor and delivery (32% [230]) were the most common conditions. Congenital cardiac conditions were significantly associated with an increased risk of RSV infection (4%, 32; adjusted RR: 3.57; 95% CI: 1.71\u20137.44). No other underlying conditions were significantly associated with RSV.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Other than congenital cardiac conditions, we found a lack of association between RSV and underlying risk factors. This differs from high-income settings, where RSV mortality is concentrated among high-risk infants. In this population, birth-related outcomes are the highest mortality risk factors. Improved neonatal care remains crucial in the fight against neonatal mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab466","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T19:11:35Z","timestamp":1621365095000},"page":"S180-S186","source":"Crossref","is-referenced-by-count":11,"title":["Association of Respiratory Syncytial Virus Infection and Underlying Risk Factors for Death Among Young Infants Who Died at University Teaching Hospital, Lusaka Zambia"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1953-2739","authenticated-orcid":false,"given":"Leah S","family":"Forman","sequence":"first","affiliation":[{"name":"Boston University School of Public Health, Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Macleod","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mwananyanda","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA"},{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Kwenda","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Department of Biomedical Sciences, University of Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pieciak","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachariah","family":"Mupila","sequence":"additional","affiliation":[{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitriona","family":"Murphy","sequence":"additional","affiliation":[{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Thea","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chilufya","family":"Chikoti","sequence":"additional","affiliation":[{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baron","family":"Yankonde","sequence":"additional","affiliation":[{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benard","family":"Ngoma","sequence":"additional","affiliation":[{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Chimoga","sequence":"additional","affiliation":[{"name":"Right to Care\u2014Zambia, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J","family":"Gill","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"2021090208213084000_CIT0001","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(10)60206-1","article-title":"Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a 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