{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:48:09Z","timestamp":1784288889215,"version":"3.55.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["HHSD2002013M53890B"],"award-info":[{"award-number":["HHSD2002013M53890B"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Understanding respiratory syncytial virus (RSV) global epidemiology is important to inform future prevention strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Hospitalized infants &amp;lt;1-year-old with acute illness were enrolled prospectively in Albania, Jordan, Nicaragua, and Philippines during respiratory seasons in 2015\u20132017. Medical chart review, parental interview, and post-discharge follow up were conducted. Respiratory specimens were tested using real-time RT-PCR for RSV. Infant characteristics associated with very severe illness (intensive care unit [ICU] admission or receipt of supplemental oxygen) were assessed using logistic regression to adjust for potential confounders (age, sex, study site, and preterm birth).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 3634 enrolled hospitalized infants, 1129 (31%) tested positive for RSV. The median age of RSV-positive infants was 2.7 (IQR: 1.4\u20136.1) months and 665 (59%) were male. Very severe illness in 583 (52%) RSV-positive infants was associated with younger age (aOR 4.1, 95% CI: 2.6\u20136.5 for 0\u20132 compared to 9\u201311-months; P &amp;lt; .01), low weight-for-age z-score (aOR 1.9, 95% CI: 1.2\u20132.8; P &amp;lt; .01), ICU care after birth (aOR 1.6, 95% CI: 1.0\u20132.5; P = .048), and cesarean delivery (aOR 1.4, 95% CI: 1.0\u20131.8; P = .03). RSV subgroups A and B co-circulated at all sites with alternating predominance by year; subgroup was not associated with severity (aOR 1.0, 95% CI: 0.8\u20131.4). Nine (0.8%) RSV-positive infants died during admission or within \u226430 days of discharge, of which 7 (78%) were &amp;lt;6-months-old.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>RSV was associated with nearly a third of infant acute illness hospitalizations in four middle-income countries during the respiratory season, where, in addition to young age, factors including low weight-for-age might be important predictors of severity. RSV prevention strategies targeting young infants could substantially reduce RSV-associated hospitalizations in middle-income countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piad042","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T21:52:53Z","timestamp":1686261173000},"page":"394-405","source":"Crossref","is-referenced-by-count":12,"title":["Respiratory Syncytial Virus Infection Among Hospitalized Infants in Four Middle-Income Countries"],"prefix":"10.1093","volume":"12","author":[{"given":"Holly M","family":"Biggs","sequence":"first","affiliation":[{"name":"Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A F","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Pediatrics, 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