Hospital admissions for acute respiratory tract infections among infants from Nunavut and the burden of respiratory syncytial virus: a 10-year retrospective cohort study

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2025-02-13 DOI:10.1016/j.lana.2025.101021

Mai-Lei Woo Kinshella , Jean Allen , Jasmine Pawa , Jesse Papenburg , Radha Jetty , Rachel Dwilow , Joanne Embree , Joan Robinson , Laura Arbour , Manish Sadarangani , Ye Shen , Jeffrey N. Bone , Celia Walker , Iryna Kayda , Holden Sheffield , Darcy Scott , Amber Miners , David M. Goldfarb

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引用次数: 0

Abstract

Background

Nunavut is a northern Canadian territory where a high proportion of infants are admitted to hospital with acute respiratory tract infection (ARI). Previous studies have been limited in regional and/or short duration of coverage. This study aimed to estimate the incidence rate, microbiology and outcomes of ARI hospitalizations in Nunavut infants.

Methods

We conducted a retrospective cohort study of infants aged <1 year from Nunavut hospitalized for ARI at two regional and four tertiary pediatric hospitals in Canada, January 1, 2010, to June 30, 2020. One regional hospital was located in Nunavut; others were located across Canada. Descriptive statistics and multivariable logistic regression were performed.

Findings

We identified 1189 ARI admissions, with an incidence rate of 133.9 per 1000 infants per year (95% confidence interval (CI): 126.8, 141.3). Of these admissions, 56.0% (n = 666) were to regional hospitals alone, 72.3% (n = 860) involved hospitalization outside of Nunavut, 15.6% (n = 185) were admitted into intensive care, and 9.2% (n = 109) underwent mechanical ventilation. Among 730 admissions with a pathogen identified, 45.8% had respiratory syncytial virus (RSV; n = 334), for a yearly incidence rate of 37.8 RSV-associated hospitalizations per 1000 infants (95% CI: 33.9, 42.1). Among RSV-associated hospitalizations, 41.1% (n = 138) were infants 0–2 months of age and 32.1% (n = 108) were >6 months. Compared with non-RSV admissions, infants with RSV had higher odds of admission into intensive care, oxygen therapy, CPAP/BiPAP respiratory support and length of hospital stay over a week.

Interpretation

Understanding the high burden of ARI among Nunavut infants can inform health policy and serve as a baseline for assessing the impact of any new interventions targeting infant ARIs.

Funding

Public Health Agency of Canada and Canadian Institutes of Health Research via the Canadian Immunization Research Network (CNF 151944).

查看原文本刊更多论文

努纳武特地区婴儿急性呼吸道感染住院与呼吸道合胞病毒负担：一项10年回顾性队列研究

努纳武特是加拿大北部的一个地区，那里有很高比例的婴儿因急性呼吸道感染（ARI）而入院。以前的研究仅限于区域和/或覆盖时间较短。本研究旨在估计努纳武特地区婴儿ARI住院的发病率、微生物学和结果。方法对2010年1月1日至2020年6月30日在加拿大两家地区和四家三级儿科医院因急性呼吸道感染住院的努纳武特地区1岁婴儿进行回顾性队列研究。努纳武特有一家地区医院；其他的则分布在加拿大各地。进行描述性统计和多变量logistic回归。研究结果：我们确定了1189例ARI入院患者，每年每1000名婴儿的发病率为133.9例（95%置信区间（CI）： 126.8, 141.3）。在这些住院患者中，56.0% （n = 666）仅住在地区医院，72.3% （n = 860）住在努纳武特以外的医院，15.6% （n = 185）住进重症监护室，9.2% （n = 109）接受了机械通气。在确定病原体的730例入院患者中，45.8%感染呼吸道合胞病毒（RSV）；n = 334)，年发病率为每1000名婴儿37.8例与rsv相关的住院（95% CI: 33.9, 42.1）。在与rsv相关的住院患者中，41.1% （n = 138）为0-2月龄婴儿，32.1% （n = 108）为6月龄婴儿。与非呼吸道合胞病毒住院相比，呼吸道合胞病毒患儿进入重症监护室、吸氧治疗、CPAP/BiPAP呼吸支持和住院时间超过一周的几率更高。理解努纳武特地区婴儿急性呼吸道感染的高负担可以为卫生政策提供信息，并作为评估任何针对婴儿急性呼吸道感染的新干预措施影响的基线。通过加拿大免疫研究网络资助加拿大公共卫生署和加拿大卫生研究所（CNF 151944）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Regional Health-Americas Multiple-

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8.00

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0.00%

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期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.