Climatic, temporal, and geographic characteristics of respiratory syncytial virus disease in a tropical island population

Abstract

Respiratory syncytial virus (RSV) is an important cause of morbidity in children worldwide, although data from equatorial regions are limited. We analysed climatic, spatial, and temporal data for children presenting to hospitals in Lombok island, Indonesia with clinical pneumonia. During the study period, 2878 children presented and 741 RSV cases were identified. In multivariate analysis with an 8-day lag, occurrence of rain was associated with 64% higher incidence of RSV disease [incidence rate ratio (IRR) 1.64, 95% confidence interval (CI) 1.13-2.38]. A 1% rise in mean relative humidity and 1 degree C increase in mean air temperature was associated with a 6% (IRR 1.06, 95% CI 1.03-1.10) and 44% (IRR 1.44, 95% CI 1.24-1.66) increase in RSV cases, respectively. Four statistically significant local clusters of RSV pneumonia were identified within the annual island-wide epidemics. This study demonstrates statistical association of monsoon-associated weather in equatorial Indonesia with RSV. Moreover, within the island-wide epidemics, localized RSV outbreaks suggest local factors influence RSV disease.

Sunshine, rainfall, humidity and child pneumonia in the tropics: time-series analyses

“…In tropical settings lower respiratory infections in children are generally found to be more common during periods of higher rainfall and humidity, consistent with our results [7][8][9][10][11] . Rainfall is not convincingly associated with pneumonia incidence in time series studies from temperate settings 10,12,13 .…”

“…Low sunlight and temperature are consistently associated with high pneumonia incidence in time series studies in temperate settings, where annual peaks of lower respiratory infections occur during the short days of winter 10,[12][13][14][15][16] . The association between temperature and respiratory infections in children is inconsistent in time series studies from tropical settings, suggesting temperature is unlikely to be an important driver of pneumonia incidence in the tropics [6][7][8][9][10][11] . Less evidence examining the association of respiratory infection and sunlight exists from tropical settings.…”

“…Respiratory syncytial virus (RSV) infections were positively correlated with the number of rainy days and relative humidity in Indonesia and Malaysia, positively correlated with relative humidity and dew point in Mexico, and positively correlated with relative humidity in Hong Kong, although in Singapore a negative correlation with relative humidity was found [6][7][8][9][10][11] . In temperate settings where pneumonia peaks in winter, time series analyses have consistently found peaks of RSV and invasive pneumococcal disease (IPD) to be inversely correlated with temperature and daylight hours 10,[12][13][14][15][16] .…”

Predicción de la epidemia del virus respiratorio sincitial en Bogotá D.C. utilizando variables climatológicas

“…Para seleccionar las variables climatológicas se revisaron varios trabajos de otros autores, en los cuales se tomaron en cuenta diversas variables climatológicas (15)(16)(17). Se seleccionaron las investigaciones que reportaban un efecto positivo o negativo en la relación entre la actividad del RSV y las condiciones meteorológicas.…”

Do pollution and climate influence respiratory tract infections in children?

“…38 RSV infections appear to have a correlation with an increase atmospheric humidity. Omer et al, 39 studied 2878 children with 748 RSV(+) cases using a multivariate analysis with a lag of 8 days and the occurrence of rain. It was noted that the episodes were associated in 60% of the cases, given that when relative humidity moved from 1% to 6% there was a 39% increase in the cases of RSV 39 .…”