RSV Lower Respiratory Tract Illness in Infants of Low- and Middle-income Countries

Abstract

<p>This review addresses differences in respiratory syncytial virus (RSV) lower respiratory tract illness (LRTI) between industrial- ized and developing countries and provides observations associated with the dissimilar consequences of viral infection in both environments. RSV LRTI is an important cause of morbidity and mortality in infants worldwide. Its burden is highest in de- veloping countries, where most hospitalizations and mortality occur. Palivizumab has been approved for disease prevention in premature infants in numerous countries but its cost and requirement for several doses hampers its routine use. The significant gap between low- and high-income countries in mortality rates stresses the need to identify specific risk factors for RSV LRTI prevention in different populations.</p><p><strong>Conclusion</strong>. RSV LTRI continues to be a serious problem for industrialised and developing countries, although mortality occurs preferentially in the latter. Several vaccines and monoclonal antibodies to prevent severe disease are advancing steadily in late phase trials. The next decade may witness a change in the landscape of RSV infections in young infants.</p>

Factores clínicos y socioeconómicos asociados a bronquiolitis severa en lactantes menores de 24 meses. Estudio de caso control

“…Sin embargo, se han reportado sustanciales diferencias raciales y étnicas, en la gravedad y el requerimiento de ingreso hospitalario, con una mayor frecuencia en poblaciones afroamericanas e hispánicas en un estudio poblacional en una región (1) de EEUU . El Virus sincitial respiratorio es la causa más frecuente de las bronquiolitis y es un serio problema de salud en todo el mundo, Sin embargo, la (2) mortalidad es mayor en países poco desarrollados . Por otro lado la infección temprana por VSR se ha asociado a episodios de sibilancias recurrentes y (3) asma El segundo patógeno más frecuentemente aislado en los pacientes con bronquiolitis es el rinovirus.…”

“…Varios factores se han asociado a la severidad de la bronquiolitis en países desarrollados, tales como antecedente de nacimiento de pretérmino, la presencia de comorbilidades, como cardiopatía congénita, inmunodeficiencias y enfermedades (6) pulmonares crónicas entre las más frecuentes . Por otro lado los lactantes con bronquiolitis, hijos de mujeres que fumaron durante el embarazo, tuvieron mayor riesgo de ingresar a la UCIP por dificultad (7) respiraría En países en desarrollo existen otros factores que afectan el riesgo de enfermedad respiratoria severa y que se asocian a mayor mortalidad, como el estrato socioeconómico, acceso a los servicios de salud, la vacunación , la lactancia (2,8) materna exclusiva entre otros .…”

Asthma and Allergies: From Diagnosis-Based Approach towards Personalised Treatments

“…The articles in this issue of the journal are describing various aspects related to this modern "epidemics", starting with a practical guidance on how to deal with patients with severe asthma (2,3), highlighting the advances related to virus-induced asthma exacerbations (4) and protective factors and mechanisms underpinning resistance to asthma (5,6), then moving on to a fascinating discussion on the importance of a healthy immune status and the development thereof (7). A particular emphasis has been given to the challenges facing the low-and middle-income countries (8,9). Finally, the focus shifts from respiratory diseases to the 'third wave' of the allergy epidemic (after increases in hay fever and asthma) -that of food (specifically peanut) allergy (10).…”

“…The focus of this special issue of the journal then moves on to the issues relevant to low-and middleincome countries (LMICs) (8,9). Soto-Mar tinez et al review the obstacles for achieving asthma control in LMICs, which include social, financial, cultural and healthcare barriers (8).…”

“…Lower respiratory tract illness (LRTI) caused by the respiratory syncytial virus (RSV) is a recognised risk factor for the development of asthma (64). The most hospitalisations and mortality from RSV-related diseases occur in LMICs, and Laudanno et al review the disparities in burden and outcomes of RSV LTRI between industrialised and developing countries, and highlight the need to identify specific risk factors in different populations for a targeted RSV LRTI prevention (9). To this end, the article reviews the current state of development of several vaccines to prevent RSV infection and monoclonal antibodies to prevent severe disease, which are in the late phase of clinical trials (64).…”