Developing a prediction model to estimate the true burden of respiratory syncytial virus (RSV) in hospitalised children in Western Australia

被引:22
作者
Gebremedhin, Amanuel Tesfay [1 ]
Hogan, Alexandra B. [2 ]
Blyth, Christopher C. [1 ,3 ,4 ,5 ]
Glass, Kathryn [6 ]
Moore, Hannah C. [1 ]
机构
[1] Univ Western Australia, Telethon Kids Inst, Wesfarmers Ctr Vaccines & Infect Dis, Perth, WA 6872, Australia
[2] Imperial Coll London, Sch Publ Hlth, MRC Ctr Global Infect Dis Anal, London, England
[3] Univ Western Australia, Sch Med, Perth, WA, Australia
[4] Perth Childrens Hosp, Dept Infect Dis, Perth, WA, Australia
[5] QEII Med Ctr, PathWest Lab Med, Nedlands, WA, Australia
[6] Australian Natl Univ, Res Sch Populat Hlth, Canberra, ACT, Australia
基金
英国医学研究理事会;
关键词
RECORD LINKAGE; YOUNG-CHILDREN; INFECTION; INFANTS; BRONCHIOLITIS; EPIDEMIOLOGY; GESTATION; DISEASE; BORN;
D O I
10.1038/s41598-021-04080-3
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Respiratory syncytial virus (RSV) is a leading cause of childhood morbidity, however there is no systematic testing in children hospitalised with respiratory symptoms. Therefore, current RSV incidence likely underestimates the true burden. We used probabilistically linked perinatal, hospital, and laboratory records of 321,825 children born in Western Australia (WA), 2000-2012. We generated a predictive model for RSV positivity in hospitalised children aged < 5 years. We applied the model to all hospitalisations in our population-based cohort to determine the true RSV incidence, and under-ascertainment fraction. The model's predictive performance was determined using cross-validated area under the receiver operating characteristic (AUROC) curve. From 321,825 hospitalisations, 37,784 were tested for RSV (22.8% positive). Predictors of RSV positivity included younger admission age, male sex, non-Aboriginal ethnicity, a diagnosis of bronchiolitis and longer hospital stay. Our model showed good predictive accuracy (AUROC: 0.87). The respective sensitivity, specificity, positive predictive value and negative predictive values were 58.4%, 92.2%, 68.6% and 88.3%. The predicted incidence rates of hospitalised RSV for children aged < 3 months was 43.7/1000 child-years (95% CI 42.1-45.4) compared with 31.7/1000 child-years (95% CI 30.3-33.1) from laboratory-confirmed RSV admissions. Findings from our study suggest that the true burden of RSV may be 30-57% higher than current estimates.
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页数:12
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