Population-based incidence and etiology of community-acquired neonatal viral infections in Bangladesh: A community-based and hospital-based surveillance study

Azadeh Farzin, Samir K. Saha, Abdullah H. Baqui, Yoonjoung Choi, Nawshad Uddin Ahmed, Eric A.F. Simoes, Shams El Arifeen, Hassan M. Al-Emran, Sanwarul Bari, Syed M. Rahman, Ishtiaq Mannan, Derrick Crook, Habibur Rahman Seraji, Nazma Begum, Robert E. Black, Mathuram Santosham, Gary L. Darmstadt

Research output: Contribution to journalArticle

Abstract

Background: The etiology of >90% of cases of suspected neonatal infection remains unknown. We conducted community-based surveillance in conjunction with hospital-based surveillance in a rural region in Bangladesh from June 2006 to September 2007 to assess the incidence and etiology of community-acquired viral infections among neonates. Methods: Community health workers (CHWs) assessed neonates at home on days 0, 2, 5 and 8 after birth and referred cases of suspected illness to the hospital (CHW surveillance). Among neonates with clinically suspected upper respiratory tract infection (URTI), pneumonia, sepsis and/or meningitis, virus identification studies were conducted on nasal wash, cerebrospinal fluid and/or blood specimens. In the hospital-based surveillance, similar screening was conducted among all neonates (referred by CHWs and self-referred) who were admitted to the hospital. Results: CHW surveillance found an incidence rate of 15.6 neonatal viral infections per 1000 live births with 30% of infections identified on the day of birth. Among neonates with suspected sepsis, a viral etiology was identified in 36% of cases, with enterovirus accounting for two-thirds of those infections. Respiratory syncytial virus was the most common etiologic agent among those with viral pneumonia (91%) and URTI (68%). There was a low incidence (1.2%) of influenza in this rural population. Conclusion: Viral infections are commonly associated with acute newborn illness, even in the early neonatal period. The estimated incidence was 5-fold greater than reported previously for bacterial infections. Low-cost preventive measures for neonatal viral infections are urgently needed.

Original languageEnglish (US)
Pages (from-to)706-711
Number of pages6
JournalPediatric Infectious Disease Journal
Volume34
Issue number7
DOIs
StatePublished - Jul 4 2015

Keywords

  • Bangladesh
  • community surveillance
  • early-onset infection
  • infection
  • neonatal
  • viral

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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    Farzin, A., Saha, S. K., Baqui, A. H., Choi, Y., Ahmed, N. U., Simoes, E. A. F., El Arifeen, S., Al-Emran, H. M., Bari, S., Rahman, S. M., Mannan, I., Crook, D., Seraji, H. R., Begum, N., Black, R. E., Santosham, M., & Darmstadt, G. L. (2015). Population-based incidence and etiology of community-acquired neonatal viral infections in Bangladesh: A community-based and hospital-based surveillance study. Pediatric Infectious Disease Journal, 34(7), 706-711. https://doi.org/10.1097/INF.0000000000000726