Epidemiology of respiratory syncytial virus infection in rural and urban Kenya

J Infect Dis. 2013 Dec 15;208 Suppl 3:S207-16. doi: 10.1093/infdis/jit489.


Background: Information on the epidemiology of respiratory syncytial virus (RSV) infection in Africa is limited for crowded urban areas and for rural areas where the prevalence of malaria is high.

Methods: At referral facilities in rural western Kenya and a Nairobi slum, we collected nasopharyngeal/oropharyngeal (NP/OP) swab specimens from patients with influenza-like illness (ILI) or severe acute respiratory illness (SARI) and from asymptomatic controls. Polymerase chain reaction assays were used for detection of viral pathogens. We calculated age-specific ratios of the odds of RSV detection among patients versus the odds among controls. Incidence was expressed as the number of episodes per 1000 person-years of observation.

Results: Between March 2007 and February 2011, RSV was detected in 501 of 4012 NP/OP swab specimens (12.5%) from children and adults in the rural site and in 321 of 2744 NP/OP swab specimens (11.7%) from those in the urban site. Among children aged <5 years, RSV was detected more commonly among rural children with SARI (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.2-3.3), urban children with SARI (OR, 8.5; 95% CI, 3.1-23.6), and urban children with ILI (OR, 3.4; 95% CI, 1.2-9.6), compared with controls. The incidence of RSV disease was highest among infants with SARI aged <1 year (86.9 and 62.8 episodes per 1000 person-years of observation in rural and urban sites, respectively).

Conclusions: An effective RSV vaccine would likely substantially reduce the burden of respiratory illness among children in rural and urban areas in Africa.

Keywords: Kenya; epidemiology; incidence; respiratory syncytial virus; rural; urban.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Kenya / epidemiology
  • Male
  • Population Surveillance / methods
  • Respiratory Syncytial Virus Infections / epidemiology*
  • Respiratory Syncytial Virus Infections / physiopathology
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Virus, Human / genetics
  • Respiratory Syncytial Virus, Human / isolation & purification*
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / physiopathology
  • Respiratory Tract Infections / virology
  • Rural Population / statistics & numerical data*
  • Severity of Illness Index
  • Urban Population / statistics & numerical data*
  • Young Adult