The epidemiology of respiratory syncytial virus (RSV) infections in South African children.

OBJECTIVES: To review the incidence, outcomes and risk factors associated with respiratory syncytial virus (RSV) infection in South African children.
DESIGN: Review of published literature and laboratory records.
METHODS: Review of the published literature. Articles listed on MEDLINE with 'South African' or 'children' and 'respiratory syncytial virus' or 'acute respiratory tract infections' as text words were retrieved. We analysed the data on respiratory virus activity from January 1990 to June 1996. Data were obtained from the National Institute for Virology database, which includes information on viral respiratory infections from the seven academic virology departments in South Africa.
RESULTS: Acute respiratory tract infections cause approximately 8% of all deaths in the under-5 age group in South Africa. The published hospital-based incidence of RSV infection varies from 3% to 18%. Mortality rates in these studies were between 12% and 43%. Risk factors identified for severe RSV infection requiring hospitalisation were malnutrition, prematurity, age < 6 months, vitamin A deficiency, environmental pollution and congenital heart disease. There is a seasonal peak in RSV cases, with the majority occurring in winter.
CONCLUSIONS: Acute respiratory tract infections and RSV infections are an important cause of mortality and morbidity in young children in South Africa. However, currently available information from laboratory records and published South African literature is not sufficient to assess the impact of this infection. Age-specific incidence data in the 0-5-year age group are essential for the rational planning and implementation of future vaccine strategies, public health interventions and treatment of RSV infections.