Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019
BackgroundBronchiolitis is the most common lower respiratory tract infection (LRTI) in children and is mainly caused by the Respiratory Syncytial Virus (RSV). Bronchiolitis presents seasonally and lasts about five months, usually between October to March, with peaks of hospitalizations between Decem...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1143735/full |
| _version_ | 1797833107017039872 |
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| author | Elisa Barbieri Sara Cavagnis Antonio Scamarcia Luigi Cantarutti Lorenzo Bertizzolo Mathieu Bangert Salvatore Parisi Anna Cantarutti Anna Cantarutti Eugenio Baraldi Carlo Giaquinto Vincenzo Baldo |
| author_facet | Elisa Barbieri Sara Cavagnis Antonio Scamarcia Luigi Cantarutti Lorenzo Bertizzolo Mathieu Bangert Salvatore Parisi Anna Cantarutti Anna Cantarutti Eugenio Baraldi Carlo Giaquinto Vincenzo Baldo |
| author_sort | Elisa Barbieri |
| collection | DOAJ |
| description | BackgroundBronchiolitis is the most common lower respiratory tract infection (LRTI) in children and is mainly caused by the Respiratory Syncytial Virus (RSV). Bronchiolitis presents seasonally and lasts about five months, usually between October to March, with peaks of hospitalizations between December and February, in the Northern Hemisphere. The burden of bronchiolitis and RSV in primary care is not well understood.Materials and methodsThis retrospective analysis used data from Pedianet, a comprehensive paediatric primary care database of 161 family paediatricians in Italy. We evaluated the incidence rates (IR) of all-cause bronchiolitis (ICD9-CM codes 466.1, 466.11 or 466.19), all-cause LRTIs, RSV-bronchiolitis and RSV-LRTIs in children from 0 to 24 months of age, between January 2012 to December 2019. The role of prematurity (<37 weeks of gestational age) as a bronchiolitis risk factor was evaluated and expressed as odds ratio.ResultsOf the 108,960 children included in the study cohort, 7,956 episodes of bronchiolitis and 37,827 episodes of LRTIs were recorded for an IR of 47 and 221 × 1,000 person-years, respectively. IRs did not vary significantly throughout the eight years of RSV seasons considered, showing a seasonality usually lasting five months, between October and March, while the peak of incidence was between December and February. Bronchiolitis and LRTI IRs were higher during the RSV season, between October and March, regardless of the month of birth, with bronchiolitis IR being higher in children aged ≤12 months. Only 2.3% of bronchiolitis and LRTI were coded as RSV-related. Prematurity and comorbidity increased the risk of bronchiolitis; however, 92% of cases happened in children born at term, and 97% happened in children with no comorbidities or otherwise healthy.ConclusionsOur results confirm that all children aged ≤24 months are at risk of bronchiolitis and LRTI during the RSV season, regardless of the month of birth, gestational age or underlying health conditions. The IRs of bronchiolitis and LRTI RSV-related are underestimated due to the poor outpatient epidemiological and virological surveillance. Strengthening the surveillance system at the paediatric outpatient level, as well as at the inpatient level, is needed to unveil the actual burden of RSV-bronchiolitis and RSV-LRTI, as well as to evaluate the effectiveness of new preventive strategies for anti-RSV. |
| first_indexed | 2024-04-09T14:18:23Z |
| format | Article |
| id | doaj.art-4aec840432804aeb9ff8599e7b7111f2 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-09T14:18:23Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-4aec840432804aeb9ff8599e7b7111f22023-05-05T05:10:14ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-05-011110.3389/fped.2023.11437351143735Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019Elisa Barbieri0Sara Cavagnis1Antonio Scamarcia2Luigi Cantarutti3Lorenzo Bertizzolo4Mathieu Bangert5Salvatore Parisi6Anna Cantarutti7Anna Cantarutti8Eugenio Baraldi9Carlo Giaquinto10Vincenzo Baldo11Division of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, Padua, ItalySocieta' Servizi Telematici - Pedianet, Padua, ItalySocieta' Servizi Telematici - Pedianet, Padua, ItalySocieta' Servizi Telematici - Pedianet, Padua, ItalySanofi Vaccines, Lyon, FranceSanofi Vaccines, Lyon, FranceSanofi Vaccines, Milan, ItalyUnit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, ItalyNational Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, ItalyNeonatal Intensive Care Unit, Department of Women's and Children's Health, University of Padua, Padua, ItalyDivision of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, Padua, ItalyDepartment of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, ItalyBackgroundBronchiolitis is the most common lower respiratory tract infection (LRTI) in children and is mainly caused by the Respiratory Syncytial Virus (RSV). Bronchiolitis presents seasonally and lasts about five months, usually between October to March, with peaks of hospitalizations between December and February, in the Northern Hemisphere. The burden of bronchiolitis and RSV in primary care is not well understood.Materials and methodsThis retrospective analysis used data from Pedianet, a comprehensive paediatric primary care database of 161 family paediatricians in Italy. We evaluated the incidence rates (IR) of all-cause bronchiolitis (ICD9-CM codes 466.1, 466.11 or 466.19), all-cause LRTIs, RSV-bronchiolitis and RSV-LRTIs in children from 0 to 24 months of age, between January 2012 to December 2019. The role of prematurity (<37 weeks of gestational age) as a bronchiolitis risk factor was evaluated and expressed as odds ratio.ResultsOf the 108,960 children included in the study cohort, 7,956 episodes of bronchiolitis and 37,827 episodes of LRTIs were recorded for an IR of 47 and 221 × 1,000 person-years, respectively. IRs did not vary significantly throughout the eight years of RSV seasons considered, showing a seasonality usually lasting five months, between October and March, while the peak of incidence was between December and February. Bronchiolitis and LRTI IRs were higher during the RSV season, between October and March, regardless of the month of birth, with bronchiolitis IR being higher in children aged ≤12 months. Only 2.3% of bronchiolitis and LRTI were coded as RSV-related. Prematurity and comorbidity increased the risk of bronchiolitis; however, 92% of cases happened in children born at term, and 97% happened in children with no comorbidities or otherwise healthy.ConclusionsOur results confirm that all children aged ≤24 months are at risk of bronchiolitis and LRTI during the RSV season, regardless of the month of birth, gestational age or underlying health conditions. The IRs of bronchiolitis and LRTI RSV-related are underestimated due to the poor outpatient epidemiological and virological surveillance. Strengthening the surveillance system at the paediatric outpatient level, as well as at the inpatient level, is needed to unveil the actual burden of RSV-bronchiolitis and RSV-LRTI, as well as to evaluate the effectiveness of new preventive strategies for anti-RSV.https://www.frontiersin.org/articles/10.3389/fped.2023.1143735/fullbronchiolitisepidemiologyItalyrespiratory syncytial viruschildrenlower respiratory tract infection (LRTI) |
| spellingShingle | Elisa Barbieri Sara Cavagnis Antonio Scamarcia Luigi Cantarutti Lorenzo Bertizzolo Mathieu Bangert Salvatore Parisi Anna Cantarutti Anna Cantarutti Eugenio Baraldi Carlo Giaquinto Vincenzo Baldo Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019 Frontiers in Pediatrics bronchiolitis epidemiology Italy respiratory syncytial virus children lower respiratory tract infection (LRTI) |
| title | Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019 |
| title_full | Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019 |
| title_fullStr | Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019 |
| title_full_unstemmed | Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019 |
| title_short | Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012–2019 |
| title_sort | assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in italy 2012 2019 |
| topic | bronchiolitis epidemiology Italy respiratory syncytial virus children lower respiratory tract infection (LRTI) |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1143735/full |
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