Environmental and demographic risk factors for respiratory syncytial virus lower respiratory tract disease
Section snippets
Methods
A MEDLINE search was performed, using the following search terms: “respiratory syncytial virus” or “RSV infection,” and the following individual risk terms: “crowding,” “day care,” “socioeconomic status,” “RSV season,” “malnutrition,” “breast-feeding,” “siblings,” “race,” and “smoking” (accessed on April 15, 2003). Studies were limited to those that referred to human beings and were published between 1970 and April 2003. The abstracts of all articles were reviewed, and the complete texts of all
Results
Of the 228 publications identified through MedLine, 152 were excluded because they were either reviews, laboratory-based studies, addressed RSV only peripherally or the role of RSV was not identifiable and bronchiolitis was not an end point, described randomized controlled trials where studies were performed on children hospitalized with RSV or bronchiolitis, or were primarily cost-effectiveness studies of various therapeutic and prophylactic agents that did not directly examine the role of
Conclusions
Certain risk factors have been consistently found in studies to be important risk factors for severe RSV, such as male sex, young age, birth during the start of the RSV season, day care and crowding/siblings, and breast-feeding. (Table III). There is insufficient evidence at this time to unequivocally implicate lack of breast-feeding and tobacco smoke exposure as risk factors for the development of severe RSV LRI. Future studies should collect detailed data that quantify and qualify the
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