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Predictors of Poor Outcomes Among Infants With Respiratory Syncytial Virus–associated Acute Lower Respiratory Infection in Botswana

Patel, Sweta M., MD*; Spees, Lisa, PhD; Smieja, Marek, MD; Luinstra, Kathy, BSc; Steenhoff, Andrew P., MBBCh§,¶; Feemster, Kristen A., MD§,¶; Arscott-Mills, Tonya, MD§,‖; Boiditswe, Sefelani, BNSc; Patel, Mohamed Z., MBBCh**; Shah, Samir S., MD††,‡‡; Cunningham, Coleen K., MD§§; Kelly, Matthew S., MD§§

The Pediatric Infectious Disease Journal: May 2019 - Volume 38 - Issue 5 - p 525–527
doi: 10.1097/INF.0000000000002168
Maternal-Neonatal Reports
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Among children 1–23 months of age with respiratory syncytial virus–associated acute lower respiratory infection in Botswana, young age (<6 months), household use of wood as a cooking fuel, moderate or severe malnutrition and oxygen saturation <90% on room air were independent predictors of clinical nonresponse at 48 hours. Among HIV-uninfected infants less than six months of age, HIV exposure was associated with a higher risk of in-hospital mortality.

From the *Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University, Durham, North Carolina

The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada

§Global Health Center

Division of Infectious Diseases, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Botswana-UPenn Partnership, Gaborone, Botswana

**University of Botswana School of Medicine, Gaborone, Botswana

††Division of Hospital Medicine

‡‡Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

§§Division of Pediatric Infectious Diseases, Duke University, Durham, North Carolina.

Accepted for publication July 15, 2018.

Supported by an Early Career Award from the Thrasher Research Fund (to M.S.K.), a Burroughs Wellcome/American Society of Tropical Medicine and Hygiene Postdoctoral Fellowship in Tropical Infectious Diseases (to M.S.K.), Children’s Hospital of Philadelphia (to A.P.S. and K.A.F.), the Pincus Family Foundation and through core services from the Penn Center for AIDS Research, a National Institutes of Health (NIH)–funded program (P30-AI045008). Funding for this project was also made possible in part by a CIPHER grant (to M.S.K.) from the International AIDS Society, supported by ViiV Healthcare. The views expressed in this publication do not necessarily reflect the official policies of the International AIDS Society or ViiV Healthcare. M.S.K. and C.K.C. received financial support from the NIH through the Duke Center for AIDS Research (P30-AI064518). T.A.-M. and A.P.S. received financial support from the NIH through the Penn Center for AIDS Research (P30-AI045008). L.S. was supported by a National Service Research Award Post-Doctoral Traineeship from the Agency for Healthcare Research and Quality sponsored by Cecil G. Sheps Health Services Research, University of North Carolina at Chapel Hill (5T32 HS000032-28). M.S.K. was supported by NIH T32 training grants (5T32-HD060558-04 and 5T32-HD043029-13). S.M.P. was supported by a NIH T32 training grant (5T32-HL007538-33).

The authors have no conflicts of interest to disclose.

Address for correspondence: Sweta M. Patel, MD, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University, DAAAC Box 3810, 1821 Hillandale Road, #25-A, Durham, NC 27705. E-mail: sweta.patel@duke.edu.

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