RSV Bronchiolitis in 2018: a descriptive study of children admitted to two Johannesburg Tertiary Hospitals

Cleak, Tannah Storm
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Background. Respiratory Syncytial Virus (RSV) is the most common cause of severe bronchiolitis in children worldwide. Objectives. To describe clinical characteristics and outcomes of children hospitalized with bronchiolitis and to compare those with respiratory syncytial virus (RSV) bronchiolitis to children with other viral causes of bronchiolitis. Methods. A retrospective study of children admitted with virally screened bronchiolitis to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and Nelson Mandela Children’s Hospital (NMCH) from 01 February to 31 August 2018 was conducted, where RSV positive and negative children were compared. Results. A total of 131 children admitted with bronchiolitis from CMJAH and NMCH were compared in this study, 58 from CMJAH and 73 from NMCH. These children were identified by the National Health Laboratory Service as having undergone respiratory viral multiplex molecular assay analysis and hospital charts were retrospectively reviewed. In the sample group, 65 (49.6%) children had RSV in comparison to 66 (50.4%) children without RSV. Children with RSV consisted of 55 (42%) children with RSV only and 10 (7.6%) children with RSV in combination with another respiratory virus. Rhinovirus was the second most common virus detected (n=17, 12.9%) followed by adenovirus (n= 12, 9.2%) and coronavirus (n=9, 6.9%). A statistically significant risk factor noted in children requiring hospitalisation for RSV bronchiolitis was an age of less than six months (p-value <0.001). Conclusions. Bronchiolitis is a common disease in children. Respiratory syncytial virus is the most common cause of severe bronchiolitis in hospitalised infants less than six months of age.
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in Paediatrics to the Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Johannesburg, 2021