Reeves, Rachel Melanie;
(2017)
Respiratory Syncytial Virus in Young Children in England - Burden and Risk Factors for Severe Disease.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Respiratory syncytial virus (RSV) is a major cause of respiratory infection in infants and young children. With potential vaccines on the horizon it is essential that RSV burden is accurately calculated by age and risk group to identify optimal target populations. My PhD investigates the secondary care burden of RSV in children younger than five years in England using routinely collected national laboratory surveillance and hospital admissions data. First, I explore the use of the individual datasets to describe RSV epidemiology. Second, I use ecological time series modelling to estimate the number of weekly hospital admissions attributable to RSV. Third, I use probabilistically linked laboratory and hospital data to describe laboratory-confirmed RSV-associated hospital admissions in England for the first time, and to determine risk factors for severe RSV-associated disease. Finally, from the linked data I generate a predictive model for RSV-associated admissions in infants, and use this to estimate the national burden of RSV-associated admissions by patient and clinical characteristics. I estimate an annual average of 33,500 (95% CI: 30,400-38,500) RSV-associated admissions in children younger than five years in England. 82% (95% CI: 79-87%) of admissions for bronchiolitis in children younger than six months could be attributed to RSV. My results highlight the importance of young age (<3 months) and birth around the beginning of RSV season in the risk of RSV-associated admission, and the importance of young age, prematurity and comorbidities in the increasing severity of disease. This is the first study to use linked laboratory surveillance and hospital admissions data for RSV in England. I have produced detailed, recent estimates of RSV-associated admissions in infants and young children using multiple methods, and highlight the strengths and limitations of using routinely collected data for RSV research. My results provide essential baseline epidemiological data required for vaccine impact studies.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Respiratory Syncytial Virus in Young Children in England - Burden and Risk Factors for Severe Disease |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Third party copyright material has been removed from ethesis. |
| UCL classification: | UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10040129 |
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