Incidence of respiratory virus-associated pneumonia in urban poor young children of Dhaka, Bangladesh, 2009-2011

Nusrat Homaira, Stephen P Luby, William A Petri, Raija Vainionpaa, Mustafizur Rahman, Kamal Hossain, Cynthia B Snider, Mahmudur Rahman, A S M Alamgir, Farzina Zesmin, Masud Alam, Emily S Gurley, Rashid Uz Zaman, Tasnim Azim, Dean D Erdman, Alicia M Fry, Joseph Bresee, Marc-Alain Widdowson, Rashidul Haque, Eduardo Azziz-Baumgartner

Research output: Contribution to journalA1: Web of Science-articlepeer-review


BACKGROUND: Pneumonia is the leading cause of childhood death in Bangladesh. We conducted a longitudinal study to estimate the incidence of virus-associated pneumonia in children aged <2 years in a low-income urban community in Dhaka, Bangladesh.

METHODS: We followed a cohort of children for two years. We collected nasal washes when children presented with respiratory symptoms. Study physicians diagnosed children with cough and age-specific tachypnea and positive lung findings as pneumonia case-patients. We tested respiratory samples for respiratory syncytial virus (RSV), rhinoviruses, human metapneumovirus (HMPV), influenza viruses, human parainfluenza viruses (HPIV 1, 2, 3), and adenoviruses using real-time reverse transcription polymerase chain reaction assays.

RESULTS: Between April 2009-March 2011, we followed 515 children for 730 child-years. We identified a total of 378 pneumonia episodes, 77% of the episodes were associated with a respiratory viral pathogen. The overall incidence of pneumonia associated with a respiratory virus infection was 40/100 child-years. The annual incidence of pneumonia/100 child-years associated with a specific respiratory virus in children aged < 2 years was 12.5 for RSV, 6 for rhinoviruses, 6 for HMPV, 4 for influenza viruses, 3 for HPIV and 2 for adenoviruses.

CONCLUSION: Young children in Dhaka are at high risk of childhood pneumonia and the majority of these episodes are associated with viral pathogens. Developing effective low-cost strategies for prevention are a high priority.

Original languageEnglish
Article numbere32056
JournalPLoS ONE
Issue number2
Publication statusPublished - 2012


  • Adenoviridae/genetics
  • Child
  • Cohort Studies
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Metapneumovirus/genetics
  • Orthomyxoviridae/genetics
  • Pneumonia, Viral/epidemiology
  • Poverty
  • Real-Time Polymerase Chain Reaction/methods
  • Respiratory Syncytial Viruses/genetics
  • Respiratory Tract Infections/epidemiology
  • Respirovirus/genetics
  • Rhinovirus/genetics
  • Risk Factors
  • Urban Population


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