• Anja Poulsen, Lone Graff Stensballe, Jens Nielsen, Christine Stabell Benn, Aliu Balde, Adam Roth, Ida Maria Lisse, and Peter Aaby.
• Projecto de Saude de Bandim, Guinea-Bissau, Copenhagen, Denmark. anja@dadlnet.dk
• Pediatr. Infect. Dis. J. 2006 Nov 1; 25 (11): 1025-31.

AimThe study aimed to investigate long-term consequences of respiratory syncytial virus (RSV) positive acute lower respiratory tract infection (ALRI) in a low-income country according to severity of the initial infection.DesignThe study was a 1:1 matched case-control study of 335 RSV case children and 335 control children. The mean age of RSV ALRI was 0.9 year and at follow-up, 6.8 years. Case children were identified at the hospital and in the community with an antigen and an IgM test to diagnose RSV. Severe RSV infection was defined when a child was treated at the hospital, whereas disease was assumed less severe when a child was diagnosed at home and received no care in the hospital.ResultsAt follow-up, forced expiratory volume in 1 second (FEV1) and peak flow were significantly lower in case children (odds ratio [OR] = 0.28; 95% confidence interval [CI] 0.10-0.79), the effect being particularly marked for children with severe RSV. Bronchitis at follow-up was reported more frequently among the case children with severe disease. Fewer case children had a positive skin-prick test for local allergens than control children (OR 0.64; 95% CI = 0.44-0.94). Specific IgE for dust mites and cockroach was elevated (52%) in both case and control children. However, specific IgE to peppertree was higher in the case children (OR 2.18; 95% CI = 1.17-4.07). All identified differences were particularly marked for children with severe RSV.ConclusionSevere RSV infection in infancy was associated with decreased lung function in preschool age in Guinea-Bissau. Children with severe RSV disease had more long-term health problems than children with less severe disease.

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