Utility of RSV Rapid Diagnostic Assays in Hospitalized Children in Amman, Jordan.

BACKGROUND Respiratory syncytial virus(RSV) is the leading cause of acute respiratory infections in children worldwide and a frequent cause of hospitalization. Rapid diagnostic assays(RDAs) are available for RSV and help guide management; however, they are underutilized in developing countries. We compared molecular diagnostics to RSV RDA in hospitalized children in Amman, Jordan. MATERIALS AND METHODS Children under two years admitted with fever and/or respiratory symptoms were enrolled prospectively from March 2010-2012. Demographic and clinical data were collected through parent/guardian interviews and medical chart abstraction. RSV RDAs were performed, and nasal/throat swabs were tested for RSV using qRT-PCR. RESULTS RSV RDA and PCR were performed on specimens from 1,271 subjects. RSV RDA had a sensitivity of 26% and a specificity of 99% with positive and negative predictive values of 98.6% and 43%, respectively. RDA positive patients had fewer days of symptoms at presentation and were more likely to have a history of prematurity, lower birth weight, require supplemental oxygen, and a longer hospitalization compared to subjects with negative RDA. Multivariate analysis showed only lower birth weight, lack of cyanosis on exam, and lower cycle threshold to be independently associated with positive RDA (p≤ 0.001). CONCLUSION RSV RDAs had high specificity, but low sensitivity as compared to qRT-PCR. Positive RDA was associated with patients with more severe disease as indicated by oxygen use, longer length of stay, and higher viral load. Implementation of RDAs in developing countries could be an inexpensive and expedient method for predicting RSV disease severity and guiding management. This article is protected by copyright. All rights reserved.