120 - Hospital admissions for acute respiratory tract infections among infants from Nunavut and the burden of respiratory syncytial virus: a 10-year review in regional and tertiary hospitals

Publication Number: 120.5157

Mai-Lei Woo Kinshella, University of British Columbia, Vancouver, BC, Canada; Jean Allen, Nunavut Tunngavik Inc., Iqaluit, NU, Canada; Jasmine Pawa, Multiple, Toronto, ON, Canada; Jesse Papenburg, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Radha Jetty, CHEO, Ottawa, ON, Canada; Rachel Dwilow, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Joanne Embree, University of Manitoba, Fredericton, NB, Canada; Joan L. Robinson, University of Alberta, Edmonton, AB, Canada; Laura Arbour, University of British Columbia Faculty of Medicine, Victoria, BC, Canada; Manish Sadarangani, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; YE SHEN, BC Children's Hospital Research Institute, Richmond, BC, Canada; Jeffrey N. Bone, BCCHR, Vancouver, BC, Canada; Celia R. Walker, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada; Iryna Kayda, University of British Columbia Faculty of Medicine, Perth, Western Australia, Australia; Holden Sheffield, University of Ottawa Faculty of Medicine, Iqaluit, NU, Canada; Darcy Scott, Northwest Territories Health and Social Services Authority, Yellowknife, NT, Canada; Amber Miners, Qikiqtani General Hospital, Iqaluit, NU, Canada; David M.. Goldfarb, BC Children’s Hospital, Vancouver, BC, Canada

Background: Nunavut is a northern Canadian territory where a high proportion of infants are admitted to hospital with acute respiratory tract infection (ARI). Previous studies have been limited in regional and/or short duration of coverage.

Objective: This study aimed to estimate the incidence rate, microbiology and outcomes of ARI hospitalizations in Nunavut infants.

Design/Methods: We conducted a retrospective cohort study of infants aged < 1 year from Nunavut hospitalized for ARI at two regional and four tertiary pediatric hospitals in Canada, January 1, 2010, to June 30, 2020. Descriptive statistics and multivariable logistic regression were performed.

Results: We identified 1189 ARI admissions, with an incidence rate of 133.9 per 1000 infants per year (95% confidence interval (CI): 126.8, 141.3). Of these admissions, 56.0% (n=666) were to regional hospitals alone, 72.3% (n=860) involved hospitalization outside of Nunavut, 15.6% (n=185) were admitted into intensive care, and 9.2% (n=109) underwent mechanical ventilation. Among 730 admissions with a pathogen identified, 45.8% had respiratory syncytial virus (RSV; n=334), for a yearly incidence rate of 37.8 RSV-associated hospitalizations per 1000 infants (95% CI: 33.9, 42.1). Among RSV-associated hospitalizations, 41.1% (n=138) were infants 0-2 months of age and 32.1% (n=108) were > 6months.

Conclusion(s): We found a high rate of ARI admissions among infants from Nunavut, with RSV being the leading pathogen identified, though fortunately with a relatively low rate of in hospital mortality in the ten-year period. Understanding the high burden of ARI among Nunavut infants can inform health policy and serve as a baseline for assessing the impact of any new interventions targeting infant ARIs.