Pediatric Respiratory and Enteric Virus Acquisition and Immunogenesis in US Mothers and Children Aged 0-2: PREVAIL Cohort Study

Bibliographic Details
Title: Pediatric Respiratory and Enteric Virus Acquisition and Immunogenesis in US Mothers and Children Aged 0-2: PREVAIL Cohort Study
Authors: Morrow, Ardythe L, Staat, Mary A, DeFranco, Emily A, McNeal, Monica M, Cline, Allison R, Conrey, Shannon C, Schlaudecker, Elizabeth P, Piasecki, Alexandra M, Burke, Rachel M, Niu, Liang, Hall, Aron J, Bowen, Michael D, Gerber, Susan I, Langley, Gayle E, Thornburg, Natalie J, Campbell, Angela P, Vinjé, Jan, Parashar, Umesh D, Payne, Daniel C
Source: JMIR Research Protocols, Vol 10, Iss 2, p e22222 (2021)
Publisher Information: JMIR Publications, 2021.
Publication Year: 2021
Collection: LCC:Medicine
LCC:Computer applications to medicine. Medical informatics
Subject Terms: Medicine, Computer applications to medicine. Medical informatics, R858-859.7
More Details: BackgroundAcute gastroenteritis (AGE) and acute respiratory infections (ARIs) cause significant pediatric morbidity and mortality. Developing childhood vaccines against major enteric and respiratory pathogens should be guided by the natural history of infection and acquired immunity. The United States currently lacks contemporary birth cohort data to guide vaccine development. ObjectiveThe PREVAIL (Pediatric Respiratory and Enteric Virus Acquisition and Immunogenesis Longitudinal) Cohort study was undertaken to define the natural history of infection and immune response to major pathogens causing AGE and ARI in US children. MethodsMothers in Cincinnati, Ohio, were enrolled in their third trimester of pregnancy, with intensive child follow-up to 2 years. Blood samples were obtained from children at birth (cord), 6 weeks, and 6, 12, 18, and 24 months. Whole stool specimens and midturbinate nasal swabs were collected weekly and tested by multipathogen molecular assays. Saliva, meconium, maternal blood, and milk samples were also collected. AGE (≥3 loose or watery stools or ≥1 vomiting episode within 24 hours) and ARI (cough or fever) cases were documented by weekly cell phone surveys to mothers via automated SMS text messaging and review of medical records. Immunization records were obtained from registries and providers. follow-up ended in October 2020. Pathogen-specific infections are defined by a PCR-positive sample or rise in serum antibody. ResultsOf the 245 enrolled mother–child pairs, 51.8% (n=127) were White, 43.3% (n=106) Black, 55.9% (n=137) publicly insured, and 86.5% (n=212) initiated breastfeeding. Blood collection was 100.0% for mothers (n=245) and 85.7% for umbilical cord (n=210). A total of 194/245 (79.2%) mother–child pairs were compliant based on participation in at least 70% (≥71/102 study weeks) of child-weeks and providing 70% or more of weekly samples during that time, or blood samples at 18 or 24 months. Compliant participants (n=194) had 71.0% median nasal swab collection (IQR 30.0%-90.5%), with 98.5% (191/194) providing either an 18- or 24-month blood sample; median response to weekly SMS text message surveys was 95.1% (IQR 76.5%-100%). Compliant mothers reported 2.0 AGE and 4.5 ARI cases per child-year, of which 25.5% (160/627) and 38.06% (486/1277) of cases, respectively, were medically attended; 0.5% of AGE (3/627) and 0.55% of ARI (7/1277) cases were hospitalized. ConclusionsThe PREVAIL Cohort demonstrates intensive follow-up to document the natural history of enteric and respiratory infections and immunity in children 0-2 years of age in the United States and will contribute unique data to guide vaccine recommendations. Testing for pathogens and antibodies is ongoing. International Registered Report Identifier (IRRID)RR1-10.2196/22222
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1929-0748
Relation: http://www.researchprotocols.org/2021/2/e22222/; https://doaj.org/toc/1929-0748
DOI: 10.2196/22222
Access URL: https://doaj.org/article/5c5353a613224390a74ef0859cb82532
Accession Number: edsdoj.5c5353a613224390a74ef0859cb82532
Database: Directory of Open Access Journals
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More Details
ISSN:19290748
DOI:10.2196/22222
Published in:JMIR Research Protocols
Language:English