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. 2024 Sep;18(9):e70005.
doi: 10.1111/irv.70005.

Respiratory Viral Testing Rate Patterns in Young Children Attending Tertiary Care Across Western Australia: A Population-Based Birth Cohort Study

Belaynew W Taye  1   2 , Mohinder Sarna  1   2 , Huong Le  1   2 , Avram Levy  3   4 , Cara Minney-Smith  5 , Peter Richmond  1   6   7 , Robert Menzies  8 , Christopher C Blyth  1   5   6 , Hannah C Moore  1   2
Affiliations

Respiratory Viral Testing Rate Patterns in Young Children Attending Tertiary Care Across Western Australia: A Population-Based Birth Cohort Study

Belaynew W Taye et al. Influenza Other Respir Viruses. 2024 Sep.

Abstract

Background: An understanding of viral testing rates is crucial to accurately estimate the pathogen-specific hospitalisation burden. We aimed to estimate the patterns of testing for respiratory syncytial virus (RSV), influenza virus, parainfluenza virus (PIV) and human metapneumovirus (hMPV) by geographical location, age and time in children <5 years old in Western Australia.

Methods: We conducted a population-based cohort study of children born between 1 January 2010 and 31 December 2021, utilising linked administrative data incorporating birth and death records, hospitalisations and respiratory viral surveillance testing records from state-wide public pathology data. We examined within-hospital testing rates using survival analysis techniques and identified independent predictors of testing using binary logistic regression.

Results: Our dataset included 46,553 laboratory tests for RSV, influenza, PIV, or hMPV from 355,021 children (52.5% male). Testing rates declined in the metropolitan region over the study period (RSV testing in infants: from 242.11/1000 child-years in 2012 to 155.47/1000 child-years in 2018) and increased thereafter. Conversely, rates increased in non-metropolitan areas (e.g., RSV in Goldfields: from 364.92 in 2012 to 504.37/1000 child-years in 2021). The strongest predictors of testing were age <12 months (adjusted odds ratio [aOR] = 2.25, 95% CI 2.20-2.31), preterm birth (<32 weeks: aOR = 2.90, 95% CI 2.76-3.05) and remote residence (aOR = 0.77, 95% CI 0.73-0.81).

Conclusion: These current testing rates highlight the potential underestimation of respiratory virus hospitalisations by routine surveillance and the need for estimation of the true burden of respiratory virus admissions.

Keywords: Australia; geographic variation; respiratory virus; within‐hospital laboratory testing.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Data sources and study flowchart. The data sources presented in the figure are for the analysis to answer the main aim of the study. Data that were used to explain the interpretation of the study were presented in the supporting information. ED, emergency department.
FIGURE 2
FIGURE 2
Patterns of respiratory syncytial virus testing rate by age and time across regions of Western Australia. The lines present patterns of testing rates for children <12 months (blue), children 12–23 months of age (red), and children 24–59 months of age (green) in Perth metropolitan (A), Southwest (B), Kimberley (C), Pilbara (D), Wheatbelt (E), Goldfields (F), Midwest (G), and Great Southern (H).
FIGURE 3
FIGURE 3
Proportion of laboratory‐confirmed RSV hospitalisations for ICD‐coded admissions in children <5 years in the pre‐COVID era (2012–2019). The figures represent ICD‐coded hospitalisations/ED presentations including (A) bronchiolitis, (B) RSV bronchiolitis, (C) viral pneumonia, (D) RSV pneumonia. ICD, International Classification of Disease; RSV, respiratory syncytial virus.
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