{
  "abstract": "Introduction Respiratory tract infections (RTIs) cause significant child morbidity and mortality. Periodical influenza vaccination and respiratory syncytial virus (RSV) prophylaxis can reduce this burden in risk groups. However, in the Caribbean, the optimal timing of these interventions is unclear due to a lack of epidemiological data. We aimed to investigate pathogens associated with RTI disease burden and pathogen specific seasonality in the Caribbean in the context of COVID-19 to achieve optimal timing of preventive measures.Methods We conducted a retrospective study using patient records and pathogen detection data from St. Maarten Medical Center from 1 September 2018 to 1 September 2023. We performed regression to associate pathogens with outcomes and seasonality.Results RTI diagnoses accounted for 50.8% (N=7380) of outpatient cases and 28.0% (N=508) of inpatient cases. RSV and rhino/enterovirus were associated with more frequent oxygen requirement (OR 5.1 (95% CI 2.3 to 11) and OR 2.3 (95% CI 1.2 to 4.3), respectively) and tachypnoea/dyspnoea (OR 4.9 (95% CI 2.0 to 13) and OR 2.8 (95% CI 1.6 to 5.2), respectively) than other pathogens post-COVID-19. RSV consistently peaked during June/July and September/October, preceding RSV prophylaxis administration in October.Conclusions The overall burden on the healthcare system due to RTI visits and admissions was high. Higher disease severity was associated with RSV and rhino/enterovirus infections; therefore, universal RSV prophylaxis should be considered, and timing should be optimised based on seasonality.",
  "authors": [
    {
      "affiliations": [
        "Laboratory of Medical Immunology, Radboudumc, Nijmegen, Netherlands"
      ],
      "name": "Sam Engels"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Martijn Tilanus"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Juldany Juliet"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Marquita Euson"
    },
    {
      "affiliations": [
        "Laboratory of Medical Immunology, Radboudumc, Nijmegen, Netherlands"
      ],
      "name": "Nika Stastny"
    },
    {
      "affiliations": [
        "Laboratory of Medical Immunology, Radboudumc, Nijmegen, Netherlands",
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Charlene Maria"
    },
    {
      "affiliations": [
        "St. Eustatius Health Care Foundation, Oranjestad, Sint Eustatius and Saba, Netherlands"
      ],
      "name": "Sharda Baboe-Kalpoe"
    },
    {
      "affiliations": [
        "St. Eustatius Health Care Foundation, Oranjestad, Sint Eustatius and Saba, Netherlands"
      ],
      "name": "Fazal Baboe"
    },
    {
      "affiliations": [
        "St. Maarten Laboratory Services, Cay Hill, Sint Maarten"
      ],
      "name": "Chérina K A Fleming"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Sherryl Carty-Fleming"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Shanna Holaman"
    },
    {
      "affiliations": [
        "Laboratory of Medical Immunology, Radboudumc, Nijmegen, Netherlands"
      ],
      "name": "Kaylee Baan"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten"
      ],
      "name": "Felix Holiday"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten",
        "Ear, Nose, Throat Department, Canisius Wilhelmina Ziekenhuis, Nijmegen, Netherlands"
      ],
      "name": "Sebastiaan C F Van den Borne"
    },
    {
      "affiliations": [
        "Ear, Nose, Throat Department, Canisius Wilhelmina Ziekenhuis, Nijmegen, Netherlands"
      ],
      "name": "Rutger F Plantinga"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten",
        "De Vijf Meren Kliniek, Haarlem, Netherlands"
      ],
      "name": "Dick Wong Chung"
    },
    {
      "affiliations": [
        "Department of Pediatric Infectious Diseases and Immunology, Amalia Children's Hospital, Radboudumc, Nijmegen, Netherlands"
      ],
      "name": "Josephine van de Maat"
    },
    {
      "affiliations": [
        "Laboratory of Medical Immunology, Radboudumc, Nijmegen, Netherlands"
      ],
      "name": "Marien I de Jonge"
    },
    {
      "affiliations": [
        "St. Maarten Medical Center, Cay Hill, Sint Maarten",
        "St. Maarten Laboratory Services, Cay Hill, Sint Maarten",
        "Fundashon Mariadal, Kralendijk, Bonaire, Netherlands"
      ],
      "name": "Radjin Steingrover"
    },
    {
      "affiliations": [
        "Laboratory of Medical Immunology, Radboudumc, Nijmegen, Netherlands",
        "St. Maarten Medical Center, Cay Hill, Sint Maarten",
        "Department of Pediatric Infectious Diseases and Immunology, Amalia Children's Hospital, Radboudumc, Nijmegen, Netherlands"
      ],
      "name": "Lilly M Verhagen"
    }
  ],
  "title": "Association between common respiratory pathogens and disease severity, and pathogen-specific seasonality in the Caribbean pre-COVID-19 and post-COVID-19: a retrospective study",
  "uid": "cc8394d2-9c1a-5def-af4e-6fcecf10b452"
}