{
  "abstract": "Background We estimated the incidence, viral aetiology and risk factors of acute lower respiratory infection (ALRI) and severe ALRI among community-dwelling older adults at four sites in India.Methods Adults ≥60 years were recruited and followed between July 2018 and March 2023. Each week, trained nurses screened all participants for ALRI using modified British Thoracic Society criteria. ALRI was further categorised as severe ALRI if the respiratory rate was >30 breaths per minute or the SPO 2 was <94% or the patient was hospitalised with respiratory symptoms. Combined nasal and throat swabs from ALRI cases were tested for multiple viral pathogens. The incidence of ALRI, severe ALRI and respiratory hospitalisation per 1000 person-years (TPY) was estimated. Adjusted rate ratios (aRR) were calculated by multilevel Poisson regression to identify risk factors for ALRI and severe ALRI.Results We followed 7240 participants for 19 914 person-years; 59.5% were women. Their mean age was 66.2 years. The incidence of ALRI, severe ALRI and respiratory hospitalisation was 98.0/TPYs, 22.1/TPYs and 12.1/TPYs, respectively. Males (aRR: 1.2), those with body mass index <18.5 kg/m 2 (aRR: 1.6) or ≥30 (aRR: 1.5), coronary artery disease (aRR: 1.5), current or past tuberculosis (aRR: 2.4), chronic respiratory disease (aRR: 5.4) and the use of solid fuel in the household (aRR: 2.0) had higher risk of severe ALRI. Viruses were detected in 16.8% of ALRI cases, influenza (8.8%) was the most detected viral pathogen followed by rhinovirus (2.7%).Conclusion Rates of ALRI and severe ALRI were high; malnutrition, chronic morbidities and the use of solid fuel were important risk factors for severe ALRI.",
  "authors": [
    {
      "affiliations": [
        "Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Rakesh Kumar"
    },
    {
      "affiliations": [
        "Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Ritvik Amarchand"
    },
    {
      "affiliations": [
        "Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Lalit Dar"
    },
    {
      "affiliations": [
        "ICMR - National Institute for Research in Bacterial Infections, Kolkata, West Bengal, India"
      ],
      "name": "Suman Kanungo"
    },
    {
      "affiliations": [
        "ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, India"
      ],
      "name": "Prabu Rajkumar"
    },
    {
      "affiliations": [
        "ICMR - National Institute of Virology, Pune, Maharashtra, India"
      ],
      "name": "Sumit Dutt Bhardwaj"
    },
    {
      "affiliations": [
        "Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Kusum Shekhawat"
    },
    {
      "affiliations": [
        "Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Aashish Choudhary"
    },
    {
      "affiliations": [
        "ICMR - National Institute of Virology, Pune, Maharashtra, India"
      ],
      "name": "Varsha Potdar"
    },
    {
      "affiliations": [
        "ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, India"
      ],
      "name": "Girish Kumar CP"
    },
    {
      "affiliations": [
        "ICMR - National Institute for Research in Bacterial Infections, Kolkata, West Bengal, India"
      ],
      "name": "Alok Kumar Chakrabarty"
    },
    {
      "affiliations": [
        "Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Giridara Gopal Parameswaran"
    },
    {
      "affiliations": [
        "Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Avinash Choudekar"
    },
    {
      "affiliations": [
        "Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Wajihul Khan"
    },
    {
      "affiliations": [
        "Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Shivram Dhakad"
    },
    {
      "affiliations": [
        "Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Anand Krishnan"
    }
  ],
  "title": "Incidence, risk factors and viral aetiology of lower respiratory infections among older adults: a 5-year multicentric cohort study in India",
  "uid": "2111458d-bef6-5d0b-800e-3c4be05eb89c"
}