hMPV-Associated ALRI
During the study period, 3,509 ALRI events were recorded at the study clinics. Of those events, 160 (4.6%) were associated with hMPV. Out of the total 564 hMPV positive cases, 160 (28%) were associated with an ALRI diagnosis (Supplemental Table 2). The incidence rate for hMPV-associated ALRI was 2.1 cases per 100 person-years (95% CI 1.9, 2.4). Of the 160 ALRI events, 7 (4.4 %) were severe enough to transfer the children to a hospital for further treatment. Like symptomatic hMPV cases, there were more ALRI events reported in males (N = 116, 42% of males with hMPV) in our study compared to females (N = 94, 33% of females with hMPV), however this difference was not significant. There was a significant difference in incidence rate observed between hMPV-associated ALRI episodes in those under one year of age compared to those over a year (Rate Ratio 5.5 95% CI 4.1, 7.4 p <0.001). For children under the age of one, 55% of all symptomatic hMPV episodes resulted in an ALRI event compared to just 33% for children over one.