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REVIEW article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Volume 12 - 2024 |
doi: 10.3389/fped.2024.1452267
Respiratory syncytial virus burden in children under 2 years old in understudied areas worldwide: gap analysis of available evidence
Provisionally accepted- 1 Pfizer (Brazil), Sao Paula, Brazil
- 2 IQVIA (Portugal), Porto Salvo, Portugal
- 3 Pfizer, New York, New York, United States
- 4 Pfizer (Canada), Kirkland, Quebec, Canada
- 5 Pfizer (Colombia), Bogota, Colombia
- 6 Pfizer (Saudi Arabia), Riyadh, Saudi Arabia
- 7 Pfizer (Singapore), Singapore, Singapore
- 8 Pfizer Inc., Paris, Île-de-France, France
Background: We evaluated published evidence (2012-2022) on pediatric RSV burden in 149 countries within World Health Organization (WHO) regions of Africa (AFRO), Americas (AMRO, excluding USA and Canada), Eastern Mediterranean (EMRO), Europe (EURO, excluding European Union), Southeast Asia (SEARO), and Western Pacific (WPRO, excluding Australia, China, Japan, New Zealand, and South Korea). Methods: Gap analysis on RSV-associated disease (hospitalizations, hospital course, mortality or case fatality, detection, and incidence) in children ≤2 years old, where hospitalization rates, hospital course, mortality rate, case fatality ratio (CFR), and postmortem detection rates were summarized, by region, for each country. Results: Forty-two publications were identified covering 19% of included countries in AFRO, 18% in AMRO, 14% in EMRO, 15% in EURO, 18% in SEARO, and 13% in WPRO. Methods, case definitions, and age groups varied widely across studies. Of these 42 publications, 32 reported either hospitalization rate, hospital course, mortality rate, CFR, or postmortem detection rate. RSV-hospitalization rate (per 1,000 children per year/child-years) was higher among ≤3-month-olds (range, 38 in Nicaragua to 138 in the Philippines) and ≤6-month-olds (range, 2.6 in Singapore to 70 in South Africa) than in 1–2-year-olds (from 0.7 in Guatemala to 19 in Nicaragua). Based on 11 studies, in AFRO (South Africa), AMRO (Chile and Mexico), EMRO (Lebanon and Jordan), EURO (Turkey and Israel), and SEARO (India), hospitalized children ≤2 years old remained hospitalized for 3–8 days, with 9–30% requiring intensive care and 4–26% needing mechanical ventilation. Based on a study in India, community-based CFR was considerably higher than that in the hospital (9.1% vs. 0% in ≤3-month-olds; 7.1% vs. 2.8% in ≤6-month-olds). Conclusions: National and regional heterogeneity of evidence limits estimates of RSV burden in ≤2-year-olds in many WHO regions, where further country-specific epidemiology is needed to guide prioritization, implementation, and impact assessment of RSV-prevention strategies.
Keywords: respiratory syncytial virus, Gap analysis, Hospitalization rate, Mortality, infants, Lower respiratory tract infections, Bronchiolitis, Pneumonia
Received: 20 Jun 2024; Accepted: 14 Oct 2024.
Copyright: © 2024 Sini De Almeida, Leite, Atwell, Elsobky, La Rotta, Mousa, Thakkar and Fletcher. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Rodrigo Sini De Almeida, Pfizer (Brazil), Sao Paula, Brazil
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