Respiratory syncytial virus (RSV) is the predominant viral pathogen associated with acute lower respiratory infection (ALRI) in children under five years of age (<5y). Little is reported on the national estimates of RSV-ALRI hospital admissions in <5y based on robust RSV epidemiology data.
We included data on RSV and ALRI hospital admission in <5y from systematic literature reviews (including unpublished data) and from clinical databases. We used two different methods, namely the rate-based method and the proportion-based method, to estimate national RSV-ALRI admissions in <5y in the year 2019 among countries with robust data. The rate-based method synthesized data on laboratory-confirmed RSV-ALRI hospitalisation rates using a spatiotemporal Gaussian process meta-regression (ST-GPR). The proportion-based method applied data on RSV positive proportions among ALRI to all-cause ALRI admission envelopes using a Bayesian regularized trimmed meta-regression (MR-BRT). Where applicable, we reported estimates by both methods in order to provide a plausible range for each included country.
A total of 334 studies and 1985 data points from 58 countries were included in the analysis, accounting for 58% of the <5y population worldwide. The number of the annual national RSV-ALRI hospitalisations in <5y ranged from 0·06 thousand (95% confidence interval [CI]: 0·02–0·14) in Iceland to 936·29 thousand (95% CI: 261·23–2151·83) in China. Despite great variation among countries, a high proportion of <5 of RSV-ALRI hospitalisations were in infants <1y in all countries (median proportion: 46%, interquartile range: 32–57). In most (76%) years, RSV-ALRI hospitalisation rate fluctuated between 80% and 120% of the country’s median yearly rate. General agreement was observed between estimates by the rate method and proportion method, with a few exceptions in India, Kenya, Norway and Philippines. The estimates by the rate-based method and by the proportion-based method could be extrapolated to a global estimate of 4·1 million (95% CI: 3·8–4·5) and 2·7 million 95% CI: 1·7–5·2) RSV-ALRI hospitalisations in <5y, respectively.
By incorporating data from various sources, our study provides robust estimates on the national burden of RSV-ALRI admissions in <5y. These estimates are important for informing policy for introduction of RSV immunisations and also serve as baseline data for assessing the effectiveness of implementing RSV immunisation programmes.
The Foundation for Influenza Epidemiology
Li, You. (2020). National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in 2019: the Burden of Influenza and RSV Disease (BIRD) study [dataset]. University of Edinburgh. College of Medicine & Veterinary Medicine. https://doi.org/10.7488/ds/2802
|Date made available||31 Aug 2020|
|Temporal coverage||2019 - 2019|
|Geographical coverage||Global,58 countries|