Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection (ALRI) in infants, especially among preterm infants. Existing guidelines on RSV prophylaxis differ greatly by gestational age (GA) and other underlying risk factors, highlighting the data gaps in RSV disease burden among preterm infants. With several novel RSV prophylactic products on the horizon, there is a need for a comprehensive understanding of the global RSV disease burden specifically for children who were born preterm. To this end, we will conduct a systematic review and individual participant data (IPD) meta-analysis. The main objective is to estimate the incidence, hospital admission, and in-hospital mortality for RSV-associated ALRI in preterm infants regionally and globally in 2019, overall and by GA. Secondary objectives are to: estimate RSV disease burden among preterm-born children under two years; identify subgroup(s) of preterm infants who are most vulnerable to RSV-ALRI and severe illnesses (e.g., underlying medical conditions and socio-economic factors); understand the risk profile for RSV disease by finer chronological age groups and GA groups; and understand the severity profile of RSV-associated ALRI in preterm-born children. Three databases, Medline, Embase, and Global Health, will be searched for relevant studies on RSV disease burden for 2019 or before in preterm-born children published between 1 Jan 1995 and 31 Dec 2021. IPD will be sought by contacting the investigators identified from published literature and from existing collaboration networks. Tailored templates are designed for data extraction from published literature and for collection of IPD. One-stage and two-stage random-effects meta-analyses will be used to combine information from IPD and non-IPD studies to produce summary estimates of incidence rate, hospital admission rate, and in-hospital case fatality ratio for RSV-associated ALRI. The framework will be extended to examine subgroup(s) with the most substantial RSV disease burden.
- global disease burden