Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age -- a systematic review and meta-analysis

Ivana Lukšić, Patrick K Kearns, Fiona Scott, Igor Rudan, Harry Campbell, Harish Nair

Research output: Contribution to journalArticlepeer-review

Abstract

Aim

To estimate the proportional contribution of influenza viruses (IV), parainfluenza viruses (PIV), adenoviruses (AV), and coronaviruses (CV) to the burden of severe acute lower respiratory infections (ALRI).

Methods

The review of the literature followed PRISMA guidelines. We included studies of hospitalized children aged 0-4 years with confirmed ALRI published between 1995 and 2011. A total of 51 studies were included in the final review, comprising 56 091 hospitalized ALRI episodes.

Results

IV was detected in 3.0% (2.2%-4.0%) of all hospitalized ALRI cases, PIV in 2.7% (1.9%-3.7%), and AV in 5.8% (3.4%-9.1%). CV are technically difficult to culture, and they were detected in 4.8% of all hospitalized ALRI patients in one study. When respiratory syncytial virus (RSV) and less common viruses were included, at least one virus was detected in 50.4% (40.0%-60.7%) of all hospitalized severe ALRI episodes. Moreover, 21.9% (17.7%-26.4%) of these viral ALRI were mixed, including more than one viral pathogen. Among all severe ALRI with confirmed viral etiology, IV accounted for 7.0% (5.5%-8.7%), PIV for 5.8% (4.1%-7.7%), and AV for 8.8% (5.3%-13.0%). CV was found in 10.6% of virus-positive pneumonia patients in one study.

Conclusions

This article provides the most comprehensive analysis of the contribution of four viral causes to severe ALRI to date. Our results can be used in further cost-effectiveness analyses of vaccine development and implementation for a number of respiratory viruses.
Original languageEnglish
Pages (from-to)122-34
Number of pages13
JournalCroatian Medical Journal
Volume54
Issue number2
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Adenoviridae
  • Child, Preschool
  • Coronavirus
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Orthomyxoviridae
  • Respiratory Distress Syndrome, Adult
  • Respirovirus

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