Lukšić Ivana, Kearns Patrick K, Scott Fiona, Rudan Igor, Campbell Harry, Nair Harish
Ivana Luksic, Institute of Publich Health Dr. Andrija Štampar, Department of Microbiology, Mirogojska cesta 16, 10000 Zagreb, Croatia.
Croat Med J. 2013 Apr;54(2):122-34. doi: 10.3325/cmj.2013.54.122.
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).
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 56091 hospitalized ALRI episodes.
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.
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.
评估流感病毒（IV）、副流感病毒（PIV）、腺病毒（AV）和冠状病毒（CV）对严重急性下呼吸道感染（ALRI）负担的比例贡献。
文献综述遵循PRISMA指南。我们纳入了1995年至2011年间发表的关于确诊为ALRI的0至4岁住院儿童的研究。最终综述共纳入51项研究，包括56091例住院ALRI病例。
在所有住院ALRI病例中，IV的检出率为3.0%（2.2%-4.0%），PIV为2.7%（1.9%-3.7%），AV为5.8%（3.4%-9.1%）。CV在技术上难以培养，在一项研究中，所有住院ALRI患者中有4.8%检测到CV。当纳入呼吸道合胞病毒（RSV）和较少见病毒时，在所有住院严重ALRI病例中，50.4%（40.0%-60.7%）至少检测到一种病毒。此外，这些病毒性ALRI中有21.9%（17.7%-26.4%）为混合感染，包括不止一种病毒病原体。在所有确诊为病毒病因的严重ALRI中，IV占7.0%（5.5%-8.7%），PIV占5.8%（4.1%-7.7%），AV占8.8%（5.3%-13.0%）。在一项研究中，10.6%的病毒阳性肺炎患者中发现了CV。
本文提供了迄今为止对四种病毒病因导致严重ALRI的贡献最全面的分析。我们的结果可用于进一步对多种呼吸道病毒疫苗研发和实施的成本效益分析。
