Department of Virology, National Influenza Center, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
Department of Epidemiology and Public Health, National Influenza Center, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
Influenza Other Respir Viruses. 2018 Nov;12(6):793-803. doi: 10.1111/irv.12584. Epub 2018 Jul 5.
The epidemiology of human respiratory syncytial virus (HRSV) infection has not yet been systematically investigated in Africa. This systematic review and meta-analysis are to estimate the prevalence of HRSV infections in people with acute respiratory tract infections (ARTI) in Africa.
We searched PubMed, EMBASE, Africa Journal Online, and Global Index Medicus to identify observational studies published from January 1, 2000, to August 1, 2017. We used a random-effects model to estimate the prevalence across studies. Heterogeneity (I ) was assessed via the chi-square test on Cochran's Q statistic. Review registration: PROSPERO CRD42017076352.
A total of 67 studies (154 000 participants) were included. Sixty (90%), seven (10%), and no studies had low, moderate, and high risk of bias, respectively. The prevalence of HRSV infection varied widely (range 0.4%-60.4%). The pooled prevalence was 14.6% (95% CI 13.0-16.4, I = 98.8%). The prevalence was higher in children (18.5%; 95% CI 15.8-21.5) compared to adults (4.0%; 95% CI 2.2-6.1) and in people with severe respiratory tract infections (17.9%; 95% CI 15.8-20.1) compared to those with benign forms (9.4%; 95% CI 7.4-11.5); P-values <0.0001. The HRSV prevalence was not associated with sex, subregion in Africa, setting, altitude, latitude, longitude, and seasonality.
This study suggests a high prevalence of HRSV in people with ARTI in Africa, particularly among children and people with severe clinical form. All innovative strategies to curb the burden should first focus on children which present the highest HRSV-related burden.
人类呼吸道合胞病毒（HRSV）感染的流行病学在非洲尚未得到系统研究。本系统评价和荟萃分析旨在评估非洲急性呼吸道感染（ARTI）患者中 HRSV 感染的患病率。
我们检索了 PubMed、EMBASE、Africa Journal Online 和 Global Index Medicus，以确定 2000 年 1 月 1 日至 2017 年 8 月 1 日期间发表的观察性研究。我们使用随机效应模型来估计研究间的患病率。通过 Cochran's Q 统计量的卡方检验评估异质性（I ）。审查注册：PROSPERO CRD42017076352。
共纳入 67 项研究（154000 名参与者）。分别有 60 项（90%）、7 项（10%）和无研究具有低、中、高偏倚风险。HRSV 感染的患病率差异很大（范围 0.4%-60.4%）。总体患病率为 14.6%（95%CI 13.0-16.4，I = 98.8%）。儿童的患病率（18.5%，95%CI 15.8-21.5）高于成人（4.0%，95%CI 2.2-6.1），重症呼吸道感染患者的患病率（17.9%，95%CI 15.8-20.1）高于良性呼吸道感染患者（9.4%，95%CI 7.4-11.5）；P 值均<0.0001。HRSV 患病率与性别、非洲次区域、环境、海拔、纬度、经度和季节性无关。
本研究表明，非洲 ARTI 患者中 HRSV 感染率较高，尤其是儿童和重症临床患者。所有遏制负担的创新策略都应首先关注儿童，因为儿童的 HRSV 相关负担最高。
