From the South African Medical Research Council: Vaccines and Infectious Diseases Analytical Research Unit (VIDA), University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa.
Pediatr Infect Dis J. 2021 May 1;40(5):479-485. doi: 10.1097/INF.0000000000003041.
Human metapneumovirus (hMPV) has been associated with upper and lower respiratory tract infections (LRTI) in children and adults. This systematic review evaluated the epidemiology of hMPV-associated LRTI, including severe acute respiratory infection (SARI) hospitalization or clinically diagnosed severe pneumonia, in African children under 5 years of age.
We searched Science Direct, PubMed, Cochrane Central, Scopus, and WHO regional databases using the terms "("Human metapneumovirus" AND "Africa") OR ("hMPV" AND "Africa")" up to September 17, 2020. Other sources included ClinicalTrials.gov to obtain unpublished data. Studies were included if children were less than 5 years of age and hospitalized with hMPV-associated LRTI, SARI or if clinically diagnosed with severe pneumonia in the community. The main outcomes were prevalence of hMPV identified among children with hospitalized LRTI or SARI. We further calculated odds ratios for hMPV in cases with LRTI compared with non-LRTI controls. Pooled results were calculated using a random-effects model.
Thirty studies were eligible for inclusion in the review. The prevalence of hMPV-LRTI/SARI among hospitalized and severe pneumonia cases was 4.7% [95% confidence interval (CI): 3.9-5.6, I2 = 95.0]. The case-control studies indicated that hMPV was 2.0-fold (95% CI: 0.9-4.4) more likely to be identified in LRTI cases (10.3%) than controls (6.0%). Three of 5 studies reported hMPV-associated LRTI case fatality risk, with a pooled estimate of 1.3% (95% CI: 0.3-2.9; I2 = 49).
hMPV was associated with approximately 5% of LRTI/SARI hospitalizations or severe pneumonia cases in Africa.
人类偏肺病毒（hMPV）与儿童和成人的上呼吸道和下呼吸道感染（LRTI）有关。本系统评价评估了 hMPV 相关 LRTI 的流行病学，包括 5 岁以下非洲儿童的严重急性呼吸道感染（SARI）住院或临床诊断为严重肺炎。
我们使用术语“（Human metapneumovirus 和 Africa）或（hMPV 和 Africa）”在 Science Direct、PubMed、Cochrane Central、Scopus 和世界卫生组织区域数据库中进行了搜索，截至 2020 年 9 月 17 日。其他来源包括 ClinicalTrials.gov 以获取未发表的数据。如果儿童年龄小于 5 岁且因 hMPV 相关 LRTI、SARI 住院或在社区中临床诊断为严重肺炎，则纳入研究。主要结局是在因 LRTI 住院或 SARI 住院的儿童中确定 hMPV 的患病率。我们进一步计算了与非 LRTI 对照组相比，LRTI 病例中 hMPV 的优势比。使用随机效应模型计算汇总结果。
30 项研究符合纳入本综述的条件。住院和严重肺炎病例中 hMPV-LRTI/SARI 的患病率为 4.7%[95%置信区间（CI）：3.9-5.6，I2=95.0]。病例对照研究表明，LRTI 病例（10.3%）中 hMPV 的检出率是对照组（6.0%）的 2.0 倍（95%CI：0.9-4.4）。5 项研究中的 3 项报告了 hMPV 相关 LRTI 的病死率，汇总估计值为 1.3%（95%CI：0.3-2.9；I2=49）。
hMPV 与非洲约 5%的 LRTI/SARI 住院或严重肺炎病例有关。
