Sini de Almeida Rodrigo, Leite João, Atwell Jessica E, Elsobky Malak, LaRotta Jorge, Mousa Mostafa, Thakkar Karan, Fletcher Mark A
Vaccines and Antivirals Medical Affairs, Emerging Markets Region, Pfizer, São Paulo, Brazil.
IQVIA, Inc., Porto Salvo, Portugal.
Front Pediatr. 2024 Nov 21;12:1452267. doi: 10.3389/fped.2024.1452267. eCollection 2024.
We evaluated published evidence (2012-2022) on pediatric RSV burden in 149 countries within World Health Organization (WHO) regions of Africa (AFRO), Americas (AMRO, excluding Canada and the USA), Eastern Mediterranean (EMRO), Europe (EURO, excluding European Union countries and the UK), Southeast Asia (SEARO), and Western Pacific (WPRO, excluding Australia, China, Japan, New Zealand, and South Korea).
Gap analysis on RSV-associated disease (hospitalizations, hospital course, mortality or case fatality, detection, and incidence) in children ≤2 years old, where hospitalization rates, hospital course, mortality rate, case fatality rate (CFR), and postmortem detection rates were summarized, by region, for each country.
Forty-two publications were identified covering 19% of included countries in AFRO, 18% in AMRO, 14% in EMRO, 15% in EURO, 18% in SEARO, and 13% in WPRO. Methods, case definitions, and age groups varied widely across studies. Of these 42 publications, 25 countries reported hospitalization rate, hospital course, mortality rate, CFR, and/or postmortem detection rate. RSV hospitalization rate (per 1,000 children per year/child-years) was higher among ≤3-month-olds (range, 38 in Nicaragua to 138 in the Philippines) and ≤6-month-olds (range, 2.6 in Singapore to 70 in South Africa) than in 1-2-year-olds (from 0.7 in Guatemala to 19 in Nicaragua). Based on 11 studies, in AFRO (South Africa), AMRO (Chile and Mexico), EMRO (Lebanon and Jordan), EURO (Israel and Turkey), and SEARO (India), hospitalized children ≤2 years old remained hospitalized for 3-8 days, with 9%-30% requiring intensive care and 4%-26% needing mechanical ventilation. Based on a study in India, community-based CFR was considerably higher than that in the hospital (9.1% vs. 0% in ≤3-month-olds; 7.1% vs. 2.8% in ≤6-month-olds).
National and regional heterogeneity of evidence limits estimates of RSV burden in ≤2-year-olds in many WHO region countries, where further country-specific epidemiology is needed to guide prioritization, implementation, and impact assessment of RSV prevention strategies.
我们评估了2012年至2022年期间发表的关于世界卫生组织（WHO）非洲区域（AFRO）、美洲区域（AMRO，不包括加拿大和美国）、东地中海区域（EMRO）、欧洲区域（EURO，不包括欧盟国家和英国）、东南亚区域（SEARO）以及西太平洋区域（WPRO，不包括澳大利亚、中国、日本、新西兰和韩国）149个国家儿童呼吸道合胞病毒（RSV）负担的证据。
对2岁及以下儿童RSV相关疾病（住院治疗、住院病程、死亡率或病死率、检测及发病率）进行差距分析，按区域总结每个国家的住院率、住院病程、死亡率、病死率（CFR）及尸检检测率。
共确定了42篇出版物，涵盖AFRO区域19%的纳入国家、AMRO区域18%的纳入国家、EMRO区域14%的纳入国家、EURO区域15%的纳入国家、SEARO区域18%的纳入国家以及WPRO区域13%的纳入国家。各项研究的方法、病例定义和年龄组差异很大。在这42篇出版物中，25个国家报告了住院率、住院病程、死亡率、CFR和/或尸检检测率。≤3个月大婴儿（范围从尼加拉瓜的每1000名儿童每年/儿童年38例到菲律宾的138例）和≤6个月大婴儿（范围从新加坡的每1000名儿童每年/儿童年2.6例到南非的70例）的RSV住院率高于1至2岁儿童（从危地马拉的每1000名儿童每年/儿童年0.7例到尼加拉瓜的19例）。基于11项研究，在AFRO区域（南非）、AMRO区域（智利和墨西哥）、EMRO区域（黎巴嫩和约旦）、EURO区域（以色列和土耳其）以及SEARO区域（印度），2岁及以下住院儿童的住院时间为3至8天，9% - 30%的儿童需要重症监护，4% - 26%的儿童需要机械通气。基于印度的一项研究，社区病死率远高于医院病死率（≤3个月大婴儿中分别为9.1%和0%；≤6个月大婴儿中分别为7.1%和2.8%）。
证据的国家和区域异质性限制了许多WHO区域国家对2岁及以下儿童RSV负担的估计，在这些国家需要进一步开展针对具体国家的流行病学研究，以指导RSV预防策略的优先排序、实施和影响评估。
