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Respiratory syncytial virus in the Western Pacific Region: a systematic review and meta-analysis

Krisna N A Pangesti^1,2,3, Moataz Abd El Ghany^2,4,5, Alison M Kesson^4,6,7

¹School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.

Journal of Global Health

|January 2, 2020

Insights

Respiratory syncytial virus (RSV) is a significant cause of respiratory illness, particularly in children. This review highlights limited data in the Western Pacific Region, emphasizing the need for more research on RSV burden and epidemiology.

Area of Science:

Virology
Epidemiology
Public Health

Background:

Respiratory syncytial virus (RSV) is a primary cause of viral pneumonia and bronchiolitis in young children.
The impact of RSV in adults, especially the elderly, is increasingly recognized.
Systematic review of RSV disease burden and molecular epidemiology in the WHO Western Pacific Region (WPR) is lacking.

Purpose of the Study:

To systematically review the epidemiological aspects of RSV in WPR countries.
To investigate RSV incidence, prevalence, seasonality, and hospitalization rates.
To analyze the molecular epidemiology of RSV within the WPR.

Main Methods:

A systematic literature search was performed in major databases (MEDLINE, EMBASE, Scopus, Web of Science).
Publications from January 2000 to October 2017 were included.
Studies focused on RSV in WHO Western Pacific Region countries.

Main Results:

196 studies from 15 WPR countries were analyzed.
RSV positivity rate among respiratory tract infection patients was 16.73%.
RSV was more prevalent in hospitalized patients (18.28%) and children (20.72%) compared to outpatients and adults, respectively. Seasonality varied with latitude, and predominant genotypes were NA1 (RSV A) and BA (RSV B).

Conclusions:

Data on RSV burden and epidemiology in the WPR are scarce, particularly for non-hospitalized individuals and adults.
Most existing studies focus on pediatric and hospitalized populations.
Enhanced surveillance and laboratory-based studies are crucial to accurately determine the full burden of RSV in the WPR.

Read full analysis

Abstract

Background:

Respiratory syncytial virus (RSV) is the leading cause of viral pneumonia and bronchiolitis, especially in younger children. The burden of RSV infection in adults, particularly in the older age group, is increasingly recognised. However, RSV disease burden and molecular epidemiology in the World Health Organization (WHO) Western Pacific Region (WPR) has not been reviewed systematically. The aim of this systematic review is to investigate the epidemiological aspects of RSV (incidence, prevalence, seasonality and hospitalisation status) and the associated molecular data in the WPRO countries.

Methods:

A systematic search was conducted in international literature databases (MEDLINE, EMBASE, Scopus and Web of Science) to identify RSV-related publications from January 2000 to October 2017 in the WPR countries.

Results:

A total of 196 studies from 15 WPR countries were included. The positivity rate for RSV among respiratory tract infection patients was 16.73% (95% confidence interval (CI) = 15.12%-18.4%). The RSV-positive cases were mostly found in hospitalised compared with outpatients (18.28% vs 11.54%, P < 0.001), and children compared with adults (20.72% vs 1.87%, P < 0.001). The seasonality of RSV in the WPR countries follows the latitude, with the peak of RSV season occurring in the winter in temperate countries, and during the rainy season in tropical countries. The molecular epidemiology pattern of RSV in WPR countries was similar to the global pattern, with NA1 (RSV A) and BA (RSV B) being the predominant genotypes.

Conclusions:

The available data on RSV are limited in several countries within the WPR, with most data focusing on children and hospitalised patients. Further studies and surveillance, incorporating laboratory testing, are needed to determine the burden of RSV infection in the WPR countries.

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