ArticleJournal of the Pediatric Infectious Diseases Society2019
Performance of Surveillance Case Definitions in Detecting Respiratory Syncytial Virus Infection Among Young Children Hospitalized With Severe Respiratory Illness-South Africa, 2009-2014.
Article in Journal of the Pediatric Infectious Diseases Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Diagnostic Accuracy of Severe Acute Respiratory Infection Definitions in Hospitalized Children: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Respiratory Syncytial Virus among People Living with HIV: Is There a Case for Rolling Out Prophylaxis? A Viewpoint Based on a Systematic Review.Pathogens (Basel, Switzerland) · 2024Pooled it
- Molecular epidemiology of respiratory syncytial virus in children with acute respiratory illnesses in Africa: A systematic review and meta-analysis.Journal of global health · 2023Pooled it
- World Health Organization Influenza-Like Illness Underestimates the Burden of Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults.The Journal of infectious diseases · 2022Trial
- The prevalence and role of human respiratory syncytial virus in pediatric respiratory tract infections: a systematic review and meta-analysis of global data.EClinicalMedicine · 2026Article
- Comparing Respiratory Illness Surveillance Case Definitions to Detect Bordetella pertussis in Children Aged <5 Years With Respiratory Illness in South Africa, 2017-2023.The Journal of infectious diseases · 2026Article
- Performance of the World Health Organization (WHO) severe acute respiratory infection (SARI) case definitions in hospitalized children and youth: cross-sectional study.Lancet regional health. Americas · 2025Article
- The added value of serologic testing: A comparison of influenza incidence among pregnant persons based on molecular-based surveillance versus serologic testing.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
- Risk factors for severe respiratory syncytial virus-associated respiratory tract infection in a high HIV prevalence setting, South Africa, 2012 - 2018.BMC infectious diseases · 2024Article
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- Incidence and transmission of respiratory syncytial virus in urban and rural South Africa, 2017-2018.Nature communications · 2024Article
- Human respiratory syncytial virus subgroups A and B outbreak in a kindergarten in Zhejiang Province, China, 2023.Frontiers in public health · 2024Article
- Respiratory syncytial virus burden in children under 2 years old in understudied areas worldwide: gap analysis of available evidence, 2012-2022.Frontiers in pediatrics · 2024Review
- Respiratory Syncytial Virus Infection Among Hospitalized Infants in Four Middle-Income Countries.Journal of the Pediatric Infectious Diseases Society · 2023Article
- Article
- Estimates of the national burden of respiratory syncytial virus in Kenyan children aged under 5 years, 2010-2018.BMC medicine · 2023Article
- Respiratory Syncytial Virus Incidence and Severity in a Community-Based Prospective Cohort of Children Aged 0-14 Years.Open forum infectious diseases · 2022Article
- Human respiratory syncytial virus diversity and epidemiology among patients hospitalized with severe respiratory illness in South Africa, 2012-2015.Influenza and other respiratory viruses · 2022Article
- Assessment of surveillance predictors for suspected respiratory syncytial virus, influenza andIJID regions · 2022Article
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Authors and funding
16 authors at 8 institutions in 5 countries.
Funding
Abstract
backgroundRespiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection (ALRTI) in young children, but data on surveillance case definition performance in estimating burdens have been limited.
methodsWe enrolled children aged <5 years hospitalized for ALRTI (or neonatal sepsis in young infants) through active prospective surveillance at 5 sentinel hospitals in South Africa and collected nasopharyngeal aspirates from them for RSV molecular diagnostic testing between 2009 and 2014. Clinical data were used to characterize RSV disease and retrospectively evaluate the performance of respiratory illness case definitions (including the World Health Organization definition for severe acute respiratory infection [SARI]) in identifying hospitalized children with laboratory-confirmed RSV according to age group (<3, 3-5, 6-11, 12-23, and 24-59 months).
resultsOf 9969 hospitalized children, 2723 (27%) tested positive for RSV. Signs and symptoms in RSV-positive children varied according to age; fever was less likely to occur in children aged <3 months (57%; odds ratio [OR], 0.8 [95% CI, 0.7-0.9]) but more likely in those aged ≥12 months (82%; OR, 1.7-1.9) than RSV-negative children. The sensitivity (range, 55%-81%) and specificity (range, 27%-54%) of the SARI case definition to identify hospitalized RSV-positive children varied according to age; the lowest sensitivity was for infants aged <6 months. Using SARI as the case definition would have missed 36% of RSV-positive children aged <5 years and 49% of those aged <3 months; removing the fever requirement from the definition recovered most missed cases.
conclusionIncluding fever in the SARI case definition lowers the sensitivity for RSV case detection among young children hospitalized with an ALRTI and likely underestimates its burden.
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