Burden of respiratory syncytial virus diseases among under 5 children in Sub-Saharan Africa:

Background: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infections (ALRIs) in young children. To design preventive efforts in sub-Saharan Africa, a better knowledge of the true role of RSV in pediatric ALRIs is required. Therefore we conducted a systematic review and meta-analysis of case-control studies to estimate the etiological role of RSV to ALRIs in under 5 years children in sub-Saharan Africa. Methods: This study was done according to PRISMA guidelines. PubMed, EMBASE, SCOPUS, Web of Sciences databases, and Google Scholar were used to retrieve articles. STATA software version 17 was used for data analysis. The results of all the included studies were standardized to odds ratios (ORs) with accompanying 95 % confidence intervals (95 % CIs) and the pooled estimates of ORs, attributable fraction among the exposed (AFE), and population attributable fraction (PAF) were reported. The heterogeneity was assessed using Cochrane chi-square (I 2) statistics. Result: A total of 6200 cases and 4986 controls from 14 articles that fulfilled the inclusion criteria were included. The pooled prevalence of RSV among cases and controls was 23.52 % [95 % CI (20.68-26.47)] and 4.33 % [95 % CI (3.11-5.73)], respectively. The pooled OR is 7.04 [95 % CI (4.41-11.24)], which indicated a significant association between RSV and ALRI. Among ALRIs cases positive for RSV, the proportion of disease that was not attributable to the background rate (AFE) was 85.8 % [95 % CI (77.3-91.1)]. The fraction of ALRIs children that can be attributed to RSV (PAF) was 20.2 % [95 % CI (16-24.1)]. Conclusion: This study showed clear associations between RSV and ALRI hospitalization in young children in sub-Saharan Africa indicating the need for prophylactic measures against RSV in this age group.