Observational studyThe Lancet. Global health2025
Health-care burden related to respiratory syncytial virus in a resource-constrained setting: a prospective observational study.
Observational study in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Regional inequality in infant RSV morbidity and mortality burden in the era of expanded RSV passive immunisation: a global projection modelling study.EClinicalMedicine · 2026Article
- Seasonality and clinical characteristics of influenza-like illness and severe acute respiratory infection in children under 5 years in Cox's Bazar, Bangladesh (2021-2023).IJID regions · 2026Article
- Deadbolt Drug Discovery: Locking the Door to Class 1 Viral Entry by Small Molecules.ACS infectious diseases · 2026Review
- A strategic blueprint for strengthening respiratory syncytial virus prevention among under-five children in low- and middle-income countries: Bangladesh as a model for new immunisation approaches.Journal of global health · 2026Article
- Incidence of respiratory syncytial virus infections among children in rural Bangladesh: a prospective observational study (2021-2023).The Lancet regional health. Southeast Asia · 2026Article
- New insight into the epidemiological trends of respiratory syncytial virus infection and the underlying anti-respiratory syncytial virus mechanisms of andrographolide: integrating Global Burden of Disease database, network pharmacological analysis, andMicrobiology spectrum · 2026Article
- Reconstructing severe acute respiratory infection dynamics from ICD-10 hospital discharge data: a 10-year analysis of 11.2 million discharges in Ecuador, 2014-2023.Frontiers in public health · 2026Article
- Genetic characterization of the respiratory tract viruses in Jilin, Northeast China, 2023.Frontiers in public health · 2025Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRespiratory syncytial virus (RSV) is a leading cause of paediatric hospital admissions worldwide, straining health systems. A lack of data on the burden of RSV infections and the impact on health systems in resource-limited settings hinders evidence-based policy decisions. Here, we aimed to assess RSV's burden on the health system in Bangladesh.
methodsFrom January to December, 2019, we conducted a prospective study at Bangladesh's largest paediatric hospital among children aged 0-59 months admitted with a possible respiratory infection, as guided by the WHO RSV hospital-based surveillance case definition. Outcomes for RSV-positive children younger than 5 years were analysed. We also followed up outcomes of children denied hospitalisation due to bed shortages. Adjusted hazard ratios for children denied admission versus admitted were estimated using survival analysis. Monte Carlo simulations with a queueing model were used to estimate the effects of RSV prefusion F maternal vaccine or nirsevimab on admission denials and mortality.
findingsOf 40 664 children admitted, 31 692 were younger than 5 years; 19 940 were in study wards. Among 7191 admitted with possible respiratory infections, 6149 (85·5%) had nasopharyngeal swabs taken, with 1261 (20·5%) testing RSV-positive. The median age of children who tested positive for RSV was 3·0 months (IQR 1·0-8·0), with a median hospital stay of 5 days (IQR 4-8); 24 (1·9%) of 1261 died in hospital. 8274 (5·5%) of 151 110 bed days were for children who were positive for RSV. Additionally, of 9169 children denied admission, outcomes were tracked for 3928 and compared with 2845 admitted. The hazard ratio for death was 1·56 (95% CI 1·34 to 1·81) for children denied versus admitted, being highest for neonates at 2·27 (1·87 to 2·75). RSV prefusion F maternal vaccine or nirsevimab could have reduced denials by 677 (95% prediction interval 63 to 1347) and 1289 (684 to 1865), respectively, potentially preventing 130 (-60 to 322) and 258 (32 to 469) deaths.
interpretationRSV strains health care in Bangladesh, increasing mortality risks. Preventive interventions could lessen its impact, boosting health-care capacity and child health in resource-limited settings.
fundingThe Bill & Melinda Gates Foundation.
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