SynthesisBMJ global health2025
Disease burden due to respiratory syncytial virus infection among under-5 children of India for 2020: a multiplicative model using meta-estimates.
Synthesis in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRespiratory syncytial virus (RSV) is an important cause of acute lower respiratory infections (ALRI) among under-5 (U5) children. Generating evidence on disease burden is important to inform decisions regarding RSV preventive strategies. This systematic analysis estimated RSV-associated burden in U5 children for 2020 in India and identified data needs for decision-making regarding preventive strategies.
methodsWe conducted meta-analyses of published studies from India between January 2000 and July 2021 and used multiplicative models by applying ALRI and RSV meta-estimates to population estimates for 2020 and national pneumonia deaths. Uncertainty ranges (UR) were calculated using Monte Carlo simulations.
resultsUsing 36 eligible studies including unpublished data from three studies, we estimated 12.6 (UR: 9.9-15.2) million RSV-ALRI cases; 8.5 (UR: 6.7-10.3) million RSV-ALRI outpatient visits and 1 (UR: 0.9-1.2) million RSV-ALRI hospitalisations among U5 children in India in 2020. We estimated 36 700 RSV-ALRI overall deaths (UR: 31 200-42600) of which 27 400 (UR: 20 100-34200) were in-hospital deaths in children aged <5 years. One in four RSV-ALRI cases and 87% of all deaths occurred in children aged <1 year. Key data gaps identified were limited data availability for early infancy, high-risk groups like preterm infants and poor geographical representativeness.
conclusionsRSV burden contributed to 4.4% of U5 deaths in India for 2020. Public health interventions against RSV, including establishment of surveillance/research platforms to address data gaps and enable impact assessment, are required. PROSPERO REGISTRATION NUMBER: CRD42020213433.
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