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Introduction <p>There is a gap in the understanding of the burden of respiratory syncytial virus (RSV) among adults in low, lower-middle, and upper-middle income countries, particularly with regard to up-to-date epidemiological data. Meta-analyses were conducted to determine pooled estimates of RSV prevalence among high-risk 18–59-year-old adults and ≥ 50-year-old adults with or without risk factors or comorbidities, who present with respiratory illnesses in low, lower-middle, and upper-middle income countries.</p> Methods <p>Using studies identified from a previously described systematic literature review, a random-effects model was used to determine pooled prevalence for each study population. Subgroup analyses and meta-regression were conducted using the moderator variables deemed most relevant a priori and a mixed-effects approach.</p> Results <p>Pooled RSV prevalence estimates were 5.1% (95% confidence interval [CI] 3.9–6.6%) and 3.9% (95% CI 3.3–4.7%) across 33 studies in 18–59-year-old high-risk adults with respiratory illnesses and 66 studies in ≥ 50-year-old adults with respiratory illnesses, respectively. Subgroup analyses for 18–59-year-old high-risk adults found geography, study setting, and respiratory illness to collectively explain ~ 54% of the variation in RSV prevalence estimates. The diagnostic method for RSV was found to explain ~ 8% of the variation in RSV prevalence estimates in ≥ 50-year-old adults; no other factors explored via subgroup analyses for ≥ 50-year-old adults had a notable effect on variation. For both populations, a substantial level of residual heterogeneity was observed using Higgin’s <i>I</i><sup>2</sup> when studies were split for subgroup analyses.</p> Conclusions <p>Overall, there is a considerable disease burden associated with RSV among 18–59-year-old high-risk and ≥ 50-year-old adults with respiratory illnesses in low, lower-middle, and upper-middle income countries, highlighting the need for improved prevention programs for RSV in these populations.</p> Graphical Abstract <p></p>

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Prevalence of Respiratory Syncytial Virus in Adult Patients with Respiratory Illnesses in Low to Middle-Income Countries: A Systematic Review and Meta-Analyses

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月23日

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  • Digant Gupta,
  • Amandeep Kaur,
  • Vikas Verma,
  • Désirée A. M. Van Oorschot,
  • Yolanda Penders,
  • Adriana Guzman-Holst

摘要

Introduction

There is a gap in the understanding of the burden of respiratory syncytial virus (RSV) among adults in low, lower-middle, and upper-middle income countries, particularly with regard to up-to-date epidemiological data. Meta-analyses were conducted to determine pooled estimates of RSV prevalence among high-risk 18–59-year-old adults and ≥ 50-year-old adults with or without risk factors or comorbidities, who present with respiratory illnesses in low, lower-middle, and upper-middle income countries.

Methods

Using studies identified from a previously described systematic literature review, a random-effects model was used to determine pooled prevalence for each study population. Subgroup analyses and meta-regression were conducted using the moderator variables deemed most relevant a priori and a mixed-effects approach.

Results

Pooled RSV prevalence estimates were 5.1% (95% confidence interval [CI] 3.9–6.6%) and 3.9% (95% CI 3.3–4.7%) across 33 studies in 18–59-year-old high-risk adults with respiratory illnesses and 66 studies in ≥ 50-year-old adults with respiratory illnesses, respectively. Subgroup analyses for 18–59-year-old high-risk adults found geography, study setting, and respiratory illness to collectively explain ~ 54% of the variation in RSV prevalence estimates. The diagnostic method for RSV was found to explain ~ 8% of the variation in RSV prevalence estimates in ≥ 50-year-old adults; no other factors explored via subgroup analyses for ≥ 50-year-old adults had a notable effect on variation. For both populations, a substantial level of residual heterogeneity was observed using Higgin’s I2 when studies were split for subgroup analyses.

Conclusions

Overall, there is a considerable disease burden associated with RSV among 18–59-year-old high-risk and ≥ 50-year-old adults with respiratory illnesses in low, lower-middle, and upper-middle income countries, highlighting the need for improved prevention programs for RSV in these populations.

Graphical Abstract