Original scientific paper
Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age – a systematic review and meta-analysis
Ivana Lukšić
orcid.org/0000-0002-9302-2078
; Institute of Public Health ‘’Dr. Andrija Štampar,’’ Department of Microbiology, Zagreb, Croatia
Patrick K Kearns
; Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
Fiona Scott
; Centre for Population Health, Sciences, The University of Centre for Population Health Edinburgh Medical School, Edinburgh, Scotland, UK
Igor Rudan
; Centre for Population Health, Sciences, The University of Centre for Population Health Edinburgh Medical School, Edinburgh, Scotland, UK
Harry Campbell
; Centre for Population Health, Sciences, The University of Centre for Population Health Edinburgh Medical School, Edinburgh, Scotland, UK
Harish Nair
; Centre for Population Health, Sciences, The University of Centre for Population Health Edinburgh Medical School, Edinburgh, Scotland, UK
Abstract
Aim To estimate the proportional contribution of influenza
viruses (IV), parainfluenza viruses (PIV), adenoviruses (AV),
and coronaviruses (CV) to the burden of severe acute lower
respiratory infections (ALRI).
Methods The review of the literature followed PRISMA
guidelines. We included studies of hospitalized children
aged 0-4 years with confirmed ALRI published between
1995 and 2011. A total of 51 studies were included in the
final review, comprising 56 091 hospitalized ALRI episodes.
Results IV was detected in 3.0% (2.2%-4.0%) of all hospitalized
ALRI cases, PIV in 2.7% (1.9%-3.7%), and AV in 5.8%
(3.4%-9.1%). CV are technically difficult to culture, and they
were detected in 4.8% of all hospitalized ALRI patients in
one study. When respiratory syncytial virus (RSV) and less
common viruses were included, at least one virus was detected
in 50.4% (40.0%-60.7%) of all hospitalized severe
ALRI episodes. Moreover, 21.9% (17.7%-26.4%) of these viral
ALRI were mixed, including more than one viral pathogen.
Among all severe ALRI with confirmed viral etiology,
IV accounted for 7.0% (5.5%-8.7%), PIV for 5.8% (4.1%-7.7%),
and AV for 8.8% (5.3%-13.0%). CV was found in 10.6% of
virus-positive pneumonia patients in one study.
Conclusions This article provides the most comprehensive
analysis of the contribution of four viral causes to
severe ALRI to date. Our results can be used in further
cost-effectiveness analyses of vaccine development and
implementation for a number of respiratory viruses.
Keywords
Hrčak ID:
102806
URI
Publication date:
15.4.2013.
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