Describing global pediatric RSV disease at intensive care units in GAVI-eligible countries using molecular point-of-care diagnostics: the RSV GOLD-III study protocol

Abstract

Background Respiratory syncytial virus (RSV) infection is an important cause of hospitalization and death in young children. The majority of deaths (99%) occur in low- and lower-middle-income countries (LMICs). Vaccines against RSV infection are underway. To obtain access to RSV interventions, LMICs depend on support from Gavi, the Vaccine Alliance. To identify future vaccine target populations, information on children with severe RSV infection is required. However, there is a lack of individual patient-level clinical data on instances of life-threatening RSV infection in LMICs. The RSV GOLD III—ICU Network study aims to describe clinical, demographic and socioeconomic characteristics of children with life-threatening RSV infection in Gavi-eligible countries. Methods The RSV GOLD-III—ICU Network study is an international, prospective, observational multicenter study and will be conducted in 10 Gavi-eligible countries at pediatric intensive care units and high-dependency units (PICUs/HDUs) during local viral respiratory seasons for 2 years. Children younger than 2 years of age with respiratory symptoms fulfilling the World Health Organization (WHO) “extended severe acute respiratory infection (SARI)” case definition will be tested for RSV using a molecular point-of-care (POC) diagnostic device. Patient characteristics will be collected through a questionnaire. Mortality rates of children admitted to the PICU and/or HDU will be calculated. Discussion This multicenter descriptive study will provide a better understanding of the characteristics and mortality rates of children younger than 2 years with RSV infection admitted to the PICU/HDU in LMICs. These results will contribute to knowledge on global disease burden and awareness of RSV and will directly guide decision makers in their efforts to implement future RSV prevention strategies. Trial registration number: NL9519, May 27, 2021

RSV Infection in Refugees and Asylum Seekers: A Systematic Review and Meta-Analysis

“…Third, studies were conducted in a very broad timeframe, with a pluriannual hiatus between the reports from Thailand [ 5 , 7 , 45 ] and Kenya [ 48 , 77 ] on the one hand and the single report from Cox’s Bazar on the other hand [ 47 ]. Therefore, the eventual estimates may have been affected not only by inconsistency in the epidemiology of respiratory pathogens across the assessed timeframe [ 88 , 89 ], but also by available diagnostic options [ 88 ]. In this regard, it is important to stress that all studies were performed well before the inception of the SARS-CoV-2 pandemic.…”

Respiratory Syncytial Virus: A Systematic Review and Meta-Analysis of Tomographic Findings (2000–2022)

“…For one, a substantial selection bias reasonably affected our estimates, as suggested by the correlation analysis, which suggested a higher share of RSV cases among smaller samples. As RSV is a very common infection, particularly among infants aged 2 years or less [24,26,[70][71][72][73], the large majority of incident cases were reasonably managed as outpatient cases, not requiring any imaging and, therefore, not being included in the present estimates. Moreover, even among hospitalized (i.e., more severe) cases, CT scans were performed only in highly selected (and not necessar-ily representative cases) cases, in order to better characterize severe respiratory impairment and/or rule out other respiratory infections that would require a specific follow-up, potentially including antimicrobic therapy, otherwise useless in RSV cases [39,40,49,59,74].…”

Respiratory Infections by virus: a review properties

“…In majority, the respiratory infections in infancy are consequence of the infection by RSV [6], that causes approximately 50% of the bronchospasm and 80% of the cases of bronchiolitis. Approximately 70% of the children are infected by RSV in the first life year and almost all of them until the 3 years old.…”