Social, economic, and health impact of the respiratory syncytial virus: a systematic search

Abstract

BackgroundBronchiolitis caused by the respiratory syncytial virus (RSV) and its related complications are common in infants born prematurely, with severe congenital heart disease, or bronchopulmonary dysplasia, as well as in immunosuppressed infants. There is a rich literature on the different aspects of RSV infection with a focus, for the most part, on specific risk populations. However, there is a need for a systematic global analysis of the impact of RSV infection in terms of use of resources and health impact on both children and adults. With this aim, we performed a systematic search of scientific evidence on the social, economic, and health impact of RSV infection.MethodsA systematic search of the following databases was performed: MEDLINE, EMBASE, Spanish Medical Index, MEDES-MEDicina in Spanish, Cochrane Plus Library, and Google without time limits. We selected 421 abstracts based on the 6,598 articles identified. From these abstracts, 4 RSV experts selected the most relevant articles. They selected 65 articles. After reading the full articles, 23 of their references were also selected. Finally, one more article found through a literature information alert system was included.ResultsThe information collected was summarized and organized into the following topics: 1. Impact on health (infections and respiratory complications, mid- to long-term lung function decline, recurrent wheezing, asthma, other complications such as otitis and rhino-conjunctivitis, and mortality; 2. Impact on resources (visits to primary care and specialists offices, emergency room visits, hospital admissions, ICU admissions, diagnostic tests, and treatments); 3. Impact on costs (direct and indirect costs); 4. Impact on quality of life; and 5. Strategies to reduce the impact (interventions on social and hygienic factors and prophylactic treatments).ConclusionsWe concluded that 1. The health impact of RSV infection is relevant and goes beyond the acute episode phase; 2. The health impact of RSV infection on children is much better documented than the impact on adults; 3. Further research is needed on mid- and long-term impact of RSV infection on the adult population, especially those at high-risk; 4. There is a need for interventions aimed at reducing the impact of RSV infection by targeting health education, information, and prophylaxis in high-risk populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0544-x) contains supplementary material, which is available to authorized users.

Question 1: Palivizumab for all children with Down syndrome?

“…What about the cost-effectiveness of administering prophylaxis for high-risk children? A UK study reported that the following high-risk groups fell within the economically viable £30 000/quality-adjusted life year: infants <24 months with CLD, CHD, preterm <32 weeks and preterm 33–35 weeks with risk factors15; this was supported by the conclusions of a systematic review which stated that palivizumab was cost-effective in improving outcomes in high-risk children 16. As the evidence suggests any child with DS is at risk of similar or even more severe RSV disease than others, the argument can also be made for including them from an economic perspective.…”

Circulación del virus sincicial respiratorio en Buenos Aires. Su relación con el cambio climático global

“…10 La infección por virus sincicial respiratorio es una de las más comunes en la infancia y tiene considerable impacto sanitario, económico y social en el mundo entero. 11 A pesar de que, -en escenarios con adecuado acceso a la salud-, la enfermedad por VSR puede ser convenientemente manejada, la magnitud de esta patología implica un enorme consumo de recursos, lo que hace imprescindible una correcta planificación de las estrategias para enfrentarla. 12 Una mejor comprensión de los factores determinantes de la circulación del virus podrá contribuir a mejorar la eficiencia en el uso de recursos.…”

Evaluating Predisposition Factors of Infants Presenting with Recurrent Bronchiolitis Episodes in İstanbul Bağcılar

“…It is known that the socio-economic and cultural levels of families are risk factors in the development of bronchiolitis (25,26). The mother's level of education is important in infant nutrition.…”