Systematic Review of the Respiratory Syncytial Virus (RSV) Prevalence, Genotype Distribution, and Seasonality in Children from the Middle East and North Africa (MENA) Region

Abstract

Respiratory syncytial virus (RSV) is one of the most common viruses to infect children worldwide and is the leading cause of lower respiratory tract illness (LRI) in infants. This study aimed to conduct a systematic review by collecting and reviewing all the published knowledge about the epidemiology of RSV in the Middle East and North Africa (MENA) region. Therefore, we systematically searched four databases; Embase, Medline, Scopus, and Cochrane databases from 2001 to 2019 to collect all the information related to the RSV prevalence, genotype distribution, and seasonality in children in MENA region. Our search strategy identified 598 studies, of which 83 met our inclusion criteria, which cover the past 19 years (2000–2019). Odds ratio (OR) and confidence interval (CI) were calculated to measure the association between RSV prevalence, gender, and age distribution. An overall prevalence of 24.4% (n = 17,106/69,981) of respiratory infections was recorded for RSV. The highest RSV prevalence was reported in Jordan (64%, during 2006–2007) and Israel (56%, 2005–2006). RSV A subgroup was more prevalent (62.9%; OR = 2.9, 95%CI = 2.64–3.13) than RSV B. RSV was most prevalent in children who were less than 12 months old (68.6%; OR = 4.7, 95%CI = 2.6–8.6) and was higher in males (59.6%; OR = 2.17, 95%CI = 1.2–3.8) than in female infants. Finally, the highest prevalence was recorded during winter seasons in all countries, except for Pakistan. RSV prevalence in the MENA region is comparable with the global one (24.4% vs. 22%). This first comprehensive report about RSV prevalence in the MENA region and our data should be important to guide vaccine introduction decisions and future evaluation.

Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis

“…Even multicenter studies find that in children under 6 months the prevalence is 50% and in children under 2 years of age 88%, a fact that corroborates the high burden of RSV in children < 2 years, especially in infants < 6 months [ 50 , 51 ]. The younger the age, the greater the risk of RSV infection, as corroborated by several authors, indicating a greater risk especially in children between 3 to 5 months [ 48 , 52 , 53 ], although other studies point out that RSV-associated hospitalizations reach their maximum peak in children under 3 months [ 54 ]. Other authors suggest a higher percentage of infection in children 0 to 12 months of age [ 45 , 54 , 55 , 56 , 57 , 58 ].…”

Characteristics and forecasting of respiratory viral epidemics among children in west China

“…In both the years, there were more affected boys than girls with similar ratios of boys to girls. This indicates that boys may be more vulnerable to ARTI than girls [ 14 ] owing to greater activity levels that makes them more likely to be exposed to the viruses. The average age of the population was only 2.2 to 2.3 years old, and nearly 50% of the children were <1 year old.…”

Saudi experts’ recommendation for RSV prophylaxis in the era of COVID-19

“…Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and viral pneumonia in pediatric patients and is the leading cause of lower respiratory tract illness in infants’ first year of life. 1 , 2 Approximately, 70% of bronchiolitis cases stem from an RSV infection. 3 According to the World Health Organization (WHO), the estimated annual burden of RSV-related acute lower respiratory illness (ALRI) is approximately 33 million worldwide, with approximately 3 million hospitalizations and 59,600 deaths.…”

“…In a systematic review of all RSV-related articles in the MENA region from 2001 to 2019, high annual incidence rates of RSV were reported in Jordan (64%), followed by Pakistan (52.6%), Tunisia (50%), Qatar (48.5%), Algeria (47.8%), Egypt (46.6%), and Iran (46.1%), whereas the lowest incidence was reported in Oman (1.8%). 2 In the Kingdom of Saudi Arabia (KSA), the prevalence of RSV infection is 23.5% in pediatric patients with ALRI. 6 …”