Table 2.
Global and subgroup pooled prevalence of respiratory syncytial virus in children with lower respiratory tract infections.
| Groups | Studies (n) | RSV-Positive (n) | Total (n) | Pooled Prevalence (95% CI) | Q-Value | I2 (%) |
p Value Heterogeneity |
p Value Egger Test |
p Value Subgroup Difference |
|---|---|---|---|---|---|---|---|---|---|
| Overall | 112 | 45,900 | 308,985 | 21.51 [18.42; 24.96] | 22,893.65 | 99.0 | <0.0001 | <0.0001 | NA |
| Subgroup analyses | |||||||||
| Period | <0.0001 | ||||||||
| Pre-pandemic (2015/20) | 83 | 33,735 | 223,673 | 25.60 [22.57; 28.88] | 15,032.9 | 99.0 | <0.0001 | <0.0001 | |
| Lockdown (2020/21) | 46 | 4556 | 50,298 | 5.03 [2.67; 9.28] | 2581.79 | 98.3 | <0.0001 | 0.5569 | |
| Post-lockdown (2021/22) | 28 | 7609 | 35,014 | 42.02 [31.49; 53.33] | 3765.28 | 99.3 | <0.0001 | <0.0001 | |
| Seasons | <0.0001 | ||||||||
| 2015/16 | 24 | 7043 | 33,225 | 24.19 [19.45; 29.66] | 1620.84 | 98.60 | <0.0001 | 0.2232 | |
| 2016/17 | 21 | 4153 | 24,024 | 24.10 [17.86; 31.68] | 1298.39 | 98.50 | <0.0001 | 0.035 | |
| 2017/18 | 26 | 5295 | 40,942 | 28.82 [20.40; 39.01] | 2855.18 | 99.10 | <0.0001 | 0.0003 | |
| 2018/19 | 34 | 7369 | 41,586 | 27.02 [21.41; 33.47] | 2139.94 | 98.50 | <0.0001 | 0.0011 | |
| 2019/20 | 42 | 9875 | 83,896 | 24.29 [18.23; 31.58] | 5676.49 | 99.30 | <0.0001 | 0.0003 | |
| 2020/21 | 46 | 4556 | 50,298 | 5.03 [2.67; 9.28] | 2581.79 | 98.30 | <0.0001 | 0.5569 | |
| 2021/22 | 28 | 7609 | 35,014 | 42.02 [31.49; 53.33] | 3765.28 | 99.30 | <0.0001 | <0.0001 | |
| WHO Region | 0.0004 | ||||||||
| African | 7 | 837 | 3602 | 19.42 [14.19; 25.98] | 224.25 | 96.0 | <0.0001 | 0.0276 | |
| Americas | 13 | 2029 | 6370 | 11.17 [2.19; 41.42] | 194.76 | 93.3 | <0.0001 | 0.7522 | |
| Eastern Mediterranean | 3 | 151 | 568 | 26.53 [15.66; 41.25] | 33.53 | 94.0 | <0.0001 | NA | |
| European | 47 | 14,877 | 70,357 | 28.90 [22.73; 35.98] | 7570.45 | 98.7 | <0.0001 | 0.0004 | |
| South–East Asia | 8 | 1283 | 5987 | 24.85 [14.25; 39.67] | 758.49 | 98.7 | <0.0001 | 0.6948 | |
| Western Pacific | 34 | 26,723 | 222,101 | 14.71 [12.28; 17.52] | 8245.53 | 99.0 | <0.0001 | 0.1071 | |
| Age | <0.0001 | ||||||||
| <2 years | 35 | 6815 | 17,696 | 43.54 [35.56; 51.87] | 1972.43 | 96.7 | <0.0001 | 0.0017 | |
| <5 years | 22 | 7223 | 36,599 | 25.59 [21.03; 30.76] | 2760.33 | 98.8 | <0.0001 | 0.0781 | |
| <10 years | 4 | 7706 | 65,262 | 17.34 [11.89; 24.58] | 1267.48 | 99.0 | <0.0001 | 0.1347 | |
| <15 years | 20 | 5745 | 40,646 | 17.58 [12.82; 23.64] | 4016.97 | 99.1 | <0.0001 | 0.7428 | |
| <18 years | 27 | 17,408 | 139,980 | 10.17 [7.29; 14.02] | 5,380.77 | 99.0 | <0.0001 | 0.9850 | |
| Not reported | 4 | 1003 | 8802 | 9.94 [5.19; 18.18] | 276.85 | 95.7 | <0.0001 | 0.3230 | |
| Design | 0.0840 | ||||||||
| Cross-sectional | 75 | 35,091 | 263,251 | 19.64 [16.55; 23.15] | 15,271.27 | 98.9 | <0.0001 | <0.0001 | |
| Longitudinal | 37 | 10,809 | 45,734 | 27.34 [19.47; 36.94] | 4589.11 | 98.8 | <0.0001 | 0.0379 | |
| Timing of data collection | 0.5983 | ||||||||
| Ambispective | 4 | 1449 | 11,714 | 15.30 [4.70; 39.82] | 657.29 | 98.8 | <0.0001 | NA | |
| Prospective | 58 | 12,676 | 66,479 | 23.44 [18.63; 29.05] | 7496.05 | 98.9 | <0.0001 | 0.1370 | |
| Retrospective | 50 | 31,775 | 230,792 | 20.82 [16.90; 25.37] | 12,692.16 | 99.0 | <0.0001 | 0.0007 | |
| Risk of bias | 0.1453 | ||||||||
| Low risk | 71 | 31,179 | 222,366 | 23.29 [19.18; 27.98] | 17,585.49 | 99.2 | <0.0001 | <0.0001 | |
| Moderate risk | 41 | 14,721 | 86,619 | 18.49 [14.32; 23.54] | 5058.52 | 98.5 | <0.0001 | 0.0752 | |
| Type of assay | 0.0007 | ||||||||
| Immune assays ¥ | 22 | 19,476 | 180,647 | 13.94 [10.65; 18.04] | 4163.17 | 98.9 | <0.0001 | 0.5255 | |
| Molecular assays ¥¥ | 85 | 22,523 | 103,157 | 24.96 [20.77; 29.69] | 10,441.27 | 98.5 | <0.0001 | 0.0350 | |
| Mixed assays ¥¥¥ | 5 | 3901 | 25,181 | 14.74 [8.27; 24.91] | 872.62 | 96.3 | <0.0001 | 0.3155 | |
| Diagnostic technique $ | 0.0016 | ||||||||
| Antigen testing | 6 | 8018 | 75,112 | 17.78 [10.71; 28.05] | 1187.05 | 98.9 | <0.0001 | 0.4242 | |
| Direct immunofluorescence | 16 | 11,458 | 105,535 | 12.46 [9.14; 16.77] | 2892.56 | 99.0 | <0.0001 | 0.8831 | |
| Mixed assays ¥¥¥ | 5 | 3901 | 25,181 | 14.74 [8.27; 24.91] | 1187.05 | 98.9 | <0.0001 | 0.3155 | |
| Multiplex PCR | 14 | 2083 | 10,831 | 27.32 [14.57; 45.30] | 2965.49 | 99.0 | <0.0001 | 0.0439 | |
| Multiplex RT–PCR | 18 | 2215 | 7385 | 30.89 [22.03; 41.42] | 872.62 | 98.3 | <0.0001 | 0.3490 | |
| PCR | 16 | 7247 | 32,319 | 24.91 [16.89; 35.12] | 1756.55 | 98.7 | <0.0001 | 0.8591 | |
| qPCR | 2 | 52 | 140 | 38.93 [21.17; 60.20] | 828.23 | 97.0 | 0.0008 | NA | |
| RT–PCR | 31 | 9193 | 46,668 | 22.15 [16.57; 28.95] | 3648.00 | 99.1 | <0.0001 | 0.0936 | |
| RT–qPCR | 4 | 1733 | 5814 | 17.82 [3.59; 55.79] | 11.32 | 91.2 | <0.0001 | NA | |
| Sample type | 0.0023 | ||||||||
| Mixed specimens * | 7 | 3091 | 14,765 | 18.35 [8.59; 34.98] | 1408.90 | 99.0 | <0.0001 | 0.7840 | |
| Nasal secretions | 9 | 1209 | 3493 | 21.39 [6.94; 49.83] | 263.44 | 95.8 | <0.0001 | 0.5521 | |
| Nasopharyngeal secretions | 62 | 21,542 | 114,495 | 26.25 [21.48; 31.66] | 9150.13 | 98.7 | <0.0001 | <0.0001 | |
| Nasopharyngeal secretions or BLF | 11 | 4374 | 52,107 | 12.12 [8.34; 17.28] | 1848.89 | 98.6 | <0.0001 | 0.0770 | |
| Not reported | 8 | 10,981 | 85,775 | 21.26 [10.99; 37.13] | 2581.81 | 99.3 | <0.0001 | 0.0036 | |
| Oropharyngeal secretions | 7 | 2663 | 20,375 | 15.48 [12.23; 19.39] | 778.85 | 97.7 | <0.0001 | 0.2721 | |
| Sputum | 3 | 549 | 2063 | 25.23 [18.38; 33.58] | 44.03 | 95.5 | <0.0001 | NA | |
| Throat secretions | 5 | 1491 | 15,912 | 16.79 [7.88; 32.26] | 1097.90 | 99.3 | <0.0001 | NA |
¥ Immune assays: Antigen testing; or Direct immunofluorescence. ¥¥ Molecular assays: Multiplex PCR, Multiplex RT–PCR, PCR, qPCR, RT–PCR, or RT–qPCR. ¥¥¥ Mixed assays: Antigen testing/RT–PCR; direct immunofluorescence/RT–qPCR/antigen testing; direct immunofluorescence/RT–PCR; or indirect immunofluorescence/PCR. $ The indicated diagnostic technique is according to what is referred to by the authors. * Mixed specimens: nasopharyngeal secretions and nasal secretions or nasal and throat secretions. Abbreviations: WHO, World Health Organization; BLF, bronchoalveolar lavage fluid; NA, not applicable.