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. 2015 Jun;5(1):010408.
doi: 10.7189/jogh.05.010408.

Aetiological role of common respiratory viruses in acute lower respiratory infections in children under five years: A systematic review and meta-analysis

Ting Shi  1 , Kenneth McLean  1 , Harry Campbell  2 , Harish Nair  3
Affiliations

Aetiological role of common respiratory viruses in acute lower respiratory infections in children under five years: A systematic review and meta-analysis

Ting Shi et al. J Glob Health. 2015 Jun.

Abstract

Background: Acute lower respiratory infection (ALRI) remains a major cause of childhood hospitalization and mortality in young children and the causal attribution of respiratory viruses in the aetiology of ALRI is unclear. We aimed to quantify the absolute effects of these viral exposures.

Methods: We conducted a systematic literature review (across 7 databases) of case-control studies published from 1990 to 2014 which investigated the viral profile of 18592 children under 5 years with and without ALRI. We then computed a pooled odds ratio and virus-specific attributable fraction among the exposed of 8 common viruses - respiratory syncytial virus (RSV), influenza (IFV), parainfluenza (PIV), human metapneumovirus (MPV), adenovirus (AdV), rhinovirus (RV), bocavirus (BoV), and coronavirus (CoV).

Findings: From the 23 studies included, there was strong evidence for causal attribution of RSV (OR 9.79; AFE 90%), IFV (OR 5.10; AFE 80%), PIV (OR 3.37; AFE 70%) and MPV (OR 3.76; AFE 73%), and less strong evidence for RV (OR 1.43; AFE 30%) in young children presenting with ALRI compared to those without respiratory symptoms (asymptomatic) or healthy children. However, there was no significant difference in the detection of AdV, BoV, or CoV in cases and controls.

Conclusions: This review supports RSV, IFV, PIV, MPV and RV as important causes of ALRI in young children, and provides quantitative estimates of the absolute proportion of virus-associated ALRI cases to which a viral cause can be attributed.

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Figures

Figure 1
Figure 1
PRISMA flow diagram of the literature search.
See this image and copyright information in PMC

References

    1. World Health Organization. Factsheet: Pneumonia. Geneva: WHO, 2013. Available from: http://www.who.int/mediacentre/factsheets/fs331/en/. Accessed: 16 June 2014.
    1. Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta Z, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381:1405–16. doi: 10.1016/S0140-6736(13)60222-6. - DOI - PMC - PubMed
    1. Nair H, Simőes EAF, Rudan I, Gessner BD, Azziz–Baumgartner E, Zhang JSF, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381:1380–90. doi: 10.1016/S0140-6736(12)61901-1. - DOI - PMC - PubMed
    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post–2015 priorities: an updated systematic analysis. Lancet. 2015;385:430–40. doi: 10.1016/S0140-6736(14)61698-6. - DOI - PubMed
    1. United Nations Children's Fund, World Health Organization. Pneumonia: The forgotten killer of children. Geneva: WHO, 2006.