BMJ Glob Health. 2025 Nov 23;10(11):e015020. doi: 10.1136/bmjgh-2024-015020.
ABSTRACT
BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of acute lower respiratory infections (ALRI) among under-5 (U5) children. Generating evidence on disease burden is important to inform decisions regarding RSV preventive strategies. This systematic analysis estimated RSV-associated burden in U5 children for 2020 in India and identified data needs for decision-making regarding preventive strategies.
METHODS: We conducted meta-analyses of published studies from India between January 2000 and July 2021 and used multiplicative models by applying ALRI and RSV meta-estimates to population estimates for 2020 and national pneumonia deaths. Uncertainty ranges (UR) were calculated using Monte Carlo simulations.
RESULTS: Using 36 eligible studies including unpublished data from three studies, we estimated 12.6 (UR: 9.9-15.2) million RSV-ALRI cases; 8.5 (UR: 6.7-10.3) million RSV-ALRI outpatient visits and 1 (UR: 0.9-1.2) million RSV-ALRI hospitalisations among U5 children in India in 2020. We estimated 36 700 RSV-ALRI overall deaths (UR: 31 200-42600) of which 27 400 (UR: 20 100-34200) were in-hospital deaths in children aged <5 years. One in four RSV-ALRI cases and 87% of all deaths occurred in children aged <1 year. Key data gaps identified were limited data availability for early infancy, high-risk groups like preterm infants and poor geographical representativeness.
CONCLUSIONS: RSV burden contributed to 4.4% of U5 deaths in India for 2020. Public health interventions against RSV, including establishment of surveillance/research platforms to address data gaps and enable impact assessment, are required.
PROSPERO REGISTRATION NUMBER: CRD42020213433.
PMID:41285437 | DOI:10.1136/bmjgh-2024-015020
