The Epidemiology of Healthcare‐Acquired Respiratory Syncytial Virus Infection Among Hospitalised Paediatric Patients: a Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
BACKGROUND: Hospital-acquired respiratory syncytial virus (HA-RSV) infections pose a substantial risk to hospitalised children, previously described as composing a fifth of RSV-related deaths worldwide. Despite this, the epidemiology of HA-RSV remains under-characterised, with limited meta-analytical evidence quantifying its incidence, morbidity and mortality. METHODS: We conducted a systematic review and meta-analysis of English language papers published between January 1975 and March 2024 searching EMBASE, MEDLINE and CABI Global Health. We included studies with primary data on paediatric HA-RSV cases among either all patients, patients with RSV or patients with healthcare-acquired infections (HAIs). Outbreak reports were excluded for the purposes of this analysis. Using random-effects meta-analyses, we synthesised the HA-RSV incidence rate (IR) and mortality rate (MR) among patient groups, reported as cases and deaths per 1000 person-years respectively. HA-RSV cumulative incidence and case-fatality rate (CFR) are also reported as percentages. The Joanna-Briggs Institute critical appraisal tool was used for quality assessment. RESULTS: Twenty-seven studies from 11 countries were included. The pooled HA-RSV IR among all paediatric patients was 10.86 cases (95% confidence interval, 3.83-17.89) per 1000 person-years. The MR was 11.34 (5.57-17.11) deaths per 1000 person-years, and the pooled CFR was 13.30% (3.21%-23.40%). HA-RSV comprised 15.57% of RSV hospitalisations and 22.48% of all HAIs. CONCLUSIONS: HA-RSV is a serious and under-recognised cause of morbidity and mortality in hospitalised paediatric patients, with significantly higher mortality than community-acquired RSV. These findings underscore the need for strengthened infection control, standardised diagnostic criteria and targeted preventative strategies to mitigate its impact globally.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".