Rsv epidemiological burden in paediatric outpatients in italy: a systematic review

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Background: Respiratory Syncytial Virus (RSV) infection is a paediatric threat, being the main cause of lower respiratory tract infections (LRTIs) in children <5 years of age and often leading to severe consequences (i.e., bronchiolitis and pneumonia). Preventive strategies are and will be available to reduce the burden of this respiratory infection. Therefore, in order to assess the effect of prevention strategies, establishing a baseline before implementation may be considered to be relevant. The aim of this systematic review is to describe the epidemiological burden of RSV infection in paediatric outpatients aged 0-5 years in Italy. Methods: We performed a systematic review by consulting PubMed, Embase, Scopus and the International HTA Database. We then applied inclusion and exclusion criteria, including limiting to English and Italian languages and articles published between Jan 1st 2000 and July 14th, 2022, requirement of RSV test-positive data and from patients in the aforementioned age range. Results: We retrieved 20,845 records collectively, from which 9 articles were eligible for our study. Overall, we found RSV test-positivity in outpatient children ranged from 18% to 41%. Data comparison across studies was challenging because of differences in initial diagnosis, source of information, sample population, and study design. Importantly, the RSV positivity increased from 2001-2002 (23.8%) to 2019-2020 (40.8%): this is perhaps due to true changes in the epidemiological trends, detection bias due to increased awareness of RSV by the medical professionals and the availability of more sensitive diagnostic techniques. Conclusions: To our knowledge, this is the first review summarizing RSV epidemiology in paediatric outpatients in Italy. In the future, more data on this topic will be crucial for an appropriate and effective prevention strategy to manage the RSV-related disease burden in paediatric outpatients.

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