Epidemiology and Clinical Characteristics of Respiratory Syncytial Virus in Patients With Influenza Like Illness in the Gambia: Results From a Newly Implemented Sentinel Surveillance Program

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Abstract Respiratory syncytial virus (RSV) is a major cause of acute respiratory infections in children worldwide and can cause high mortality, especially in developing countries. The Gambia, experiences a high burden of respiratory illnesses among pediatric populations, yet there is limited data on the epidemiology and clinical characteristics of RSV infections. Here, we present results of a newly implemented sentinel surveillance program in two hospitals with a focus on epidemiological and clinical characteristics of RSV infection. From January to December 2023, nasopharyngeal samples were collected from outpatient with influenza-like illness in two referral hospitals. Clinical and socio-demographic data were obtained using a standardized questionnaire. Collected samples together with the clinical forms were sent to the National Public Health Laboratory (NPHL) on a weekly basis through the Sample Referral Network. Once in the laboratory, samples were tested by targeting 3 respiratory pathogens, including RSV, SARS-CoV2 and influenza A/B viruses using a multiplex RT-PCR. Overall, 267 respiratory specimens were received and analyzed during this pilot phase. Among enrolled patients, 142 (53.2%) were males, 129 (48.3%) were infants aged under 1 year and children above 5 years of age represented 36.3% of all patients. RSV was detected in 14.2%, among which RSV type A was confirmed in 38.1% and RSV type B in 61.9%. RSV detection rates in the different age groups varied significantly with infants aged ≤11 months accounting for 66.7% of positive patients. The highest detection rate of RSV was noted in August (38.1%), which coincide with the rainy season in the Gambia. The most frequently observed symptoms among patients with confirmed RSV infection were cough (90.5%), fever (80.9%) and Dyspnea (52.4%). In summary, our findings from the newly implemented sentinel surveillance program reveal a relatively high prevalence of RSV infection among pediatric patients in the Gambia with co-circulation of both type of RSV. Enhanced surveillance of Severe acute respiratory illnesses in pediatric inpatients in needed.

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