Background
Methods
Search strategy
Selection criteria
Participants
Study characteristics
Literature selection and data extraction
Study | Region | Objectives | Study design | Population | Sample size | Outcome measures | Findings |
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Moore et al. (2020) [23] | WA | Describe age-specific epidemiology of RSV infections, including clinical severity and outcomes | Retrospective cohort study | Community, ED, general hospital ward, ICU 2000–2012 | 469,589 (birth cohort) 45,699 children with RSV testing record 0–16 years | Age-specific RSV testing and positivity rates (per 1000 child-years) | - Overall positivity rate highest in age < 3 months (31, 95% CI 30.2–32.5) - Hospitalised positivity rate highest in age < 3 months (28, 95% CI 27.1–29.2) - Community positivity rates highest in age 3–5 months (1.6, 95%CI 1.4–1.9) - ED positivity rates highest in age 3–5 months (2.3, 95%CI 2-2.7). - Overall testing rate highest in < 3 months (141, 95%CI 138.7-143.6) and second highest in 3–5 month (78.1, 95%CI 76.3–80) - Majority of hospitalisations in age < 6 months (48.2% Indigenous and 48.1% non-Indigenous) |
Homaira et al. (2019) [29] | NSW | Investigate an association between hospitalised RSV between 0–2 years old and risk of subsequent asthma | Retrospective cohort study | General hospital ward, ICU 2001–2011 | 888,154 children (birth cohort) 18,402 infants with RSV hospitalisation 0–2 years | Age distribution of RSV hospitalisations; Age-specific asthma hospitalisation incidence rate (per 1000 child-years) | - 34% of RSV hospitalisations in age < 3 months, 57% in age < 6 months - Incidence rate of asthma following RSV for age < 3 months was 0.5 (95% CI 0.2–0.7), age 3–6 months was 0.9 (95% CI 0.5–1.3) - Rate ratio for asthma hospitalisation was 2–7 fold greater in age > 6 months, compared to < 6 months |
Gebremedhin et al. (2022) [22] | WA | Describe rate of RSV positivity in hospitalised children, develop model to estimate the true incidence of RSV hospitalisations | Retrospective cohort study | General hospital ward, ICU 2000–2012 | 321,825 children (birth cohort) 37,784 children with RSV testing record in hospital 0–5 years | Age distribution of RSV testing, percent positivity, and hospitalisation; Age-specific RSV hospitalisation incidence rate and predicted rate (per 1000 child-years) | - Of those tested for RSV, 22.4% were aged < 3 months and 35.8% were age < 6 months - RSV percent positivity was highest in infants aged < 3 months and 3-<6 months (31% and 32% respectively) - Of those hospitalised with RSV, 30% were age < 3 months, 48.9% were < 6 months - Hospitalisation incidence rate highest in age 28 days – 3 months (31.7, 95% CI 30.3–33.1), second highest in age < 28 days (21.3, 95% CI 19.7–23.0) - Predicted hospitalisation incidence rates highest in age < 3 months (43.7, 95% CI 42.1–45.4) |
Moore et al. (2019) [25] | WA | Estimate effectiveness of palivizumab for preventing RSV infections in infants admitted to the NICU at birth | Retrospective cohort study, case series analysis | Community, general hospital ward, ICU 2002–2013 | 24,329 ex-NICU infants 1506 RSV detected 0–2 years | Age distribution of RSV infections | - Majority (52.1%) of RSV infections were in infants aged < 6 months |
Anderson et al. (2021) [37] | VIC | Describe clinical, laboratory, demographic characteristics of children hospitalised with RSV to identify factors associated with severity | Retrospective cohort study | General hospital ward, ICU 2017–2019 | 970 infants hospitalised with RSV 0–2 years | Predictors of severity (level of respiratory support required) | - Age < 2 months was an independent predictor of severe RSV disease (OR 2.3, 95% CI 1.6–3.3), significantly more likely to require HFNP, CPAP, BiPAP or mechanical ventilation |
Homaira et al. (2016) [31] | NSW | Provide population-based age-specific rates of severe RSV illness in children, comparing Indigenous status and those with and without risk factors | Retrospective cohort study | General hospital ward, ICU 2001–2010 | 870,314 children (birth cohort) 16,119 RSV hospitalisations 0–5 years | Age distribution of RSV hospitalisations; Age-specific RSV hospitalisation incidence rate (per 1000 child-years) in children with and without risk factors (BPD, pre-term, LBW) | - 35.5% of hospitalisations in age 0–3 months, 24.0% in 4–6 months, and 59.5% in age 0–6 months - In children without risk factors, hospitalisation incidence highest in age 0–3 months (25.6, 95% CI 23.9–25.3)*, then 4–6 months (16.7, 95% CI 16.2–17.4) - In children with risk factors, hospitalisation incidence highest in infants with BPD aged 4–6 months (275, 95% CI 194.8–378.0) - In indigenous children, hospitalisation incidence highest in ages 0–3 months (58, 95% CI 49.5–60.5) |
Lim et al. (2017) [32] | WA | Describe the pathogen-specific burden and age-specific rates of respiratory viruses in a cohort of hospitalised children | Retrospective cohort study | General hospital ward, ICU 2000–2012 | 469,589 children (birth cohort) 30,859 children with RSV testing record 8769 RSV positive 0–16 years | Age-specific hospitalisation incidence rate (per 100,000 child-years) | - RSV hospitalisation incidence rate highest in age 1–5 months (~ 2400) and < 1 month (~ 2100) |
Dede et al. (2010) [34] | NT | Describe seasonality of RSV infection in a desert region, compare age-specific RSV hospitalisation rate | Retrospective case series | General hospital ward 2000–2004 | 173 infants with RSV hospitalisation < 2 years | Age distribution of RSV hospitalisations | - 11.6% of RSV hospitalisations were in infants aged < 1 month, 29.5% in age < 3 months, 52.6% in < 6 months |
Saravanos et al. (2019) [3] | AUS | Estimate the age-specific rates of RSV-associated hospitalisation to identify groups at risk of serious RSV disease | Retrospective cohort study | General hospital ward, ICU 2006–2015 | 86,687 RSV hospitalisations All ages | Age-specific RSV hospitalisation rates (per 100,000 population) compare Indigenous and non-Indigenous; Hospitalisation risk | - Highest hospitalisation incidence rate in infants aged 0–2 months (3129), second highest in age < 6 months (2468) - RSV hospitalisation rate higher in Indigenous versus non-Indigenous infants aged < 6 months (4310 versus 2253) - Risk of RSV hospitalisation was 1.9 times higher in Indigenous infants compared to non-Indigenous infants age < 6 months (IRR 1.9, 95% CI 1.8-2.0). |
Saravanos et al. (2022) [24] | NSW | Characterise the magnitude, severity and age-related changes of the shifted RSV epidemic during the SARS-CoV-2 pandemic compared to pre-pandemic | Ecological study | Community, ED, General hospital ward, ICU 2014–2020 | 22,997 RSV infections 0–16 years | Age distribution of RSV infections, hospitalisations, ICU admissions (annual average count); RSV test positivity | - Pre-SARS-CoV-2 (2014–2019), RSV infections highest in age 0–5 months (453 cases, SD 43.15) - Hospitalisations highest in age 0–5 months (454, SD 32.25) - ICU admissions highest in age 0–5 months (131, SD 18.76) - Annual counts quadruple that seen in age 6–11 months - Age-related trends persisted in 2020 during SARS-CoV-2 pandemic - Highest RSV test percent positivity was in infants aged 0–5 months (23.82% in 2015–2019, and 19.54% in 2020). |
Fagan et al. (2017) [26] | NT | Determine age-specific prevalence of RSV in NT, investigate drivers of seasonality | Retrospective audit | Community, ED, General hospital ward, ICU 2012–2014 | 272 RSV infections All ages | Age distribution of RSV infections | - 32% of all RSV infections in infants aged < 6 months - 26.8% of infections were in non-Indigenous children aged < 6 months and 36.2% in Indigenous children aged < 6 months - RSV detection is positively correlated with higher rainfall |
Butler et al. (2019) [30] | SA, QLD | Determine factors associated with severe RSV disease in hospitalised children | Retrospective cohort study | General hospital ward, ICU 2013–2014 | 496 RSV infections < 3 years | Age distribution of RSV hospitalisation; Predictors of severity (ICU/ HDU, NG/IV rehydration, LOS > 5 days, oxygen, mechanical ventilation) | - Majority of RSV hospitalisations were in infants aged < 6 months (68.8%) - Age negatively associated with RSV disease severity (OR 0.95; 95% CI 0.90–0.99, p = 0.02), decreasing age (months) increases risk of severe disease - Median age for severe hospitalised RSV was 4.7 months (IQR 0.33-6.0) |
Pham et al. (2020) [36] | VIC | Describe epidemiology and treatment of RSV infection in a tertiary paediatric ICU | Descriptive case study | ICU 2005–2015 | 604 RSV infections 0–16 years | Age distribution of ICU admissions | - 43% of RSV infections requiring ICU admission were in infants aged < 3 months, 6% were in infants < 30 days old |
Fathima et al. (2018) [33] | WA | Assessed the impact of pneumococcal vaccination on all-cause and pathogen-specific pneumonia hospitalisations | Retrospective cohort study | General hospital ward, ICU 2000–2012 | 469,589 children (birth cohort) 15,175 pneumonia hospitalisations 1097 RSV positive 0–16 years | Age-specific and pathogen-specific detection rates (per 100,000 child-years) | - In indigenous infants < 6 months, RSV detection rate was highest of all pathogens (488.3) - Highest RSV detection rate was in ages < 6 months (488.3) compared to all other ages. Lower RSV detection rates in non-Indigenous infants < 6 months (80.1) |
Nguyen et al. (2023) [35] | WA | To present the number, clinical presentation and severity of RSV-related admissions during a global pandemic. | Ecological study | General hospital ward 2018–2021 | 294 RSV hospitalisations 0–16 years | Age-distribution of RSV hospitalisation; Severity of RSV infection (respiratory support) | - In 2018, 22.4% of RSV hospitalisations were aged 0–1 month, 2019 there were 16.3% and 2020 there were 5.4% - Significantly lower need for oxygen therapy in 2020 vs. 2018 (p = 0.004), due to changed age distribution, lower proportion of 0–1 month age group, most likely to require respiratory support |
Moore et al. (2012) [27] | WA | To document the proportion of ALRI hospitalisations with positive identification of a respiratory pathogen. | Descriptive case study | General hospital ward, ICU 2000–2005 | 19,857 ALRI hospitalisations 8980 with RSV testing record 0–9 years | Pathogen-specific cause of ALRI | - RSV was the most common pathogen identified in infants aged < 6 months admitted with bronchiolitis (63.7%) - RSV was the most common pathogen identified in infants aged < 6 months admitted with ALRI (36.6%) |
Chappell et al. (2013) [28] | QLD | To assess the diversity and prevalence of bacterial pathogens associated with viral infections of the respiratory tract in children. | Descriptive case study | General hospital ward, ICU 2012 | 201 children 0–5 years | Pathogen-specific cause of ALRI | - Overall, RSV was the most common pathogen identified in infants aged 0–6 months with ALRI (34.9% of 89 samples tested). - RSV mono-infection was most common in 0–6 month age group (31.3% of samples), compared to other age groups up to 5 years. |