Burden of respiratory syncytial virus diseases among under 5 children in Sub-Saharan Africa: A systematic review and meta-analysis

Background: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infections (ALRIs) in young children. To design preventive efforts in sub-Saharan Africa, a better knowledge of the true role of RSV in pediatric ALRIs is required. Therefore we conducted a systematic review and meta-analysis of case–control studies to estimate the etiological role of RSV to ALRIs in under 5 years children in sub-Saharan Africa. Methods: This study was done according to PRISMA guidelines. PubMed, EMBASE, SCOPUS, Web of Sciences databases, and Google Scholar were used to retrieve articles. STATA software version 17 was used for data analysis. The results of all the included studies were standardized to odds ratios (ORs) with accompanying 95 % confidence intervals (95 % CIs) and the pooled estimates of ORs, attributable fraction among the exposed (AFE), and population attributable fraction (PAF) were reported. The heterogeneity was assessed using Cochrane chi-square (I 2) statistics. Result: A total of 6200 cases and 4986 controls from 14 articles that fulfilled the inclusion criteria were included. The pooled prevalence of RSV among cases and controls was 23.52 % [95 % CI (20.68–26.47)] and 4.33 % [95 % CI (3.11–5.73)], respectively. The pooled OR is 7.04 [95 % CI (4.41–11.24)], which indicated a significant association between RSV and ALRI. Among ALRIs cases positive for RSV, the proportion of disease that was not attributable to the background rate (AFE) was 85.8 % [95 % CI (77.3–91.1)]. The fraction of ALRIs children that can be attributed to RSV (PAF) was 20.2 % [95 % CI (16–24.1)]. Conclusion: This study showed clear associations between RSV and ALRI hospitalization in young children in sub-Saharan Africa indicating the need for prophylactic measures against RSV in this age group

Hematological and Clinical Features Associated with Initial Poor Treatment Outcomes in Visceral Leishmaniasis Patients with and without HIV Coinfection in Gondar, Northwest Ethiopia

Ethiopia is among the countries with a high leishmaniasis burden. In this retrospective review, we aimed to determine hematological and clinical features associated with initial poor treatment outcomes of visceral leishmaniasis (VL) patients. The majority of VL cases in this study had leucopenia (94.3%), thrombocytopenia (87.1%), and anemia (85.9%). HIV coinfection was present in 7.0% (n = 23) of VL cases. At the center, VL patients without HIV coinfection were treated with sodium stibogluconate and paromomycin combination, whereas HIV coinfected cases were treated with AmBisome and miltefosine combination therapy. End-of-treatment cure rates among HIV-positive and HIV-negative visceral leishmaniasis cases, respectively, were 52.2% and 96.9%. Case fatality rates were 34.8% and 2.7% in HIV-positive and HIV-negative cases, respectively. Overall, non-survivors in this study were more likely to have HIV (55.0% vs. 4.1%, p p = 0.019), and dyspnea (40.0% vs. 2.7%, p < 0.001) at admission. In this regard, particular attention to the management of superimposed disease conditions at admission, including sepsis, HIV, and dyspnea, is needed to improve VL patients’ treatment outcomes. The inadequacy of the current treatments, i.e., AmBisome and miltefosine combination therapy, for HIV coinfected visceral leishmaniasis patients requires further attention as it calls for new treatment modalities