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Epidemiology of respiratory syncytial virus and its subtypes among cases of influenza like illness and severe acute respiratory infection : findings from nationwide sentinel surveillance in Ethiopia

Tayachew, Adamu ; Mekuria, Zelalem ; Shure, Wolde ; Arimide, Dawit Assefa LU orcid ; Gebeyehu, Ayele ; Berkesa, Tsegaye ; Gonta, Melaku ; Teka, Gizaw ; Kebede, Mandefro and Melese, Daniel , et al. (2025) In BMC Infectious Diseases 25(1).
Abstract

Background: Data in Ethiopia on the epidemiology of Respiratory Syncytial Virus (RSV) and subtypes among influenza-like illness (ILI) and severe acute respiratory infections (SARI) cases is limited. Here, we assessed the epidemiology of RSV and its subtypes among the pediatric and adult ILI /SARI cases in Ethiopia. Methods: We conducted prospective, multicenter facility-based study from May 2023 to April 2024. Respiratory swab specimens, epidemiological and clinical data were collected from participants of all age groups, and both hospitalized and non-hospitalized individuals who met the World Health Organization (WHO) case definition for ILI/SARI and provided informed consent. Laboratory investigation was performed using reverse... (More)

Background: Data in Ethiopia on the epidemiology of Respiratory Syncytial Virus (RSV) and subtypes among influenza-like illness (ILI) and severe acute respiratory infections (SARI) cases is limited. Here, we assessed the epidemiology of RSV and its subtypes among the pediatric and adult ILI /SARI cases in Ethiopia. Methods: We conducted prospective, multicenter facility-based study from May 2023 to April 2024. Respiratory swab specimens, epidemiological and clinical data were collected from participants of all age groups, and both hospitalized and non-hospitalized individuals who met the World Health Organization (WHO) case definition for ILI/SARI and provided informed consent. Laboratory investigation was performed using reverse transcription polymerase chain reaction (RT-PCR). Data were analyzed using SPSS V29. Descriptive statistics were used to summarize frequencies and ratios, and multivariable logistic regression model was employed to assess factors associated with RSV positivity. Results: In total, 4170 participants were enrolled, the majority (57.9%) of whom were cases from children under five and SARI (76.5%). RSV was detected in 654 cases (15.7%; 95% CI: 14.6–16.8). RSV subtyping was carried out for 475 (72.6%) of 654 RSV positive samples. The finding revealed that both RSV-A and RSV-B subtypes were co-circulating in Ethiopia, with predominance of RSV-B (68.8%). Age group, season and timing of sample collection were factors independently associated with RSV positivity. Accordingly, children aged < 2 years (AOR: 8.20, 95% CI: 3.57–18.81) and 2–4 years (AOR: 5.01, 95% CI: 2.15–11.67), autumn (AOR: 5.89, 95% CI: 3.79–9.17) and winter (AOR: 3.27, 95% CI: 2.07–5.16) seasons, and case whose samples were collected within three days of symptom onset (AOR: 1.76, 95% CI: 1.09–2.84) were significantly associated with RSV positivity. Conclusions: The study provides evidence of RSV circulation among ILI/SARI cases in Ethiopia. It also revealed that RSV-B was the predominant subtype circulating in the country. The age-specific and temporal patterns of RSV positivity identified in this study contribute to the understanding of RSV and its subtypes epidemiology in Ethiopia. The findings provide valuable evidence to inform implementation of RSV vaccine introduction programs, particularly targeting high-risk populations during periods of peak transmission. Future research focusing on RSV genomic analysis and disease burden is needed to better understand RSV viral evolution, transmission dynamics and public health impacts in Ethiopia.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Ethiopia, ILI/SARI, RSV, RSV subtypes, RT-PCR
in
BMC Infectious Diseases
volume
25
issue
1
article number
941
publisher
BioMed Central (BMC)
external identifiers
  • pmid:40707913
  • scopus:105011520302
ISSN
1471-2334
DOI
10.1186/s12879-025-11330-6
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2025.
id
f67f28f2-8fd7-40d3-8b86-4477d397451f
date added to LUP
2025-08-04 09:36:29
date last changed
2025-08-18 10:46:24
@article{f67f28f2-8fd7-40d3-8b86-4477d397451f,
  abstract     = {{<p>Background: Data in Ethiopia on the epidemiology of Respiratory Syncytial Virus (RSV) and subtypes among influenza-like illness (ILI) and severe acute respiratory infections (SARI) cases is limited. Here, we assessed the epidemiology of RSV and its subtypes among the pediatric and adult ILI /SARI cases in Ethiopia. Methods: We conducted prospective, multicenter facility-based study from May 2023 to April 2024. Respiratory swab specimens, epidemiological and clinical data were collected from participants of all age groups, and both hospitalized and non-hospitalized individuals who met the World Health Organization (WHO) case definition for ILI/SARI and provided informed consent. Laboratory investigation was performed using reverse transcription polymerase chain reaction (RT-PCR). Data were analyzed using SPSS V29. Descriptive statistics were used to summarize frequencies and ratios, and multivariable logistic regression model was employed to assess factors associated with RSV positivity. Results: In total, 4170 participants were enrolled, the majority (57.9%) of whom were cases from children under five and SARI (76.5%). RSV was detected in 654 cases (15.7%; 95% CI: 14.6–16.8). RSV subtyping was carried out for 475 (72.6%) of 654 RSV positive samples. The finding revealed that both RSV-A and RSV-B subtypes were co-circulating in Ethiopia, with predominance of RSV-B (68.8%). Age group, season and timing of sample collection were factors independently associated with RSV positivity. Accordingly, children aged &lt; 2 years (AOR: 8.20, 95% CI: 3.57–18.81) and 2–4 years (AOR: 5.01, 95% CI: 2.15–11.67), autumn (AOR: 5.89, 95% CI: 3.79–9.17) and winter (AOR: 3.27, 95% CI: 2.07–5.16) seasons, and case whose samples were collected within three days of symptom onset (AOR: 1.76, 95% CI: 1.09–2.84) were significantly associated with RSV positivity. Conclusions: The study provides evidence of RSV circulation among ILI/SARI cases in Ethiopia. It also revealed that RSV-B was the predominant subtype circulating in the country. The age-specific and temporal patterns of RSV positivity identified in this study contribute to the understanding of RSV and its subtypes epidemiology in Ethiopia. The findings provide valuable evidence to inform implementation of RSV vaccine introduction programs, particularly targeting high-risk populations during periods of peak transmission. Future research focusing on RSV genomic analysis and disease burden is needed to better understand RSV viral evolution, transmission dynamics and public health impacts in Ethiopia.</p>}},
  author       = {{Tayachew, Adamu and Mekuria, Zelalem and Shure, Wolde and Arimide, Dawit Assefa and Gebeyehu, Ayele and Berkesa, Tsegaye and Gonta, Melaku and Teka, Gizaw and Kebede, Mandefro and Melese, Daniel and Wossen, Mesfin and Abte, Melkamu and Hailu, Mesay and Berhe, Nega and Medstrand, Patrik and Kebede, Nigatu}},
  issn         = {{1471-2334}},
  keywords     = {{Epidemiology; Ethiopia; ILI/SARI; RSV; RSV subtypes; RT-PCR}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Infectious Diseases}},
  title        = {{Epidemiology of respiratory syncytial virus and its subtypes among cases of influenza like illness and severe acute respiratory infection : findings from nationwide sentinel surveillance in Ethiopia}},
  url          = {{http://dx.doi.org/10.1186/s12879-025-11330-6}},
  doi          = {{10.1186/s12879-025-11330-6}},
  volume       = {{25}},
  year         = {{2025}},
}