Respiratory Syncytial Virus Epidemiology and Clinical Characteristics among Young Children Hospitalized in Sierra Leone

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in children under 5 years of age, resulting in significant morbidity and mortality worldwide. The aim of the current study is to investigate the prevalence and clinical features of RSV disease in hospitalized infants in Sierra Leone. A prospective study was conducted on children under 2 years of age who were hospitalized at Kenema Government Hospital between October 1, 2020, and January 31, 2023. A total of 912 children participated in the study, with 147 (22.8%) testing positive for RSV of 644 (70.6%) who tested positive for at least one virus. During the rainy seasons of 2021 and 2022 (May to November), a surge in RSV cases was observed, particularly those attributed to RSV-A. Conversely, during the dry season (December to April), RSV activity was relatively lower. Respiratory syncytial virus B was significantly associated with a higher disease severity score and increased likelihood of requiring oxygen therapy or referral to the intensive care unit (ICU). Younger children infected with RSV were significantly more likely to require oxygen therapy or referral to the ICU and exhibit higher severity scores. In conclusion, the current study provides valuable insights into the epidemiology and clinical characteristics of RSV in hospitalized children under 2 years of age in Sierra Leone. These findings highlight the need for continuous surveillance and monitoring of RSV infections, especially during peak and transitional seasons, to inform public health interventions and reduce the burden of RSV on children's health.