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BackgroundMost observational population-based studies identify respiratory syncytial virus (RSV) by nasal/nasopharyngeal swab reverse transcriptase real-time PCR (RT-PCR) only. We conducted a systematic review and meta-analyses to quantify specimen and diagnostic testing-based underascertainment of adult RSV infection.MethodsEMBASE, PubMed, and Web of Science were searched (January 2000−December 2021) for studies including adults using/comparing >1 RSV testing approach. We quantified test performance and RSV detection increase associated with using multiple specimen types.ResultsAmong 8066 references identified, 154 met inclusion. Compared to RT-PCR, other methods were less sensitive: rapid antigen detection test (RADT; pooled sensitivity, 64%), direct fluorescent antibody (DFA; 83%), and viral culture (86%). Compared to singleplex PCR, multiplex PCR's sensitivity was lower (93%). Compared to nasal/nasopharyngeal swab RT-PCR alone, adding another specimen type increased detection: sputum RT-PCR, 52%; 4-fold rise in paired serology, 44%; and oropharyngeal swab RT-PCR, 28%. Sensitivity was lower in estimates limited to only adults (for RADT, DFA, and viral culture), and detection rate increases were largely comparable.ConclusionsRT-PCR, particularly singleplex testing, is the most sensitive RSV diagnostic test in adults. Adding additional specimen types to nasopharyngeal swab RT-PCR testing increased RSV detection. Synergistic effects of using ≥3 specimen types should be assessed, as this approach may improve the accuracy of adult RSV burden estimates.

Background: Some reports suggest differences regarding health needs between the population affiliated to subsidized health insurance scheme (SS) compared to the contributory health insurance scheme (CS) in Colombia. Therefore, the objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia, to establish if there are differences compared to CS in terms of: incident diseases, prevalent diseases, and use of health services and to estimate the magnitude of the differences from statistical analyzes of the data retrieved in a systematic review of data published in the literature and other sources of information. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. The search was made from 1993, with none other restriction. The information was synthesized in five categories according to the most important risk populations. We estimated combined incidences from epidemiological surveillance data, prevalence ratio, and other measures to estimate the difference between the studied groups. A 95% interval confidence was considered. A random effects models were used weighted by the inverse of the variance of the cumulative incidence calculated for each disease. The risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Results: 16.236 we identified, 14.972 were exclude after the title and abstract screening, 725 articles were verified as full text and finally 268 articles were included. The relative risk for non-communicable and communicable diseases was lower in the SS than the RC (RR: 0,37 and 0,72 respectively, p-value Conclusions: This study allowed to conclude that there are differences in the incidence, prevalence, and use of health services between health affiliation scheme (SS and CS) in Colombia allowing to guide decision-making to stakeholders. Registration: PROSPERO Registration number CRD42021279234.