Human Metapneumovirus: A Neglected Contributor to Acute Respiratory Infections in Bangladesh: A Public Health Perspective.

BACKGROUND AND AIMS: Acute respiratory tract infections (ARTIs) are a primary cause of mortality in Bangladesh, yet the Human Metapneumovirus (hMPV) remains critically underdiagnosed. This perspective aims to evaluate the current diagnostic landscape, identify specific surveillance gaps, and propose a prioritized strategic framework for integrating hMPV into national health priorities.

SEARCH STRATEGY: We conducted a targeted narrative synthesis of existing regional and local literature, utilizing databases such as PubMed, Google Scholar, and Banglajol, focusing on epidemiological data from the PERCH study and IEDCR reports.

RESULTS

Preliminary evidence suggests that hMPV may account for up to 7.4% of pediatric ARTI hospitalizations in urban centers like Dhaka. However, a critical lack of RT-PCR access in rural areas and a narrow surveillance focus on Influenza and SARS-CoV-2 result in a likely underestimation of the hMPV burden. Systemic hurdles include high diagnostic costs (approximately 3000-5000 BDT per test) and limited clinician awareness.

CONCLUSION

To mitigate this critical gap, Bangladesh must transition from research-based detection to integrated sentinel surveillance. We recommend a tiered approach involving laboratory modernization, clinician training, and the adoption of affordable point-of-care testing to protect vulnerable populations.