Prevalence of RSV among patients in tertiary hospitals and healthcare worker knowledge in The Gambia: A paradigm shift from reactive to proactive 3PM-guided care is envisaged

OBJECTIVE: Respiratory syncytial virus (RSV) is a leading cause of pediatric acute lower respiratory infections in The Gambia, without an effective management. This study aimed to provide a comprehensive analysis of RSV landscape in The Gambia to inform actionable predictive preventive personalized medicine (3PM) strategies. METHODS: A cross-sectional study was conducted across five major healthcare facilities. A patient cohort (n=427) with acute respiratory infection provided virological and personal factor data. A healthcare worker (HCW) cohort (n=490) was surveyed on their knowledge, attitudes, and practices (KAP) regarding RSV. Logistic regression was used to identify risk factors for RSV infection. RESULTS: RSV was the most prevalent virus (19.4%) in children under five. Critical HCW knowledge gaps showed 85.1% poor knowledge, and 82.2% no formal RSV training. Only 33.7% HCWs requested laboratory confirmation, and 87.6% had no masking. Only 11% of HCWs had prescribed monoclonal antibodies (e.g., nirsevimab) for RSV prophylaxis, reflecting that such advanced prophylactics are not yet routinely available in The Gambia. Also, young age (0-5 years) and larger household size were identified as independent risk factors for RSV, while mask-wearing was a significant protective factor. CONCLUSION: This study reveals a high RSV prevalence, low community prevention, and critical healthcare system gaps. 3PM is an effective strategy to improve the overall management of RSV in The Gambia.