Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study.


Shi, T; McAllister, DA; O'Brien, KL; Simoes, EAF; Madhi, SA; Gessner, BD; Polack, FP; Balsells, E; Acacio, S; Aguayo, C; Alassani, I; Ali, A; Antonio, M; Awasthi, S; Awori, JO; Azziz-Baumgartner, E; Baggett, HC; Baillie, VL; Balmaseda, A; Barahona, A; Basnet, S; Bassat, Q; Basualdo, W; Bigogo, G; Bont, L; Breiman, RF; Brooks, WA; Broor, S; Bruce, N; Bruden, D; Buchy, P; Campbell, S; Carosone-Link, P; Chadha, M; Chipeta, J; Chou, M; Clara, W; Cohen, C; de Cuellar, E; Dang, DA; Dash-Yandag, B; Deloria-Knoll, M; Dherani, M; Eap, T; Ebruke, BE; Echavarria, M; de Freitas Lázaro Emediato, CC; Fasce, RA; Feikin, DR; Feng, L; Gentile, A; Gordon, A; Goswami, D; Goyet, S; Groome, M; Halasa, N; Hirve, S; Homaira, N; Howie, SRC; Jara, J; Jroundi, I; Kartasasmita, CB; Khuri-Bulos, N; Kotloff, KL; Krishnan, A; Libster, R; Lopez, O; Lucero, MG; Lucion, F; Lupisan, SP; Marcone, DN; McCracken, JP; Mejia, M; Moisi, JC; Montgomery, JM; Moore, DP; Moraleda, C; Moyes, J; Munywoki, P; Mutyara, K; Nicol, MP; Nokes, DJ; Nymadawa, P; da Costa Oliveira, MT; Oshitani, H; Pandey, N; Paranhos-Baccalà, G; Phillips, LN; Picot, VS; Rahman, M; Rakoto-Andrianarivelo, M; Rasmussen, ZA; Rath, BA; Robinson, A; Romero, C; Russomando, G; Salimi, V; Sawatwong, P; Scheltema, N; Schweiger, B; Scott, JAG; Seidenberg, P; Shen, K; Singleton, R; Sotomayor, V; Strand, TA; Sutanto, A; Sylla, M; Tapia, MD; Thamthitiwat, S; Thomas, ED; Tokarz, R; Turner, C; Venter, M; Waicharoen, S; Wang, J; Watthanaworawit, W; Yoshida, LM; Yu, H; Zar, HJ; Campbell, H; Nair, H; RSV Global Epidemiology Network, ; (2017) Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. ISSN 0140-6736 DOI: 10.1016/S0140-6736(17)30938-8

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Abstract

We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015. We estimated the incidence and hospital admission rate of RSV-associated ALRI (RSV-ALRI) in children younger than 5 years stratified by age and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies. We estimated the RSV-ALRI incidence for 132 developing countries using a risk factor-based model and 2015 population estimates. We estimated the in-hospital RSV-ALRI mortality by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-ALRI mortality by identifying studies reporting monthly data for ALRI mortality in the community and RSV activity. We estimated that globally in 2015, 33·1 million (uncertainty range [UR] 21·6-50·3) episodes of RSV-ALRI, resulted in about 3·2 million (2·7-3·8) hospital admissions, and 59 600 (48 000-74 500) in-hospital deaths in children younger than 5 years. In children younger than 6 months, 1·4 million (UR 1·2-1·7) hospital admissions, and 27 300 (UR 20 700-36 200) in-hospital deaths were due to RSV-ALRI. We also estimated that the overall RSV-ALRI mortality could be as high as 118 200 (UR 94 600-149 400). Incidence and mortality varied substantially from year to year in any given population. Globally, RSV is a common cause of childhood ALRI and a major cause of hospital admissions in young children, resulting in a substantial burden on health-care services. About 45% of hospital admissions and in-hospital deaths due to RSV-ALRI occur in children younger than 6 months. An effective maternal RSV vaccine or monoclonal antibody could have a substantial effect on disease burden in this age group. The Bill & Melinda Gates Foundation.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 28689664
URI: http://researchonline.lshtm.ac.uk/id/eprint/4052694

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