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, Ting;
McAllister, David A;
O'Brien, Katherine L;
Simoes, Eric AF;
Madhi, Shabir A;
Gessner, Bradford D;
Polack, Fernando P;
Balsells, Evelyn;
Acacio, Sozinho;
Aguayo, Claudia;
+113 more...Alassani, Issifou;
Ali, Asad;
Antonio, Martin;
Awasthi, Shally;
Awori, Juliet O;
Azziz-Baumgartner, Eduardo;
Baggett, Henry C;
Baillie, Vicky L;
Balmaseda, Angel;
Barahona, Alfredo;
Basnet, Sudha;
Bassat, Quique;
Basualdo, Wilma;
Bigogo, Godfrey;
Bont, Louis;
Breiman, Robert F;
Brooks, W Abdullah;
Broor, Shobha;
Bruce, Nigel;
Bruden, Dana;
Buchy, Philippe;
Campbell, Stuart;
Carosone-Link, Phyllis;
Chadha, Mandeep;
Chipeta, James;
Chou, Monidarin;
Clara, Wilfrido;
Cohen, Cheryl;
de Cuellar, Elizabeth;
Dang, Duc-Anh;
Dash-Yandag, Budragchaagiin;
Deloria-Knoll, Maria;
Dherani, Mukesh;
Eap, Tekchheng;
Ebruke, Bernard E;
Echavarria, Marcela;
de Freitas Lázaro Emediato, Carla Cecília;
Fasce, Rodrigo A;
Feikin, Daniel R;
Feng, Luzhao;
Gentile, Angela;
Gordon, Aubree;
Goswami, Doli;
Goyet, Sophie;
Groome, Michelle;
Halasa, Natasha;
Hirve, Siddhivinayak;
Homaira, Nusrat;
Howie, Stephen RC;
Jara, Jorge;
Jroundi, Imane;
Kartasasmita, Cissy B;
Khuri-Bulos, Najwa;
Kotloff, Karen L;
Krishnan, Anand;
Libster, Romina;
Lopez, Olga;
Lucero, Marilla G;
Lucion, Florencia;
Lupisan, Socorro P;
Marcone, Debora N;
McCracken, John P;
Mejia, Mario;
Moisi, Jennifer C;
Montgomery, Joel M;
Moore, David P;
Moraleda, Cinta;
Moyes, Jocelyn;
Munywoki, Patrick;
Mutyara, Kuswandewi;
Nicol, Mark P;
Nokes, D James;
Nymadawa, Pagbajabyn;
da Costa Oliveira, Maria Tereza;
Oshitani, Histoshi;
Pandey, Nitin;
Paranhos-Baccalà, Gláucia;
Phillips, Lia N;
Picot, Valentina Sanchez;
Rahman, Mustafizur;
Rakoto-Andrianarivelo, Mala;
Rasmussen, Zeba A;
Rath, Barbara A;
Robinson, Annick;
Romero, Candice;
Russomando, Graciela;
Salimi, Vahid;
Sawatwong, Pongpun;
Scheltema, Nienke;
Schweiger, Brunhilde;
Scott, J Anthony G;
Seidenberg, Phil;
Shen, Kunling;
Singleton, Rosalyn;
Sotomayor, Viviana;
Strand, Tor A;
Sutanto, Agustinus;
Sylla, Mariam;
Tapia, Milagritos D;
Thamthitiwat, Somsak;
Thomas, Elizabeth D;
Tokarz, Rafal;
Turner, Claudia;
Venter, Marietjie;
Waicharoen, Sunthareeya;
Wang, Jianwei;
Watthanaworawit, Wanitda;
Yoshida, Lay-Myint;
Yu, Hongjie;
Zar, Heather J;
Campbell, Harry;
Nair, Harish;
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, 390 (10098).
pp. 946-958.
ISSN 0140-6736
DOI: https://doi.org/10.1016/S0140-6736(17)30938-8
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BACKGROUND: 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. METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: The Bill & Melinda Gates Foundation.
