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 - PubMed (original) (raw)
Review
. 2017 Sep 2;390(10098):946-958.
doi: 10.1016/S0140-6736(17)30938-8. Epub 2017 Jul 7.
David A McAllister 2, Katherine L O'Brien 3, Eric A F Simoes 4, Shabir A Madhi 5, Bradford D Gessner 6, Fernando P Polack 7, Evelyn Balsells 1, Sozinho Acacio 8, Claudia Aguayo 9, Issifou Alassani 10, Asad Ali 11, Martin Antonio 12, Shally Awasthi 13, Juliet O Awori 14, Eduardo Azziz-Baumgartner 15, Henry C Baggett 16, Vicky L Baillie 17, Angel Balmaseda 18, Alfredo Barahona 19, Sudha Basnet 20, Quique Bassat 21, Wilma Basualdo 22, Godfrey Bigogo 23, Louis Bont 24, Robert F Breiman 25, W Abdullah Brooks 26, Shobha Broor 27, Nigel Bruce 28, Dana Bruden 29, Philippe Buchy 30, Stuart Campbell 1, Phyllis Carosone-Link 31, Mandeep Chadha 32, James Chipeta 33, Monidarin Chou 34, Wilfrido Clara 35, Cheryl Cohen 36, Elizabeth de Cuellar 37, Duc-Anh Dang 38, Budragchaagiin Dash-Yandag 39, Maria Deloria-Knoll 3, Mukesh Dherani 28, Tekchheng Eap 40, Bernard E Ebruke 12, Marcela Echavarria [ 41](#full-view-affiliation-41 "Centro de Educación Médica envestigaciones Clínicas "CEMIC", Argentina."), Carla Cecília de Freitas Lázaro Emediato 42, Rodrigo A Fasce 43, Daniel R Feikin 44, Luzhao Feng 45, Angela Gentile 46, Aubree Gordon 47, Doli Goswami 26, Sophie Goyet 48, Michelle Groome 5, Natasha Halasa 49, Siddhivinayak Hirve 50, Nusrat Homaira 51, Stephen R C Howie 52, Jorge Jara 53, Imane Jroundi 54, Cissy B Kartasasmita 55, Najwa Khuri-Bulos 56, Karen L Kotloff 57, Anand Krishnan 27, Romina Libster 58, Olga Lopez 59, Marilla G Lucero 60, Florencia Lucion 46, Socorro P Lupisan 61, Debora N Marcone [ 41](#full-view-affiliation-41 "Centro de Educación Médica envestigaciones Clínicas "CEMIC", Argentina."), John P McCracken 53, Mario Mejia 62, Jennifer C Moisi 6, Joel M Montgomery 63, David P Moore 5, Cinta Moraleda 64, Jocelyn Moyes 36, Patrick Munywoki 65, Kuswandewi Mutyara 55, Mark P Nicol 66, D James Nokes 67, Pagbajabyn Nymadawa 68, Maria Tereza da Costa Oliveira 42, Histoshi Oshitani 69, Nitin Pandey 13, Gláucia Paranhos-Baccalà 70, Lia N Phillips 71, Valentina Sanchez Picot 70, Mustafizur Rahman 72, Mala Rakoto-Andrianarivelo 73, Zeba A Rasmussen 74, Barbara A Rath 75, Annick Robinson 76, Candice Romero 77, Graciela Russomando 78, Vahid Salimi 79, Pongpun Sawatwong 80, Nienke Scheltema 24, Brunhilde Schweiger 81, J Anthony G Scott 82, Phil Seidenberg 83, Kunling Shen 84, Rosalyn Singleton 85, Viviana Sotomayor 9, Tor A Strand 86, Agustinus Sutanto 87, Mariam Sylla 88, Milagritos D Tapia 57, Somsak Thamthitiwat 80, Elizabeth D Thomas 74, Rafal Tokarz 89, Claudia Turner 90, Marietjie Venter 91, Sunthareeya Waicharoen 92, Jianwei Wang 93, Wanitda Watthanaworawit 90, Lay-Myint Yoshida 94, Hongjie Yu 45, Heather J Zar 95, Harry Campbell 1, Harish Nair 96; RSV Global Epidemiology Network
Affiliations
- PMID: 28689664
- PMCID: PMC5592248
- DOI: 10.1016/S0140-6736(17)30938-8
Review
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
Ting Shi et al. Lancet. 2017.
Abstract
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.
Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Figures
Figure 1
Approaches for estimation of global RSV associated morbidity and mortality in children aged 0–4 years In this study, we report four different sets of estimates—number of episodes of (severe) RSV-ALRI at global and national levels, global RSV-ALRI hospital admissions, and global estimates of RSV-ALRI deaths in hospital and overall (in community). This figure summarises our approach for each of these categories and also shows how they relate to (and feed into each other). Global estimates of hospital admissions for RSV-ALRI have been estimated using two independent approaches and datasets (after ensuring all included studies satisfy the common case definition that hospital admission was based on a physician diagnosis of ALRI). Similarly, the in-hospital deaths due to RSV-ALRI are based on studies reporting in-hospital CFR for RSV and RSV-ALRI hospital admissions (again ensuring that all included studies satisfy the common case definition). RSV=respiratory syncytial virus. ALRI=acute lower respiratory infection. hCFR=in-hospital case fatality ratio. VA=verbal autopsy. DHS=demographic and health survey. *For details description of imputation see appendix p 7. †For detailed description of risk-factor based model see appendix pp 54–57.
Figure 2
Flow diagram for selection of studies RSV=respiratory synctical virus. Studies could have contributed data to more than one category.
Figure 3
Location of studies reporting incidence, hospital admission, and in-hospital case fatality in children with RSV-ALRI RSV-ALRI=RSV-associated acute lower respiratory infection.
Figure 4
Global burden of RSV-associated severe ALRI including burden on hospital services RSV=respiratory syncytial virus. ALRI=acute lower respiratory infection. Understanding the contribution of RSV to burden on hospital services and the proportion of “severe” cases not accessing hospital care or deaths outside of hospital is relevant for development of health policies to reduce global (RSV-associated) ALRI mortality. The orange boxes show the estimated number of “severe cases” and overall RSV-related deaths in LMICs that are based on relatively limited data. The green boxes show estimated burden on hospital inpatient services that are based on robust data. The blue boxes reflect the inferred (derived) burden estimates for severe cases and deaths that have no access to hospital care.
References
- Mazur NI, Martinon-Torres F, Baraldi E. Lower respiratory tract infection caused by respiratory syncytial virus: current management and new therapeutics. Lancet Respir Med. 2015;3:888–900. - PubMed
- WHO . The World Health Organization Product Development for Vaccines Advisory Committee (PDVAC) 7–9 Sep 2015: Initial Summary. World Health Organization; Geneva: 2015.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Research Materials
Miscellaneous