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
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Fernando Polack
- Function : Author
Evelyn Balsells
- Function : Author
Sozinho Acacio
- Function : Author
Claudia Aguayo
- Function : Author
Alfredo Barahona
- Function : Author
Wilma Basualdo
- Function : Author
Dana Bruden
- Function : Author
Philippe Buchy
- Function : Author
- PersonId : 758512
- ORCID : 0000-0003-1372-3008
- IdRef : 130418579
Stuart Campbell
- Function : Author
Mandeep Chadha
- Function : Author
James Chipeta
- Function : Author
Elizabeth de Cuellar
- Function : Author
Budragchaagiin Dash-Yandag
- Function : Author
Maria Deloria-Knoll
- Function : Author
Marcela Echavarria
- Function : Author
Carla Cecília de Freitas Lázaro Emediato
- Function : Author
Sophie Goyet
- Function : Author
- PersonId : 765897
- ORCID : 0000-0002-1835-4478
- IdRef : 19579401X
Michelle Groome
- Function : Author
Jorge Jara
- Function : Author
- PersonId : 786717
- ORCID : 0000-0003-3176-0689
Cissy Kartasasmita
- Function : Author
Karen Kotloff
- Function : Author
Romina Libster
- Function : Author
Olga Lopez
- Function : Author
Debora Marcone
- Function : Author
Mario Mejia
- Function : Author
David Moore
- Function : Author
Kuswandewi Mutyara
- Function : Author
Pagbajabyn Nymadawa
- Function : Author
Maria da Costa Oliveira
- Function : Author
Valentina Sanchez Picot
- Function : Author
Barbara Rath
- Function : Author
- PersonId : 766812
- IdRef : 198085532
Annick Robinson
- Function : Author
Candice Romero
- Function : Author
J Anthony G Scott
- Function : Author
Kunling Shen
- Function : Author
Viviana Sotomayor
- Function : Author
Tor Strand
- Function : Author
Agustinus Sutanto
- Function : Author
Maria Sylla
- Function : Author
Milagritos Tapia
- Function : Author
Claudia Turner
- Function : Author
Wanitda Watthanaworawit
- Function : Author
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.