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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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(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. The Lancet, 390 (10098). pp. 946-958. doi:10.1016/S0140-6736(17)30938-8 ISSN 0140-6736.
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Official URL: http://dx.doi.org/10.1016/S0140-6736(17)30938-8
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and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies.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by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies.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.
| Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||
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| Subjects: | R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services | ||||||||||||||||||||||||||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||||||||||||||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Children -- Diseases, Respiratory syncytial virus -- Mortality -- Statistics | ||||||||||||||||||||||||||||||||||||
| Journal or Publication Title: | The Lancet | ||||||||||||||||||||||||||||||||||||
| Publisher: | Lancet Publishing Group | ||||||||||||||||||||||||||||||||||||
| ISSN: | 0140-6736 | ||||||||||||||||||||||||||||||||||||
| Official Date: | 2 September 2017 | ||||||||||||||||||||||||||||||||||||
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| Volume: | 390 | ||||||||||||||||||||||||||||||||||||
| Number: | 10098 | ||||||||||||||||||||||||||||||||||||
| Page Range: | pp. 946-958 | ||||||||||||||||||||||||||||||||||||
| DOI: | 10.1016/S0140-6736(17)30938-8 | ||||||||||||||||||||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||||||||||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||||||||||||||||||||||||||
| Date of first compliant deposit: | 1 August 2017 | ||||||||||||||||||||||||||||||||||||
| Date of first compliant Open Access: | 1 August 2017 | ||||||||||||||||||||||||||||||||||||
| Funder: | Bill & Melinda Gates Foundation, China Scholarship Council (CSC), Wellcome Trust (London, England), Innovative Medicines Initiative (IMI) , Horizon 2020 (European Commission) (H2020), Japan. Monbu Kagakushō [Japan. Ministry of Education, Culture, Sports, Science and Technology] (MEXT), Japan. Iryō kenkyū kaihatsu kikō [Japan Agency for Medical Research and Development] (AMED) | ||||||||||||||||||||||||||||||||||||
| Grant number: | OPP1088499, OPP1017641 (Bill & Melinda Gates Foundation), 201492/Z/16/Z, OXF-COR03, 02975, 098532 (Wellcome Trust (London, England)), 116019 (IMI) | ||||||||||||||||||||||||||||||||||||
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