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

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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.

Original languageEnglish
Pages (from-to)946-958
Number of pages13
JournalThe Lancet
Volume390
Issue number10098
DOIs
Publication statusPublished - 2 Sept 2017
Externally publishedYes

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