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 Barahona & 102 others Sudha 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

Research output: Contribution to journalArticle

237 Citations (Scopus)

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 Sep 2017
Externally publishedYes

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Respiratory Syncytial Viruses
Respiratory Tract Infections
Uncertainty
Mortality
Incidence
Developing Countries
Respiratory Syncytial Virus Vaccines
Population
United Nations
Hospital Mortality
Health Services
Research Design
Age Groups

Cite this

Shi, Ting ; McAllister, David A. ; O'Brien, Katherine L. ; Simoes, Eric A.F. ; Madhi, Shabir A. ; Gessner, Bradford D. ; Polack, Fernando P. ; Balsells, Evelyn ; Acacio, Sozinho ; Aguayo, Claudia ; 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 R.C. ; 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. / 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. In: The Lancet. 2017 ; Vol. 390, No. 10098. pp. 946-958.
@article{c4642f15e8a94d75b9f3868e5649baec,
title = "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",
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.",
author = "Ting Shi and McAllister, {David A.} and O'Brien, {Katherine L.} and Simoes, {Eric A.F.} and Madhi, {Shabir A.} and Gessner, {Bradford D.} and Polack, {Fernando P.} and Evelyn Balsells and Sozinho Acacio and Claudia Aguayo and Issifou Alassani and Asad Ali and Martin Antonio and Shally Awasthi and Awori, {Juliet O.} and Eduardo Azziz-Baumgartner and Baggett, {Henry C.} and Baillie, {Vicky L.} and Angel Balmaseda and Alfredo Barahona and Sudha Basnet and Quique Bassat and Wilma Basualdo and Godfrey Bigogo and Louis Bont and Breiman, {Robert F.} and Brooks, {W. Abdullah} and Shobha Broor and Nigel Bruce and Dana Bruden and Philippe Buchy and Stuart Campbell and Phyllis Carosone-Link and Mandeep Chadha and James Chipeta and Monidarin Chou and Wilfrido Clara and Cheryl Cohen and {de Cuellar}, Elizabeth and Dang, {Duc Anh} and Budragchaagiin Dash-yandag and Maria Deloria-Knoll and Mukesh Dherani and Tekchheng Eap and Ebruke, {Bernard E.} and Marcela Echavarria and {de Freitas L{\'a}zaro Emediato}, {Carla Cec{\'i}lia} and Fasce, {Rodrigo A.} and Feikin, {Daniel R.} and Luzhao Feng and Angela Gentile and Aubree Gordon and Doli Goswami and Sophie Goyet and Michelle Groome and Natasha Halasa and Siddhivinayak Hirve and Nusrat Homaira and Howie, {Stephen R.C.} and Jorge Jara and Imane Jroundi and Kartasasmita, {Cissy B.} and Najwa Khuri-Bulos and Kotloff, {Karen L.} and Anand Krishnan and Romina Libster and Olga Lopez and Lucero, {Marilla G.} and Florencia Lucion and Lupisan, {Socorro P.} and Marcone, {Debora N.} and McCracken, {John P.} and Mario Mejia and Moisi, {Jennifer C.} and Montgomery, {Joel M.} and Moore, {David P.} and Cinta Moraleda and Jocelyn Moyes and Patrick Munywoki and Kuswandewi Mutyara and Nicol, {Mark P.} and Nokes, {D. James} and Pagbajabyn Nymadawa and {da Costa Oliveira}, {Maria Tereza} and Histoshi Oshitani and Nitin Pandey and Gl{\'a}ucia Paranhos-Baccal{\`a} and Phillips, {Lia N.} and Picot, {Valentina Sanchez} and Mustafizur Rahman and Mala Rakoto-Andrianarivelo and Rasmussen, {Zeba A.} and Rath, {Barbara A.} and Annick Robinson and Candice Romero and Graciela Russomando and Vahid Salimi and Pongpun Sawatwong and Nienke Scheltema and Brunhilde Schweiger and Scott, {J. Anthony G.} and Phil Seidenberg and Kunling Shen and Rosalyn Singleton and Viviana Sotomayor and Strand, {Tor A.} and Agustinus Sutanto and Mariam Sylla and Tapia, {Milagritos D.} and Somsak Thamthitiwat and Thomas, {Elizabeth D.} and Rafal Tokarz and Claudia Turner and Marietjie Venter and Sunthareeya Waicharoen and Jianwei Wang and Wanitda Watthanaworawit and Yoshida, {Lay Myint} and Hongjie Yu and Zar, {Heather J.} and Harry Campbell and Harish Nair",
year = "2017",
month = "9",
day = "2",
doi = "10.1016/S0140-6736(17)30938-8",
language = "English",
volume = "390",
pages = "946--958",
journal = "Lancet",
issn = "0140-6736",
publisher = "Academic Press",
number = "10098",

}

Shi, T, McAllister, DA, O'Brien, KL, Simoes, EAF, Madhi, SA, Gessner, BD, Polack, FP, Balsells, E, Acacio, S, Aguayo, C, Alassani, I, Ali, A, Antonio, M, Awasthi, S, Awori, JO, Azziz-Baumgartner, E, Baggett, HC, Baillie, VL, Balmaseda, A, Barahona, A, Basnet, S, Bassat, Q, Basualdo, W, Bigogo, G, Bont, L, Breiman, RF, Brooks, WA, Broor, S, Bruce, N, Bruden, D, Buchy, P, Campbell, S, Carosone-Link, P, Chadha, M, Chipeta, J, Chou, M, Clara, W, Cohen, C, de Cuellar, E, Dang, DA, Dash-yandag, B, Deloria-Knoll, M, Dherani, M, Eap, T, Ebruke, BE, Echavarria, M, de Freitas Lázaro Emediato, CC, Fasce, RA, Feikin, DR, Feng, L, Gentile, A, Gordon, A, Goswami, D, Goyet, S, Groome, M, Halasa, N, Hirve, S, Homaira, N, Howie, SRC, Jara, J, Jroundi, I, Kartasasmita, CB, Khuri-Bulos, N, Kotloff, KL, Krishnan, A, Libster, R, Lopez, O, Lucero, MG, Lucion, F, Lupisan, SP, Marcone, DN, McCracken, JP, Mejia, M, Moisi, JC, Montgomery, JM, Moore, DP, Moraleda, C, Moyes, J, Munywoki, P, Mutyara, K, Nicol, MP, Nokes, DJ, Nymadawa, P, da Costa Oliveira, MT, Oshitani, H, Pandey, N, Paranhos-Baccalà, G, Phillips, LN, Picot, VS, Rahman, M, Rakoto-Andrianarivelo, M, Rasmussen, ZA, Rath, BA, Robinson, A, Romero, C, Russomando, G, Salimi, V, Sawatwong, P, Scheltema, N, Schweiger, B, Scott, JAG, Seidenberg, P, Shen, K, Singleton, R, Sotomayor, V, Strand, TA, Sutanto, A, Sylla, M, Tapia, MD, Thamthitiwat, S, Thomas, ED, Tokarz, R, Turner, C, Venter, M, Waicharoen, S, Wang, J, Watthanaworawit, W, Yoshida, LM, Yu, H, Zar, HJ, Campbell, H & Nair, H 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, vol. 390, no. 10098, pp. 946-958. https://doi.org/10.1016/S0140-6736(17)30938-8

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 A.F.; Madhi, Shabir A.; Gessner, Bradford D.; Polack, Fernando P.; Balsells, Evelyn; Acacio, Sozinho; Aguayo, Claudia; 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 R.C.; 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.

In: The Lancet, Vol. 390, No. 10098, 02.09.2017, p. 946-958.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015

T2 - a systematic review and modelling study

AU - Shi, Ting

AU - McAllister, David A.

AU - O'Brien, Katherine L.

AU - Simoes, Eric A.F.

AU - Madhi, Shabir A.

AU - Gessner, Bradford D.

AU - Polack, Fernando P.

AU - Balsells, Evelyn

AU - Acacio, Sozinho

AU - Aguayo, Claudia

AU - Alassani, Issifou

AU - Ali, Asad

AU - Antonio, Martin

AU - Awasthi, Shally

AU - Awori, Juliet O.

AU - Azziz-Baumgartner, Eduardo

AU - Baggett, Henry C.

AU - Baillie, Vicky L.

AU - Balmaseda, Angel

AU - Barahona, Alfredo

AU - Basnet, Sudha

AU - Bassat, Quique

AU - Basualdo, Wilma

AU - Bigogo, Godfrey

AU - Bont, Louis

AU - Breiman, Robert F.

AU - Brooks, W. Abdullah

AU - Broor, Shobha

AU - Bruce, Nigel

AU - Bruden, Dana

AU - Buchy, Philippe

AU - Campbell, Stuart

AU - Carosone-Link, Phyllis

AU - Chadha, Mandeep

AU - Chipeta, James

AU - Chou, Monidarin

AU - Clara, Wilfrido

AU - Cohen, Cheryl

AU - de Cuellar, Elizabeth

AU - Dang, Duc Anh

AU - Dash-yandag, Budragchaagiin

AU - Deloria-Knoll, Maria

AU - Dherani, Mukesh

AU - Eap, Tekchheng

AU - Ebruke, Bernard E.

AU - Echavarria, Marcela

AU - de Freitas Lázaro Emediato, Carla Cecília

AU - Fasce, Rodrigo A.

AU - Feikin, Daniel R.

AU - Feng, Luzhao

AU - Gentile, Angela

AU - Gordon, Aubree

AU - Goswami, Doli

AU - Goyet, Sophie

AU - Groome, Michelle

AU - Halasa, Natasha

AU - Hirve, Siddhivinayak

AU - Homaira, Nusrat

AU - Howie, Stephen R.C.

AU - Jara, Jorge

AU - Jroundi, Imane

AU - Kartasasmita, Cissy B.

AU - Khuri-Bulos, Najwa

AU - Kotloff, Karen L.

AU - Krishnan, Anand

AU - Libster, Romina

AU - Lopez, Olga

AU - Lucero, Marilla G.

AU - Lucion, Florencia

AU - Lupisan, Socorro P.

AU - Marcone, Debora N.

AU - McCracken, John P.

AU - Mejia, Mario

AU - Moisi, Jennifer C.

AU - Montgomery, Joel M.

AU - Moore, David P.

AU - Moraleda, Cinta

AU - Moyes, Jocelyn

AU - Munywoki, Patrick

AU - Mutyara, Kuswandewi

AU - Nicol, Mark P.

AU - Nokes, D. James

AU - Nymadawa, Pagbajabyn

AU - da Costa Oliveira, Maria Tereza

AU - Oshitani, Histoshi

AU - Pandey, Nitin

AU - Paranhos-Baccalà, Gláucia

AU - Phillips, Lia N.

AU - Picot, Valentina Sanchez

AU - Rahman, Mustafizur

AU - Rakoto-Andrianarivelo, Mala

AU - Rasmussen, Zeba A.

AU - Rath, Barbara A.

AU - Robinson, Annick

AU - Romero, Candice

AU - Russomando, Graciela

AU - Salimi, Vahid

AU - Sawatwong, Pongpun

AU - Scheltema, Nienke

AU - Schweiger, Brunhilde

AU - Scott, J. Anthony G.

AU - Seidenberg, Phil

AU - Shen, Kunling

AU - Singleton, Rosalyn

AU - Sotomayor, Viviana

AU - Strand, Tor A.

AU - Sutanto, Agustinus

AU - Sylla, Mariam

AU - Tapia, Milagritos D.

AU - Thamthitiwat, Somsak

AU - Thomas, Elizabeth D.

AU - Tokarz, Rafal

AU - Turner, Claudia

AU - Venter, Marietjie

AU - Waicharoen, Sunthareeya

AU - Wang, Jianwei

AU - Watthanaworawit, Wanitda

AU - Yoshida, Lay Myint

AU - Yu, Hongjie

AU - Zar, Heather J.

AU - Campbell, Harry

AU - Nair, Harish

PY - 2017/9/2

Y1 - 2017/9/2

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85021970644&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(17)30938-8

DO - 10.1016/S0140-6736(17)30938-8

M3 - Article

VL - 390

SP - 946

EP - 958

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - 10098

ER -