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

Shi, T. et al. (2017) Global, regional and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015. Lancet, 390(10098), pp. 946-958. (doi: 10.1016/S0140-6736(17)30938-8) (PMID:28689664) (PMCID:PMC5592248)

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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and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies.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by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies.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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:McAllister, Professor David
Authors: Shi, T., McAllister, D. A., O'Brien, K. L., Simoes, E. A.F., Madhi, S. A., Gessner, B. D., Polack, F. P., Balsells, E., Acacio, S., Aguayo, C., Alassani, I., Ali, A., Antonio, M., Awasthi, S., Awori, J. O., Azziz-Baumgartner, E., Baggett, H. C., Baillie, V. L., Balmaseda, A., Barahona, A., Basnet, S., Bassat, Q., Basualdo, W., Bigogo, G., Bont, L., Breiman, R. F., Brooks, W. A., Broor, S., Bruce, N., Bruden, D., Buchy, P., Campbell, S., Carosone-Link, P., Chadha, M., Chipeta, J., Chou, M., Clara, W., Cohen, C., de Cullar, E., Dang, D.-A., Dash-yandag, B., Deloria-Knoll, M., Dherani, M., Eap, T., Ebruke, B. E., Echavarria, M., de Freitas Lazaro Emediato, C. C., Fasce, R. A., Feikin, D. R., Feng, L., Gentile, A., Gordon, A., Goswami, D., Goyet, S., Groome, M., Halasa, N., Hirve, S., Homaira, N., Howie, S. R.C., Jara, J., Jroundi, I., Kartasasmita, C. B., Khuri-Bulos, N., Kotloff, K. L., Krishnan, A., Libster, R., Lopez, O., Lucero, M. G., Lucion, F., Lupisan, S. P., Marcone, D. N., McCracken, J. P., Mejia, M., Moisi, J. C., Montgomery, J. M., Moore, D. P., Moraleda, C., Moyes, J., Munywoki, P., Mutyara, K., Nicol, M. P., Nokes, D. J., Nymadawa, P., Tereza da Costa Oliveira, M., Oshitani, H., Pandey, N., Paranhos-Baccala, G., Phillips, L. N., Picot, V. S., Rahman, M., Rakoto-Andrianarivelo, M., Rasmussen, Z. A., Rath, B. A., Robinson, A., Romero, C., Russomando, G., Salimi, V., Sawatwong, P., Scheltema, N., Schweiger, B., Scott, J. A. G., Seidenberg, P., Shen, K., Singleton, R., Sotomayor, V., Strand, T. A., Sustanto, A., Sylla, M., Tapia, M. D., Thamthitiwat, S., Thomas, E. D., Tokarz, R., Turner, C., Venter, M., Waicharoen, S., Wang, J., Watthaoaworawit, W., Yoshida, L.-M., Yu, H., Zar, H. J., Campbell, H., and Nair, H.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:Lancet
Publisher:The Lancet Publishing Group
ISSN (Online):1474-547X
Published Online:07 July 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Lancet 390(10098):946-958
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
754451Combining efficacy estimates from clinical trials with the natural history obtained from large routine healthcare databases to determine net overall treatment benefitsDavid McAllisterWellcome Trust (WELLCOME)201492/Z/16/ZIHW - PUBLIC HEALTH