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

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and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies.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by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies.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

Multicenter case–control study protocol of pneumonia etiology in children: Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries (GABRIEL network)

Made available in DSpace on 2015-06-17T12:05:23Z (GMT). No. of bitstreams: 2 license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) patricia_barretoetal_IOC_2014.pdf: 442142 bytes, checksum: dfb79e91e1be1c313d56b6e04b7de26f (MD5) Previous issue date: 2014Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.Hospices Civils de Lyon. Edouard Herriot Hospital. Infection Control and Epidemiology Unit. Lyon, Grance / Universit of Lyon 1, Epidemiology and Public Health Unit. Lyon, France.Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.University of Health Sciences. Faculty of Pharmacy. Phnom Penh, Cambodia.National Pediatric Hospital. Department of Pneumology. Phnom Penh, Cambodia.MOH Key Laboratory of Systems Biology of Pathogens. Dr. Christophe Mérieux Laboratory. Fondation Mérieux. Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College. Beijing, China.Capital Medical University. Key Laboratory of Major Diseases in Children. National Key Discipline of Pediatrics. Ministry of Education. Beijing Pediatric Research Institute. Beijing Children’s Hospital. Capital Medical University, Beijing, China.GHESKIO (Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes) Centers. Port au Prince, Haiti.GHESKIO (Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes) Centers. Port au Prince, Haiti.Chatrapati Shahuji Maharaj University. Lucknow, India.Chatrapati Shahuji Maharaj University. Lucknow, India.KEM Hospital Research Center. Pune, India.KEM Hospital Research Center. Pune, India.Hôpital Femme-Mère-Enfant. Antananarivo, Madagascar.Fondation Mérieux. Centre d’Infectiologie Charles Mérieux (CICM); Antananarivo, Madagascar.Fondation Mérieux. Centre d’Infectiologie Charles Mérieux (CICM); Antananarivo, Madagascar.Gabriel Touré Hospital. Bamako, Mali.Centre d`Infectiologie Charles Mérieux (CICM). Bamako, Mali.Mongolian Academy of Medical Sciences. Ulaanbaatar, Mongolia.Bayanzurkh District General Hospital. Ulaanbaatar, Mongolia.Research Institute of health. Asuncion, Paraguay.Hospital Pediátrico ! Niños de Acosta ¨Nu". San Lorenzo, Paraguay.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Vírus Respiratórios e Sarampo. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Vírus Respiratórios e Sarampo. Rio de Janeiro, RJ, Brasil.Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.Hospices Civils de Lyon. Edouard Herriot Hospital. Infection Control and Epidemiology Unit. Lyon, Grance / Universit of Lyon 1, Epidemiology and Public Health Unit. Lyon, France.Fondation Mérieux. Centre Internationale Recherche en Infectiologie (CIRI). Emerging Pathogens Laboratory. Lyon, France.Background: Data on the etiologies of pneumonia among children are inadequate, especially in developing countries. The principal objective is to undertake a multicenter incident case–control study of <5-year-old children hospitalized with pneumonia in developing and emerging countries, aiming to identify the causative agents involved in pneumonia while assessing individual and microbial factors associated with the risk of severe pneumonia. Methods/design: A multicenter case–control study, based on the GABRIEL network, is ongoing. Ten study sites are located in 9 countries over 3 continents: Brazil, Cambodia, China, Haiti, India, Madagascar, Mali, Mongolia, and Paraguay. At least 1,000 incident cases and 1,000 controls will be enrolled and matched for age and date. Cases are hospitalized children <5 years with radiologically confirmed pneumonia, and the controls are children without any features suggestive of pneumonia. Respiratory specimens are collected from all enrolled subjects to identify 19 viruses and 5 bacteria. Whole blood from pneumonia cases is being tested for 3 major bacteria. S. pneumoniae-positive specimens are serotyped. Urine samples from cases only are tested for detection of antimicrobial activity. The association between procalcitonin, C-reactive protein and pathogens is being evaluated. A discovery platform will enable pathogen identification in undiagnosed samples. Discussion: This multicenter study will provide descriptive results for better understanding of pathogens responsible for pneumonia among children in developing countries. The identification of determinants related to microorganisms associated with pneumonia and its severity should facilitate treatment and prevention

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

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