Global respiratory syncytial virus–related infant community deaths

Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P < .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P < 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines

The Historical Evolution of Monetary Policy in Latin America

Recent monetary policy in Latin America has evolved in five different phases. The first one revolves around the monetary doctoring missions, mainly but not exclusively, from the United States that established the first central banks in the region in the 1920s and 1930s adhering to a gold standard regime. The second phase comprises the first attempts to adopt a proactive countercyclical monetary stance and the granting of ample discretionary powers to the central bank to protect economies from the effects of the international business cycle. The third phase consists in the generalized adoption of developmental and inward industrialization goals by central banks. The fourth phase is characterized by central bank’s abandonment of developmental objectives placing the focus of their actions on price stability. The last phase in the evolution of monetary policy centers on inflation targeting. Currently, the most important and pressing challenges of monetary policy relate to its impact and pass-through on the real economy and to the relationships between monetary policy, fiscal policy, the financial system, and financial stability