TY  - JOUR
T1  - Global, regional, and national burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic reviw 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  - Phyllis, Carosone-Link
AU  - Chadha, Mandeep
AU  - Chipeta, James
AU  - Chou, Moindarin
AU  - Clara, Wilfrido
AU  - Cohen, Cheryl
AU  - dde Cuellar, Elizabeth
AU  - Dang, Duc-Anh
AU  - Dash-Yandag, Budragchaagiin
AU  - Deloria-Knoll, Maria
AU  - Dherani, Mukesh
AU  - Eap, Tekcheng
AU  - Echavarria, Marcela
AU  - de Freitas Lazaro Emediato, Carla Cecilia
AU  - Fasce, Rodrigo A.
AU  - Feikin, Daniel
AU  - Feng, Luzhao
AU  - Gentile, Angela
AU  - Gordon, Aubree
AU  - Goswani, 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, Hitoshi
AU  - Pandey, Nitin
AU  - Paranhos-Baccala, Glaucia
AU  - Phillips, Lia N.
AU  - Picot, Valentina Sanchez
AU  - Rahman, Mustafizur
AU  - Rakoto-Adrianarivelo, 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  - Sutano, 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, Wantida
AU  - Yoshida, Lay-Myint
AU  - Yu, Hongjie
AU  - Zar, Heather J.
AU  - Campbell, Harry
AU  - Nair, Harish
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.
KW  - 610 Medizin und Gesundheit
PY  - 2017
LA  - und
PB  - Robert Koch-Institut
JO  - The Lancet
VL  - 390
IS  - 10098
SP  - 946
EP  - 958
DO  - 10.1016/S0140-6736(17)30938-8
ER  -