tetano
Editor, Senior Moderator
Lancet Respir Med
. 2020 Sep 21;S2213-2600(20)30322-2.
doi: 10.1016/S2213-2600(20)30322-2. Online ahead of print.
National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in 2019 among 58 countries: a modelling study
You Li[SUP] 1 [/SUP], Emily K Johnson[SUP] 2 [/SUP], Ting Shi[SUP] 1 [/SUP], Harry Campbell[SUP] 1 [/SUP], Sandra S Chaves[SUP] 3 [/SUP], Catherine Commaille-Chapus[SUP] 4 [/SUP], Izzie Dighero[SUP] 1 [/SUP], Spencer L James[SUP] 2 [/SUP], C?dric Mah?[SUP] 3 [/SUP], Yujing Ooi[SUP] 1 [/SUP], John Paget[SUP] 5 [/SUP], Tayma van Pomeren[SUP] 5 [/SUP], C?cile Viboud[SUP] 6 [/SUP], Harish Nair[SUP] 7 [/SUP]
Affiliations
Abstract
Background: Respiratory syncytial virus (RSV) is the predominant viral pathogen associated with acute lower respiratory infection (ALRI) in children who are younger than 5 years. Little is reported on the national estimates of RSV-associated ALRI hospitalisations in these children on the basis of robust epidemiological data. We aimed to generate national level estimates for RSV-associated ALRI hospitalisations in children aged younger than 5 years.
Methods: We included data for RSV and ALRI hospitalisation in children who were younger than 5 years from systematic literature reviews (including unpublished data) and from inpatient databases, representing 58 countries. We used two different methods, the rate-based method and the proportion-based method, to estimate national RSV-associated ALRI hospitalisations in children younger than 5 years in 2019. The rate-based method synthesised data for laboratory-confirmed RSV-associated ALRI hospitalisation rates using a spatiotemporal Gaussian process meta-regression (ST-GPR). The proportion-based method applied data for RSV positive proportions among ALRI to all-cause ALRI hospitalisation envelopes (ie, total disease burden of ALRI hospitalisations of any cause) using a Bayesian regularised trimmed meta-regression (MR-BRT). Where applicable, we reported estimates by both methods to provide a plausible range for each country.
Findings: A total of 334 studies and 1985 data points (defined as an individual estimate for one age group and 1 year for each study) were included in our analysis, accounting for 398 million (59%) of the 677 million children aged younger than 5 years worldwide representing 58 countries. We reported the number of annual national RSV-associated ALRI hospitalisations for 29 countries using the rate-based method, and for 42 countries using the proportion-based method. The median number of RSV-associated ALRI hospitalisations in children younger than 5 years was 8?25 thousand (IQR 1?97-48?01), and the median rate of RSV-associated ALRI hospitalisations was 514 (339-866) hospitalisations per thousand children younger than 5 years. Despite large variation among countries, a high proportion of the RSV-associated ALRI hospitalisations were in infants aged younger than 1 year in all countries (median proportion 45%, IQR 32-56). In 272 (76%) of the 358 years included in the analysis, the RSV-associated ALRI hospitalisation rate fluctuated between 0?8 and 1?2 times the country's median yearly rate. General agreement was observed between estimates by the rate-based method and proportion-based method, with the exceptions of India, Kenya, Norway, and Philippines.
Interpretation: By incorporating data from various sources, our study provides robust estimates on national level burden of RSV-associated ALRI hospitalisation in children aged younger than 5 years. These estimates are important for informing policy for the introduction of RSV immunisations and also serve as baseline data for the RSV disease burden in young children.
Funding: The Foundation for Influenza Epidemiology.
. 2020 Sep 21;S2213-2600(20)30322-2.
doi: 10.1016/S2213-2600(20)30322-2. Online ahead of print.
National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in 2019 among 58 countries: a modelling study
You Li[SUP] 1 [/SUP], Emily K Johnson[SUP] 2 [/SUP], Ting Shi[SUP] 1 [/SUP], Harry Campbell[SUP] 1 [/SUP], Sandra S Chaves[SUP] 3 [/SUP], Catherine Commaille-Chapus[SUP] 4 [/SUP], Izzie Dighero[SUP] 1 [/SUP], Spencer L James[SUP] 2 [/SUP], C?dric Mah?[SUP] 3 [/SUP], Yujing Ooi[SUP] 1 [/SUP], John Paget[SUP] 5 [/SUP], Tayma van Pomeren[SUP] 5 [/SUP], C?cile Viboud[SUP] 6 [/SUP], Harish Nair[SUP] 7 [/SUP]
Affiliations
- PMID: 32971018
- DOI: 10.1016/S2213-2600(20)30322-2
Abstract
Background: Respiratory syncytial virus (RSV) is the predominant viral pathogen associated with acute lower respiratory infection (ALRI) in children who are younger than 5 years. Little is reported on the national estimates of RSV-associated ALRI hospitalisations in these children on the basis of robust epidemiological data. We aimed to generate national level estimates for RSV-associated ALRI hospitalisations in children aged younger than 5 years.
Methods: We included data for RSV and ALRI hospitalisation in children who were younger than 5 years from systematic literature reviews (including unpublished data) and from inpatient databases, representing 58 countries. We used two different methods, the rate-based method and the proportion-based method, to estimate national RSV-associated ALRI hospitalisations in children younger than 5 years in 2019. The rate-based method synthesised data for laboratory-confirmed RSV-associated ALRI hospitalisation rates using a spatiotemporal Gaussian process meta-regression (ST-GPR). The proportion-based method applied data for RSV positive proportions among ALRI to all-cause ALRI hospitalisation envelopes (ie, total disease burden of ALRI hospitalisations of any cause) using a Bayesian regularised trimmed meta-regression (MR-BRT). Where applicable, we reported estimates by both methods to provide a plausible range for each country.
Findings: A total of 334 studies and 1985 data points (defined as an individual estimate for one age group and 1 year for each study) were included in our analysis, accounting for 398 million (59%) of the 677 million children aged younger than 5 years worldwide representing 58 countries. We reported the number of annual national RSV-associated ALRI hospitalisations for 29 countries using the rate-based method, and for 42 countries using the proportion-based method. The median number of RSV-associated ALRI hospitalisations in children younger than 5 years was 8?25 thousand (IQR 1?97-48?01), and the median rate of RSV-associated ALRI hospitalisations was 514 (339-866) hospitalisations per thousand children younger than 5 years. Despite large variation among countries, a high proportion of the RSV-associated ALRI hospitalisations were in infants aged younger than 1 year in all countries (median proportion 45%, IQR 32-56). In 272 (76%) of the 358 years included in the analysis, the RSV-associated ALRI hospitalisation rate fluctuated between 0?8 and 1?2 times the country's median yearly rate. General agreement was observed between estimates by the rate-based method and proportion-based method, with the exceptions of India, Kenya, Norway, and Philippines.
Interpretation: By incorporating data from various sources, our study provides robust estimates on national level burden of RSV-associated ALRI hospitalisation in children aged younger than 5 years. These estimates are important for informing policy for the introduction of RSV immunisations and also serve as baseline data for the RSV disease burden in young children.
Funding: The Foundation for Influenza Epidemiology.