You Li1, Emily K Johnson2, Ting Shi1, Harry Campbell1, Sandra S Chaves3, Catherine Commaille-Chapus4, Izzie Dighero1, Spencer L James2, Cédric Mahé3, Yujing Ooi1, John Paget5, Tayma van Pomeren5, Cécile Viboud6, Harish Nair7. 1. Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK. 2. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. 3. Foundation for Influenza Epidemiology, Fondation de France, Paris, France; Sanofi Pasteur, Lyon, France. 4. OpenHealth, Paris, France. 5. Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands. 6. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA. 7. Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Respiratory Syncytial Virus Network (ReSViNET) Foundation, Zeist, Netherlands. Electronic address: harish.nair@ed.ac.uk.
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RSV and ALRI hospitalisation in children who were younger than 5 years from systematic literature reviews (including unpublished data) and from inpatient databases, representing 58 countries.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.
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.
Authors: You Li; Xin Wang; Dianna M Blau; Mauricio T Caballero; Daniel R Feikin; Christopher J Gill; Shabir A Madhi; Saad B Omer; Eric A F Simões; Harry Campbell; Ana Bermejo Pariente; Darmaa Bardach; Quique Bassat; Jean-Sebastien Casalegno; Giorgi Chakhunashvili; Nigel Crawford; Daria Danilenko; Lien Anh Ha Do; Marcela Echavarria; Angela Gentile; Aubree Gordon; Terho Heikkinen; Q Sue Huang; Sophie Jullien; Anand Krishnan; Eduardo Luis Lopez; Joško Markić; Ainara Mira-Iglesias; Hannah C Moore; Jocelyn Moyes; Lawrence Mwananyanda; D James Nokes; Faseeha Noordeen; Evangeline Obodai; Nandhini Palani; Candice Romero; Vahid Salimi; Ashish Satav; Euri Seo; Zakhar Shchomak; Rosalyn Singleton; Kirill Stolyarov; Sonia K Stoszek; Anne von Gottberg; Danielle Wurzel; Lay-Myint Yoshida; Chee Fu Yung; Heather J Zar; Harish Nair Journal: Lancet Date: 2022-05-19 Impact factor: 202.731
Authors: Patrick E Obermeier; Albert Heim; Barbara Biere; Elias Hage; Maren Alchikh; Tim Conrad; Brunhilde Schweiger; Barbara A Rath Journal: iScience Date: 2022-04-21
Authors: Shokoofeh Nourbakhsh; Affan Shoukat; Kevin Zhang; Guillaume Poliquin; Donna Halperin; Holden Sheffield; Scott A Halperin; Joanne M Langley; Seyed M Moghadas Journal: EClinicalMedicine Date: 2021-09-24