Background: We have previously estimated that respiratory syncytial virus (RSV) is associated with 22% of all episodes of acute lower respiratory infection (ALRI) and severe ALRI resulting in 55,000 to 199,000 deaths in children younger than five years in 2005. In the last five years, there has been substantial activity in the field of RSV research and new data from developing countries have become available. We aimed to update the global incidence, hospitalisation rate and mortality from episodes of ALRI due to RSV in young children. Methods We estimated the incidence and hospitalisation rate of RSV-associated ALRI in children younger than five years stratified by age and World Bank income regions from a systematic review of studies published between January 1995 and August 2015, and 78 unpublished population-based studies. We estimated the incidence of RSV-associated ALRI for 132 developing countries using a risk factor based model. We estimated the in-hospital RSV-associated ALRI mortality by combining in-hospital case fatality ratios with hospitalisation estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-associated ALRI mortality by identifying studies reporting monthly data on ALRI mortality in the community and RSV activity. Findings We estimated that in 2015 there were about 33 (20.6-53.2) million episodes of RSV-associated ALRI resulting in about 3.1 (2.0-5.2) million hospitalisations, and 59600 (47000-74500) in-hospital deaths in children younger than 5 years. In children younger than six months, there are about 1.4 (1.1-2.0) million hospitalisations, and 27,300 (20,700-36,200) in-hospital deaths due to RSV-associated ALRI. We also estimated that the overall RSV-associated ALRI mortality could be as high as 134,300 (107,500-169,400). Incidence and mortality varied substantially from year to year in any one setting. Conclusion Globally, RSV is a common cause of childhood ALRI and a major cause of hospital admission in young children, resulting in a substantial burden on healthcare services. About 45% of hospitalisations and in-hospital deaths due to RSV-associated ALRI occur in children younger than six months. Around 99% of in-hospital deaths occur in developing countries. An effective maternal RSV vaccine or monoclonal antibody in newborns could prevent up to 1.1 million hospitalisations and 22,000 in-hospitals deaths (on assumption of 80% effectiveness of vaccine) in this age group annually.
Nair, Harish. (2016). Global, regional and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015, 1995-2015 [dataset]. University of Edinburgh. Usher Institute of Population Health Sciences and Informatics.
|Date made available||4 Oct 2016|
|Temporal coverage||Jan 1995 - Jan 2015|