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, Emily K Johnson, Ting Shi, Harry Campbell, Sandra S Chaves, Catherine Commaille-Chapus, Izzie Dighero, Spencer L. James, Cédric Mahé, Yujing Ooi, John Paget, Tayma van Pomeren, Cecile Viboud, Harish Nair

Research output: Contribution to journalArticlepeer-review

Abstract

BackgroundRespiratory syncytial virus (RSV) is the predominant viral pathogen associated with acute lower respiratory infection (ALRI) in children under five years of age (<5y). Little is reported on the national estimates of RSV-ALRI hospitalisations in <5y based on robust RSV epidemiology data.MethodsWe included data on RSV and ALRI hospitalisation in <5y from systematic literature reviews (including unpublished data) and from inpatient databases, representing 58 countries. We used two different methods, namely the rate-based method and the proportion-based method, to estimate national RSV-ALRI hospitalisations in <5y in the year of 2019. The rate-based method synthesized data on laboratory-confirmed RSV-ALRI hospitalisation rates using a spatiotemporal Gaussian process meta-regression (ST-GPR). The proportion-based method applied data on RSV positive proportions among ALRI to all-cause ALRI hospitalisation envelopes using a Bayesian regularized trimmed meta-regression (MR-BRT). Where applicable, we reported estimates by both methods in order to provide a plausible range for each included country.FindingsA total of 334 studies and 1985 data points were included in the analysis, accounting for 59% (398 million/677 million) of the <5y population worldwide. We reported the number of the annual national RSV-ALRI hospitalisations for 29 countries using the rate-based method and 42 countries using the proportion-based method. Despite great variation among countries, a high proportion of the RSV-ALRI hospitalisations were in infants <1y in all countries (median proportion: 45%, interquartile range: 32–56). In most (76%, 272/358) of the study years, RSV-ALRI hospitalisation rate fluctuated between 0·8 and 1·2 fold of country’s median yearly rate. General agreement was observed between estimates by the rate-based method and proportion-based method, with a few exceptions in India, Kenya, Norway and Philippines.
InterpretationBy incorporating data from various sources, our study provides robust estimates on the national burden of RSV-ALRI hospitalisation in <5y. These estimates are important for informing policy for introduction of RSV immunisations and also serve as baseline data for RSV disease burden in young children.
Original languageEnglish
JournalThe Lancet Respiratory Medicine
Early online date21 Sep 2020
DOIs
Publication statusE-pub ahead of print - 21 Sep 2020

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