Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis.
BACKGROUND
The global burden of disease attributable to respiratory syncytial virus (RSV) remains unknown. We aimed to estimate the global incidence of and mortality from episodes of acute lower respiratory infection (ALRI) due to RSV in children younger than 5 years in 2005.


METHODS
We estimated the incidence of RSV-associated ALRI in children younger than 5 years, stratified by age, using data from a systematic review of studies published between January, 1995, and June, 2009, and ten unpublished population-based studies. We estimated possible boundaries for RSV-associated ALRI mortality by combining case fatality ratios with incidence estimates from hospital-based reports from published and unpublished studies and identifying studies with population-based data for RSV seasonality and monthly ALRI mortality.


RESULTS
In 2005, an estimated 33.8 (95% CI 19.3-46.2) million new episodes of RSV-associated ALRI occurred worldwide in children younger than 5 years (22% of ALRI episodes), with at least 3.4 (2.8-4.3) million episodes representing severe RSV-associated ALRI necessitating hospital admission. We estimated that 66 000-199 000 children younger than 5 years died from RSV-associated ALRI in 2005, with 99% of these deaths occurring in developing countries. Incidence and mortality can vary substantially from year to year in any one setting.


CONCLUSIONS
Globally, RSV is the most common cause of childhood ALRI and a major cause of admission to hospital as a result of severe ALRI. Mortality data suggest that RSV is an important cause of death in childhood from ALRI, after pneumococcal pneumonia and Haemophilus influenzae type b. The development of novel prevention and treatment strategies should be accelerated as a priority.


BACKGROUND
WHO; Bill & Melinda Gates Foundation.
Nair
Harish
H
Centre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK.
Nokes
D James
DJ
Gessner
Bradford D
BD
Dherani
Mukesh
M
Madhi
Shabir A
SA
Singleton
Rosalyn J
RJ
O'Brien
Katherine L
KL
Roca
Anna
A
Wright
Peter F
PF
Bruce
Nigel
N
Chandran
Aruna
A
Theodoratou
Evropi
E
Sutanto
Agustinus
A
Sedyaningsih
Endang R
ER
Ngama
Mwanajuma
M
Munywoki
Patrick K
PK
Kartasasmita
Cissy
C
Simões
Eric A F
EA
Rudan
Igor
I
Weber
Martin W
MW
Campbell
Harry
H
D017677:Age Distribution; D000554:Ambulatory Care Facilities; D002675:Child, Preschool; D019049:Developed Countries; D003906:Developing Countries; D014943:Global Health; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D012720:Severity of Illness Index
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