title: Respiratory syncytial virus hospitalization and mortality: Systematic review and meta-analysis.
abstract: Respiratory syncytial virus (RSV) is a major public health burden worldwide. We aimed to review the current literature on the incidence and mortality of severe RSV in children globally.
  
  
  
  Systematic literature review and meta-analysis of published data from 2000 onwards, reporting on burden of acute respiratory infection (ARI) due to RSV in children. Main outcomes were hospitalization for severe RSV-ARI and death.
  
  
  
  Five thousand two hundred and seventy-four references were identified. Fifty-five studies were included from 32 countries. The global RSV-ARI hospitalization estimates, reported per 1,000 children per year (95% Credible Interval (CrI), were 4.37 (2.98, 6.42) among children <5 years, 19.19 (15.04, 24.48) among children <1 year, 20.01 (9.65, 41.31) among children <6 months and 63.85 (37.52, 109.70) among premature children <1 year. The RSV-ARI global case-fatality estimates, reported per 1,000 children, (95% Crl) were 6.21 (2.64, 13.73) among children <5 years, 6.60 (1.85, 16.93) for children <1 year, and 1.04 (0.17, 12.06) among preterm children <1 year.
  
  
  
  A substantial proportion of RSV-associated morbidity occurs in the first year of life, especially in children born prematurely. These data affirm the importance of RSV disease in the causation of hospitalization and as a significant contributor to pediatric mortality and further demonstrate gestational age as a critical determinant of disease severity. An important limitation of case-fatality ratios is the absence of individual patient characteristics of non-surviving patients. Moreover, case-fatality ratios cannot be translated to population-based mortality. Pediatr Pulmonol. 2017;52:556-569. © 2016 The Authors. Pediatric Pulmonology. Published by Wiley Periodicals, Inc.
authors.affiliation: Department of Pediatrics, Hospital da PUCRS & Biomedical Research Institute, Porto Alegre, Brazil.
authors.forename: Renato T
authors.initials: RT
authors.lastname: Stein
authors.affiliation: Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Bont
authors.affiliation: Department of Paediatrics and Child Health, Red Cross Childrens Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Heather
authors.initials: H
authors.lastname: Zar
authors.affiliation: Fundacion INFANT, Buenos Aires, Argentina.|Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Fernando P
authors.initials: FP
authors.lastname: Polack
authors.affiliation: AbbVie Inc., North Chicago, Illinois.
authors.forename: Caroline
authors.initials: C
authors.lastname: Park
authors.affiliation: Doctor Evidence, LLC, Santa Monica, California.
authors.forename: Ami
authors.initials: A
authors.lastname: Claxton
authors.affiliation: Doctor Evidence, LLC, Santa Monica, California.
authors.forename: Gerald
authors.initials: G
authors.lastname: Borok
authors.affiliation: Doctor Evidence, LLC, Santa Monica, California.
authors.forename: Yekaterina
authors.initials: Y
authors.lastname: Butylkova
authors.affiliation: AbbVie Inc., North Chicago, Illinois.
authors.forename: Colleen
authors.initials: C
authors.lastname: Wegzyn
mesh_terms: D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D014943:Global Health; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000401:mortality; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification
keywords: burden; epidemiology; infant; morbidity; preterm