Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis
Open accessAbstract
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by age, using data from a systematic review of studies published between January, 1995, and June, 2009, and ten unpublished population-based studies.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mortality by combining case fatality ratios with incidence estimates from hospital-based reports from published and unpublished studies and identifying studies with population-based data for RSV seasonality and monthly ALRI mortality.Findings In 2005, an estimated 33.8 (95% CI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.Interpretation 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.Funding WHO; Bill & Melinda Gates Foundation.
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Nair and colleagues assumed no RSV deaths in people older than 2 years based on expert opinion, although the literature records such deaths.
“They reviewed the published studies on RSV but chose, on the basis of expert opinion, to assume no RSV deaths in individuals older than 2 years;75 the scientific literature, however, records deaths in those older than 2 years.77,78”
From Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. (2012) · cites this paper as [75]
The Results passage says the authors assumed that all deaths from RSV-associated severe acute lower respiratory infection occurred in the first two years of life. It grounds that assumption in age-stratified mortality data from unpublished studies, not expert opinion. The assumption concerns severe disease in young children, not all RSV deaths in people older than two; the separate claim about recorded deaths carries other citations. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNair and colleagues reported 66,000 to 199,000 RSV deaths for the year 2005.
“the 66 000 to 199 000 deaths for the year 2005 reported by Nair and colleagues75 in 2010”
Steroid-based therapies have recognized disappointing or incomplete protection in asthma exacerbations which are of viral etiology.
“Also of note is the recognized disappointing or incomplete protection of steroid-based therapies in asthma exacerbations (64, 197, 295) which are of viral etiology.”
From The airway epithelium: soldier in the fight against respiratory viruses (2011) · cites this paper as [197]
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- Authors
- Nair, H., Nokes, D. J., Gessner, B. D., Dherani, M., Madhi, S. A., Singleton, R. J., O'Brien, K. L., Roca, A., Wright, P. F., Bruce, N., Chandran, A., Theodoratou, E., Sutanto, A., Sedyaningsih, E. R., Ngama, M., Munywoki, P. K., Kartasasmita, C., Simões, E. A., Rudan, I., Weber, M. W., & Campbell, H.
- Affiliations
- Public Health Foundation of India (IN)
- Kenya Medical Research Institute (KE)
- Agence de Médecine Préventive (FR)
- University of Liverpool (GB)
- University of the Witwatersrand (ZA)
- Centers for Disease Control and Prevention (US)
- Manhiça Health Research Centre (MZ)
- Dartmouth–Hitchcock Medical Center (US)
- Johns Hopkins University (US)
- Kementerian Kesehatan Republik Indonesia (ID)
- Dr. Hasan Sadikin General Hospital (ID)
- University of Colorado Denver (US)
- University of Split (HR)
- University of Edinburgh (GB)
- Corresponding author
- Campbell, Harry
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 375
- Issue
- 9725
- Pages
- 1545-1555
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC2864404
- OpenAlex
- W2120949068
- Cited by
- 2,773
- References
- 55
- Citations by year
- 2026: 77 · 2025: 130 · 2024: 150 · 2023: 168 · 2022: 167 · 2021: 193 · 2020: 194 · 2019: 182 · 2018: 208 · 2017: 246 · 2016: 226 · 2015: 243 · 2014: 172 · 2013: 184 · 2012: 119
- FWCI
- 15.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (084633, 061584, 076278)
- Topics
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
- Keywords
- respiratory syncytial virus, acute lower respiratory tract infection, young children, global burden of disease, incidence, mortality, hospitalization, case fatality rate, RSV seasonality, developing countries, child mortality
- MeSH terms
- Ambulatory Care Facilities, Child, Preschool, Developing Countries, Hospitalization, Humans, Infant, Infant, Newborn, Severity of Illness Index, Global Health, Incidence, Age Distribution, Respiratory Syncytial Virus Infections, Developed Countries
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