The Lancet Global Health (Oct 2017)
Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series
- Nienke M Scheltema, MD,
- Angela Gentile, MD,
- Florencia Lucion, MD,
- D James Nokes, PhD,
- Patrick K Munywoki, PhD,
- Shabir A Madhi, PhD,
- Michelle J Groome, PhD,
- Cheryl Cohen, PhD,
- Jocelyn Moyes, MD,
- Kentigern Thorburn, FCPaed,
- Somsak Thamthitiwat, MD,
- Hitoshi Oshitani, MD,
- Socorro P Lupisan, MD,
- Aubree Gordon, PhD,
- José F Sánchez, MD,
- Katherine L O'Brien, MD,
- Bradford D Gessner, MD,
- Agustinus Sutanto, MD,
- Asuncion Mejias, PhD,
- Octavio Ramilo, MD,
- Najwa Khuri-Bulos, MD,
- Natasha Halasa, MD,
- Fernanda de-Paris, PhD,
- Márcia Rosane Pires,
- Michael C Spaeder, MD,
- Bosco A Paes, FRCPC,
- Eric A F Simões, MD,
- Ting F Leung, MD,
- Maria Tereza da Costa Oliveira, PhD,
- Carla Cecília de Freitas Lázaro Emediato,
- Quique Bassat, PhD,
- Warwick Butt, MD,
- Hsin Chi, MD,
- Uzma Bashir Aamir, PhD,
- Asad Ali, MBBS,
- Marilla G Lucero, PhD,
- Rodrigo A Fasce, BSc,
- Olga Lopez, MD,
- Barbara A Rath, PhD,
- Fernando P Polack, MD,
- Jesse Papenburg, MD,
- Srđan Roglić, MD,
- Hisato Ito, MD,
- Edward A Goka, PhD,
- Diederick E Grobbee, PhD,
- Harish Nair, PhD,
- Dr Louis J Bont, MD
Affiliations
- Nienke M Scheltema, MD
- Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
- Angela Gentile, MD
- Department of Epidemiology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina
- Florencia Lucion, MD
- Department of Epidemiology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina
- D James Nokes, PhD
- Kenya Medical Research Institute, Wellcome Trust Research Programme, Centre for Geographic Medicine Research—Coast, Kilifi, Kenya
- Patrick K Munywoki, PhD
- Kenya Medical Research Institute, Wellcome Trust Research Programme, Centre for Geographic Medicine Research—Coast, Kilifi, Kenya
- Shabir A Madhi, PhD
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
- Michelle J Groome, PhD
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
- Cheryl Cohen, PhD
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Jocelyn Moyes, MD
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
- Kentigern Thorburn, FCPaed
- Department of Paediatric Intensive Care, Alder Hey Children's Hospital, Liverpool, UK
- Somsak Thamthitiwat, MD
- Division of Global Health Protection, Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- Hitoshi Oshitani, MD
- Department of Virology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
- Socorro P Lupisan, MD
- Research Institute for Tropical Medicine, Alabang Muntinlupa City, Metro Manila Philippines
- Aubree Gordon, PhD
- Department of Epidemiology, School of Public Health, University of Michigan, MI, USA
- José F Sánchez, MD
- Department of Medicine, Hospital Infantil Manuel de Jesus Rivera, Managua, Nicaragua
- Katherine L O'Brien, MD
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Bradford D Gessner, MD
- Agence de Medecine Preventive, Paris, France
- Agustinus Sutanto, MD
- West Nusa Tenggara Provincial Government, Lombok, Indonesia
- Asuncion Mejias, PhD
- Department of Pediatrics, Division of Infectious Diseases, Ohio State University, Columbus, OH, USA
- Octavio Ramilo, MD
- Department of Pediatrics, Division of Infectious Diseases, Ohio State University, Columbus, OH, USA
- Najwa Khuri-Bulos, MD
- Department of Pediatrics, University of Jordan, Aljubeiha, Amman, Jordan
- Natasha Halasa, MD
- Vanderbilt University Medical Center, Nashville, TN, USA
- Fernanda de-Paris, PhD
- Molecular Biology Laboratory, Hospital de Clínicas de Porto Alegre, Bairro Santa Cecília, Porto Alegre, Brazil
- Márcia Rosane Pires
- Infection Control Commission, Hospital de Clínicas de Porto Alegre, Bairro Santa Cecília, Porto Alegre, Brazil
- Michael C Spaeder, MD
- Division of Pediatric Critical Care, University of Virginia School of Medicine, Charlottesville, VA, USA
- Bosco A Paes, FRCPC
- Neonatal Division, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Eric A F Simões, MD
- Department of Pediatrics and Center for Global Health, University of Colorado, Aurora, CO, USA
- Ting F Leung, MD
- Department of Paediatrics, Faculty of Medicine and Chinese University of Hong Kong-University Medical Center Utrecht Joint Research Laboratory of Respiratory Virus and Immunobiology, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China
- Maria Tereza da Costa Oliveira, PhD
- Health Secretariat of the City of Belo Horizonte, Belo Horizonte, Brazil
- Carla Cecília de Freitas Lázaro Emediato
- Health Secretariat of the City of Belo Horizonte, Belo Horizonte, Brazil
- Quique Bassat, PhD
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Warwick Butt, MD
- Department of Intensive Care, Royal Children's Hospital, Melbourne, VIC, Australia
- Hsin Chi, MD
- Department of Pediatric Infectious Disease, MacKay Children's Hospital, Taipei, Taiwan
- Uzma Bashir Aamir, PhD
- Department of Virology, National Institute of Health, Islamabad, Pakistan
- Asad Ali, MBBS
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Marilla G Lucero, PhD
- Research Institute for Tropical Medicine, Alabang Muntinlupa City, Metro Manila Philippines
- Rodrigo A Fasce, BSc
- Public Health Institute, Ñuñoa, Santiago, Chile
- Olga Lopez, MD
- Hospital Dr. Ernesto Torres Galdames, Iquique, Chile
- Barbara A Rath, PhD
- Vienna Vaccine Safety Initiative, Berlin, Germany
- Fernando P Polack, MD
- Fundacion Infant, Buenos Aires, Argentina
- Jesse Papenburg, MD
- Department of Microbiology, Division of Pediatric Infectious Diseases, McGill University Health Centre, Montreal, QC, Canada
- Srđan Roglić, MD
- Department of Paediatric Infectious Diseases, University Hospital for Infectious Diseases, Zagreb, Croatia
- Hisato Ito, MD
- Department of Pediatrics, Nantan General Hospital, Ueno, Yagichoyagi, Nantan-shi, Kyoto, Japan
- Edward A Goka, PhD
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- Diederick E Grobbee, PhD
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Harish Nair, PhD
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Dr Louis J Bont, MD
- Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
- DOI
- https://doi.org/10.1016/S2214-109X(17)30344-3
- Journal volume & issue
-
Vol. 5,
no. 10
pp. e984 – e991
Abstract
Background: Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data for fatal RSV infection are scarce. We aimed to identify clinical and socioeconomic characteristics of children aged younger than 5 years with RSV-related mortality using individual patient data. Methods: In this retrospective case series, we developed an online questionnaire to obtain individual patient data for clinical and socioeconomic characteristics of children aged younger than 5 years who died with community-acquired RSV infection between Jan 1, 1995, and Oct 31, 2015, through leading research groups for child pneumonia identified through a comprehensive literature search and existing research networks. For the literature search, we searched PubMed for articles published up to Feb 3, 2015, using the key terms “RSV”, “respiratory syncytial virus”, or “respiratory syncytial viral” combined with “mortality”, “fatality”, “death”, “died”, “deaths”, or “CFR” for articles published in English. We invited researchers and clinicians identified to participate between Nov 1, 2014, and Oct 31, 2015. We calculated descriptive statistics for all variables. Findings: We studied 358 children with RSV-related in-hospital death from 23 countries across the world, with data contributed from 31 research groups. 117 (33%) children were from low-income or lower middle-income countries, 77 (22%) were from upper middle-income countries, and 164 (46%) were from high-income countries. 190 (53%) were male. Data for comorbidities were missing for some children in low-income and middle-income countries. Available data showed that comorbidities were present in at least 33 (28%) children from low-income or lower middle-income countries, 36 (47%) from upper middle-income countries, and 114 (70%) from high-income countries. Median age for RSV-related deaths was 5·0 months (IQR 2·3–11·0) in low-income or lower middle-income countries, 4·0 years (2·0–10·0) in upper middle-income countries, and 7·0 years (3·6–16·8) in high-income countries. Interpretation: This study is the first large case series of children who died with community-acquired RSV infection. A substantial proportion of children with RSV-related death had comorbidities. Our results show that perinatal immunisation strategies for children aged younger than 6 months could have a substantial impact on RSV-related child mortality in low-income and middle-income countries. Funding: Bill & Melinda Gates Foundation.
