The burden of RSV-associated illness in children aged < 5 years, South Africa, 2011 to 2016
Jocelyn Moyes,
Stefano Tempia,
Sibongile Walaza,
Meredith L. McMorrow,
Florette Treurnicht,
Nicole Wolter,
Anne von Gottberg,
Kathleen Kahn,
Adam L. Cohen,
Halima Dawood,
Ebrahim Variava,
Cheryl Cohen
Affiliations
Jocelyn Moyes
Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service
Stefano Tempia
Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service
Sibongile Walaza
Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service
Meredith L. McMorrow
Division of Viral Diseases, Centers for Disease Control and Prevention
Florette Treurnicht
Division of Virology, Faculty of Health Sciences, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital
Nicole Wolter
Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service
Anne von Gottberg
Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service
Kathleen Kahn
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Epidemiology and Global Health Unit
Adam L. Cohen
Influenza Division, Centers for Disease Control and Prevention
Halima Dawood
Department of Medicine, Pietermaritzburg Metropolitan Hospital
Ebrahim Variava
Department of Medicine, Klerksdorp-Tshepong Hospital Complex
Cheryl Cohen
Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service
Abstract Background Vaccines and monoclonal antibodies to protect the very young infant against the respiratory syncytial virus (RSV)-associated illness are effective for limited time periods. We aimed to estimate age-specific burden to guide implementation strategies and cost-effectiveness analyses. Methods We combined case-based surveillance and ecological data to generate a national estimate of the burden of RSV-associated acute respiratory illness (ARI) and severe acute respiratory illness (SARI) in South African children aged < 5 years (2011–2016), including adjustment for attributable fraction. We estimated the RSV burden by month of life in the < 1-year age group, by 3-month intervals until 2 years, and then 12 monthly intervals to < 5 years for medically and non-medically attended illness. Results We estimated a mean annual total (medically and non-medically attended) of 264,112 (95% confidence interval (CI) 134,357–437,187) cases of RSV-associated ARI and 96,220 (95% CI 66,470–132,844) cases of RSV-associated SARI (4.7% and 1.7% of the population aged < 5 years, respectively). RSV-associated ARI incidence was highest in 2-month-old infants (18,361/100,000 population, 95% CI 9336–28,466). The highest incidence of RSV-associated SARI was in the < 1-month age group 14,674/100,000 (95% CI 11,175–19,645). RSV-associated deaths were highest in the first and second month of life (110.8 (95% CI 74.8–144.5) and 111.3 (86.0–135.8), respectively). Conclusions Due to the high burden of RSV-associated illness, specifically SARI cases in young infants, maternal vaccination and monoclonal antibody products delivered at birth could prevent significant RSV-associated disease burden.
