TY - JOUR
T1 - Global burden of respiratory infections due to seasonal influenza in young children
T2 - A systematic review and meta-analysis
AU - Nair, Harish
AU - Brooks, W. Abdullah
AU - Katz, Mark
AU - Roca, Anna
AU - Berkley, James A.
AU - Madhi, Shabir A.
AU - Simmerman, James Mark
AU - Gordon, Aubree
AU - Sato, Masatoki
AU - Howie, Stephen
AU - Krishnan, Anand
AU - Ope, Maurice
AU - Lindblade, Kim A.
AU - Carosone-Link, Phyllis
AU - Lucero, Marilla
AU - Ochieng, Walter
AU - Kamimoto, Laurie
AU - Dueger, Erica
AU - Bhat, Niranjan
AU - Vong, Sirenda
AU - Theodoratou, Evropi
AU - Chittaganpitch, Malinee
AU - Chimah, Osaretin
AU - Balmaseda, Angel
AU - Buchy, Philippe
AU - Harris, Eva
AU - Evans, Valerie
AU - Katayose, Masahiko
AU - Gaur, Bharti
AU - O'Callaghan-Gordo, Cristina
AU - Goswami, Doli
AU - Arvelo, Wences
AU - Venter, Marietjie
AU - Briese, Thomas
AU - Tokarz, Rafal
AU - Widdowson, Marc Alain
AU - Mounts, Anthony W.
AU - Breiman, Robert F.
AU - Feikin, Daniel R.
AU - Klugman, Keith P.
AU - Olsen, Sonja J.
AU - Gessner, Bradford D.
AU - Wright, Peter F.
AU - Rudan, Igor
AU - Broor, Shobha
AU - Simões, Eric Af
AU - Campbell, Harry
N1 - Funding Information:
Financial support for this work was provided by WHO Global Influenza Program (grant number HQGIP1002906 ) and the Bill & Melinda Gates Foundation (grant number 51285 ). The study in Ballabgarh, India, received financial support from US Centers for Disease Control and Prevention (CDC) and Indian Council of Medical Research. This work was done as part of the wider programme of the Child Health Epidemiology Working Group (CHERG) to establish the major causes of global childhood disease burden. Walter Ochieng sadly died suddenly and unexpectedly while this paper was being prepared for publication. We would like to acknowledge his important contribution to this study and his role in strengthening influenza surveillance in Kenya. We thank Johannes Forster (Department of Paediatrics, St Josefskrankenhaus Freiburg and University of Freiburg, Freiburg, Germany), Gabriele Ihorst (Clinical Trials Center, University Medical Centre Freiburg, Freiburg, Germany), Terho Heikkinen (Turku University Hospital, Turku, Finland), Alex Ezeh, Samuel Oti, and Catherine Kyobutungi (African Population and Health Research Centre, Nairobi, Kenya), and the Influenza Emerging Infections Program Network, USA for providing additional data from their published papers; Vivek Gupta and Sanjay K Rai (Comprehensive Rural Health Services Project, Ballabgarh and All India Institute of Medical Sciences, New Delhi, India); Samander Kaushik and Yashpal Singh (Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India); National Institute of Virology, Pune, India; Wallace D Bulimo (National Influenza Centre, Nairobi, Kenya); Respiratory and Zoonosis group, Department of Medical Virology, University of Pretoria, South Africa; D James Nokes (KEMRI, Kilifi, Kenya); Locadiah Kuwanda (Chris Hani Baragwanath Hospital, Johannesburg, South Africa); Pedro L Alonso, Ll Quinto, Q Bassat (CRESIB, Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain and Centro de Investigação em Saúde da Manhiça, Ministerio de Saúde, Maputo, Mozambique); Jens Levy (Influenza Division and International Emerging Infections Program, US CDC–Thailand MOPH Collaboration, Nonthaburi, Thailand); Alejandra Estevez, Fabiola Moscoso, and Jennifer Gray (Centro de Estudios en Salud, Universidad del Valle de Guatemala); Lissette Reyes, Juan Carlos Moir (Ministerio de Salud Pública y Asistencia Social, Guatemala); Alicia M Fry (Influenza Division, CDC, Atlanta, USA); Hanna Nohynek, Taneli Puumalainen and Petri Ruutu (National Institute for Health and Welfare, Finland); Leilani Nillos (Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa, Philippines) and ARIVAC consortium; Ian Lipkin (University of Columbia, New York); Gerard Morris (University Witwatersrand, South Africa); Grant Mackenzie, Readon Ideh, Bernard Ebruke, Claire Oluwalana (MRC, Gambia) and the Gambia Severe Pneumonia Studies Group; Karen Fowler (University of Alabama at Birmingham, Birmingham, AL, USA); Katherine O'Brien (Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA) for their assistance; Jian Shayne F Zhang (Centre for Population Health Sciences, The University of Edinburgh, UK) for doing the literature search in Chinese language databases; Carolyn B Bridges (Influenza Division, National Center for Immunizations and Respiratory Disease, CDC, Atlanta, GA, USA) for critically reviewing the manuscript and providing helpful comments. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the US CDC or WHO.
Funding Information:
SAM has received research funding from Wyeth for the Soweto study that contributed to the data. He has received consultancy from Pfizer, GSK, and Novartis and speaker fees from Pfizer and GSK. However, no honoraria were received for work included in this study. BDG has received consultancy from WHO and a travel grant from Sanofi Pasteur to attend a conference on influenza in 2010. He is employed by Agence de Médecine Préventive, which has received funding from WHO, Pfizer, GlaxoSmithKline, and Merck. In 2010, the Agence de Médecine Préventive was hired by Sanofi Pasteur to organize a conference on influenza. However, no grants or honoraria were received for work included in this study. EAFS has received speaker fees and consultancy from MedImmune and research grants from Roche and MedImmune. However, no grants or honoraria were received for work included in this study. NB is employed by Johns Hopkins University which has received funding from Aventis Pasteur and Evans-Powderject. All other authors declare that they have no conflicts of interest.
PY - 2011
Y1 - 2011
N2 - The global burden of disease attributable to seasonal influenza virus in children is unknown. We aimed to estimate the global incidence of and mortality from lower respiratory infections associated with influenza in children younger than 5 years. We estimated the incidence of influenza episodes, influenza-associated acute lower respiratory infections (ALRI), and influenza-associated severe ALRI in children younger than 5 years, stratified by age, with data from a systematic review of studies published between Jan 1, 1995, and Oct 31, 2010, and 16 unpublished population-based studies. We applied these incidence estimates to global population estimates for 2008 to calculate estimates for that year. We estimated possible bounds for influenza-associated ALRI mortality by combining incidence estimates with case fatality ratios from hospital-based reports and identifying studies with population-based data for influenza seasonality and monthly ALRI mortality. We identified 43 suitable studies, with data for around 8 million children. We estimated that, in 2008, 90 million (95 CI 49-162 million) new cases of influenza (data from nine studies), 20 million (13-32 million) cases of influenza-associated ALRI (13 of all cases of paediatric ALRI; data from six studies), and 1 million (1-2 million) cases of influenza-associated severe ALRI (7 of cases of all severe paediatric ALRI; data from 39 studies) occurred worldwide in children younger than 5 years. We estimated there were 28 000-111 500 deaths in children younger than 5 years attributable to influenza-associated ALRI in 2008, with 99 of these deaths occurring in developing countries. Incidence and mortality varied substantially from year to year in any one setting. Influenza is a common pathogen identified in children with ALRI and results in a substantial burden on health services worldwide. Sufficient data to precisely estimate the role of influenza in childhood mortality from ALRI are not available. WHO; Bill & Melinda Gates Foundation.
AB - The global burden of disease attributable to seasonal influenza virus in children is unknown. We aimed to estimate the global incidence of and mortality from lower respiratory infections associated with influenza in children younger than 5 years. We estimated the incidence of influenza episodes, influenza-associated acute lower respiratory infections (ALRI), and influenza-associated severe ALRI in children younger than 5 years, stratified by age, with data from a systematic review of studies published between Jan 1, 1995, and Oct 31, 2010, and 16 unpublished population-based studies. We applied these incidence estimates to global population estimates for 2008 to calculate estimates for that year. We estimated possible bounds for influenza-associated ALRI mortality by combining incidence estimates with case fatality ratios from hospital-based reports and identifying studies with population-based data for influenza seasonality and monthly ALRI mortality. We identified 43 suitable studies, with data for around 8 million children. We estimated that, in 2008, 90 million (95 CI 49-162 million) new cases of influenza (data from nine studies), 20 million (13-32 million) cases of influenza-associated ALRI (13 of all cases of paediatric ALRI; data from six studies), and 1 million (1-2 million) cases of influenza-associated severe ALRI (7 of cases of all severe paediatric ALRI; data from 39 studies) occurred worldwide in children younger than 5 years. We estimated there were 28 000-111 500 deaths in children younger than 5 years attributable to influenza-associated ALRI in 2008, with 99 of these deaths occurring in developing countries. Incidence and mortality varied substantially from year to year in any one setting. Influenza is a common pathogen identified in children with ALRI and results in a substantial burden on health services worldwide. Sufficient data to precisely estimate the role of influenza in childhood mortality from ALRI are not available. WHO; Bill & Melinda Gates Foundation.
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U2 - 10.1016/S0140-6736(11)61051-9
DO - 10.1016/S0140-6736(11)61051-9
M3 - Article
C2 - 22078723
AN - SCOPUS:82755189828
VL - 378
SP - 1917
EP - 1930
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 9807
ER -