Deaths Attributed to Respiratory Syncytial Virus in Young Children in High-Mortality Rate Settings: Report from Child Health and Mortality Prevention Surveillance (CHAMPS).
Respiratory syncytial virus
cause of death
child mortality
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
02 09 2021
02 09 2021
Historique:
entrez:
2
9
2021
pubmed:
3
9
2021
medline:
8
10
2021
Statut:
ppublish
Résumé
Lower respiratory tract infections are a leading cause of death in young children, but few studies have collected the specimens needed to define the role of specific causes. The Child Health and Mortality Prevention Surveillance (CHAMPS) platform aims to investigate causes of death in children aged <5 years in high-mortality rate settings, using postmortem minimally invasive tissue sampling and other advanced diagnostic techniques. We examined findings for deaths identified in CHAMPS sites in 7 countries in sub-Saharan Africa and south Asia to evaluate the role of respiratory syncytial virus (RSV). We included deaths that occurred between December 2016 and December 2019. Panels determined causes of deaths by reviewing all available data including pathological results from minimally invasive tissue sampling, polymerase chain reaction screening for multiple infectious pathogens in lung tissue, nasopharyngeal swab, blood, and cerebrospinal fluid samples, clinical information from medical records, and verbal autopsies. We evaluated 1213 deaths, including 695 in neonates (aged <28 days), 283 in infants (28 days to <12 months), and 235 in children (12-59 months). RSV was detected in postmortem specimens in 67 of 1213 deaths (5.5%); in 24 deaths (2.0% of total), RSV was determined to be a cause of death, and it contributed to 5 other deaths. Younger infants (28 days to <6 months of age) accounted for half of all deaths attributed to RSV; 6.5% of all deaths in younger infants were attributed to RSV. RSV was the underlying and only cause in 4 deaths; the remainder (n = 20) had a median of 2 (range, 1-5) other conditions in the causal chain. Birth defects (n = 8) and infections with other pathogens (n = 17) were common comorbid conditions. RSV is an important cause of child deaths, particularly in young infants. These findings add to the substantial body of literature calling for better treatment and prevention options for RSV in high-mortality rate settings.
Sections du résumé
BACKGROUND
Lower respiratory tract infections are a leading cause of death in young children, but few studies have collected the specimens needed to define the role of specific causes. The Child Health and Mortality Prevention Surveillance (CHAMPS) platform aims to investigate causes of death in children aged <5 years in high-mortality rate settings, using postmortem minimally invasive tissue sampling and other advanced diagnostic techniques. We examined findings for deaths identified in CHAMPS sites in 7 countries in sub-Saharan Africa and south Asia to evaluate the role of respiratory syncytial virus (RSV).
METHODS
We included deaths that occurred between December 2016 and December 2019. Panels determined causes of deaths by reviewing all available data including pathological results from minimally invasive tissue sampling, polymerase chain reaction screening for multiple infectious pathogens in lung tissue, nasopharyngeal swab, blood, and cerebrospinal fluid samples, clinical information from medical records, and verbal autopsies.
RESULTS
We evaluated 1213 deaths, including 695 in neonates (aged <28 days), 283 in infants (28 days to <12 months), and 235 in children (12-59 months). RSV was detected in postmortem specimens in 67 of 1213 deaths (5.5%); in 24 deaths (2.0% of total), RSV was determined to be a cause of death, and it contributed to 5 other deaths. Younger infants (28 days to <6 months of age) accounted for half of all deaths attributed to RSV; 6.5% of all deaths in younger infants were attributed to RSV. RSV was the underlying and only cause in 4 deaths; the remainder (n = 20) had a median of 2 (range, 1-5) other conditions in the causal chain. Birth defects (n = 8) and infections with other pathogens (n = 17) were common comorbid conditions.
CONCLUSIONS
RSV is an important cause of child deaths, particularly in young infants. These findings add to the substantial body of literature calling for better treatment and prevention options for RSV in high-mortality rate settings.
Identifiants
pubmed: 34472577
pii: 6362483
doi: 10.1093/cid/ciab509
pmc: PMC8411256
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
S218-S228Subventions
Organisme : Bill and Melinda Gates Foundation
ID : OPP1126780
Investigateurs
Yasmin Adam
(Y)
Janet Agaya
(J)
Sara Ajanovic
(S)
Addisu Alemu
(A)
Solomon Ali
(S)
George Aol
(G)
Henry Badji
(H)
Sanwarul Bari
(S)
Justina Bramugy
(J)
James Bunn
(J)
Richard Chawana
(R)
Atique Iqbal Chowdhury
(AI)
Karen D Fairchild
(KD)
Surafel Fentaw
(S)
Meerjady Sabrina Flora
(MS)
Dickson Gethi
(D)
Nelesh P Govender
(NP)
Carol L Greene
(CL)
Tadesse Gure
(T)
Martin Hale
(M)
Juan Carlos Hurtado
(JC)
Kitiezo Aggrey Igunza
(KA)
Farzana Islam
(F)
J Kristie Johnson
(J)
Tatiana Keita
(T)
Sammy Khagayi
(S)
Iqbal Ansary Khan
(IA)
Rima Koka
(R)
Diakaridia Kone
(D)
Nana Kourouma
(N)
Magdalene N Kuria
(MN)
Sandra Lako
(S)
Sanjay G Lala
(SG)
Hennie Lombaard
(H)
Ronita Luke
(R)
Thomas Misore
(T)
Paul K Mitei
(PK)
Alexander M Ibrahim
(AM)
Andrew Moultrie
(A)
Florence V Murila
(FV)
Nellie Myburgh
(N)
Peter Nyamthimba
(P)
Richard Oliech
(R)
Richard Omore
(R)
Uma U Onwuchekwa
(UU)
Stian M S Orlien
(SMS)
Louis Othieno
(L)
Peter Otieno
(P)
Kephas Otieno
(K)
Gregory Ouma
(G)
Benard Owuor
(B)
Shahana Parveen
(S)
Karen L Petersen
(KL)
Mahbubur Rahman
(M)
Natalia Rakislova
(N)
Emily A Rogena
(EA)
Doh Sanogo
(D)
Tahmina Shirin
(T)
Diakaridia Sidibe
(D)
Seydou Sissoko
(S)
Fatima Solomon
(F)
Gillian Sorour
(G)
James Sylvester Squire
(J)
Peter J Swart
(PJ)
Fikremelekot Temesgen
(F)
Sharon M Tennant
(SM)
Bukiwe Nana Thwala
(BN)
Cheick Bougadari Traore
(CB)
Sithembiso Velaphi
(S)
Pio Vitorino
(P)
Jeannette Wadula
(J)
Melisachew Mulatu Yeshi
(MM)
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
Clin Infect Dis. 2019 Oct 9;69(Suppl 4):S262-S273
pubmed: 31598664
Lancet. 2019 Aug 31;394(10200):757-779
pubmed: 31257127
Clin Infect Dis. 2019 Oct 9;69(Suppl 4):S302-S310
pubmed: 31598667
Lancet. 2018 Jul 14;392(10142):145-159
pubmed: 30025808
Ann Allergy Asthma Immunol. 2020 Jul;125(1):36-46
pubmed: 32217187
Clin Infect Dis. 2019 Oct 9;69(Suppl 4):S322-S332
pubmed: 31598668
Clin Infect Dis. 2019 Oct 9;69(Suppl 4):S311-S321
pubmed: 31598666
N Engl J Med. 2015 Feb 26;372(9):835-45
pubmed: 25714161
Popul Health Metr. 2011 Aug 01;9:25
pubmed: 21806831
Lancet. 2017 Dec 17;388(10063):3027-3035
pubmed: 27839855
Lancet. 2017 Sep 2;390(10098):946-958
pubmed: 28689664
J Infect Dis. 2013 Dec 15;208 Suppl 3:S167-72
pubmed: 24265474
Lancet. 2010 May 1;375(9725):1545-55
pubmed: 20399493
Lancet Infect Dis. 2018 Oct;18(10):e295-e311
pubmed: 29914800
Lancet Respir Med. 2016 May;4(5):345-7
pubmed: 27304556
Clin Infect Dis. 2019 Oct 9;69(Suppl 4):S333-S341
pubmed: 31598661
Lancet Glob Health. 2020 Jul;8(7):e909-e919
pubmed: 32562647