The burden of RSV-associated illness in children aged < 5 years, South Africa, 2011 to 2016.


Journal

BMC medicine
ISSN: 1741-7015
Titre abrégé: BMC Med
Pays: England
ID NLM: 101190723

Informations de publication

Date de publication:
11 04 2023
Historique:
received: 23 09 2022
accepted: 27 03 2023
medline: 12 4 2023
entrez: 10 4 2023
pubmed: 11 4 2023
Statut: epublish

Résumé

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. 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. 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). 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.

Sections du résumé

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.

Identifiants

pubmed: 37038125
doi: 10.1186/s12916-023-02853-3
pii: 10.1186/s12916-023-02853-3
pmc: PMC10088270
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

139

Informations de copyright

© 2023. The Author(s).

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Auteurs

Jocelyn Moyes (J)

Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa. jossmoyes@gmail.com.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. jossmoyes@gmail.com.

Stefano Tempia (S)

Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa.

Sibongile Walaza (S)

Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Meredith L McMorrow (ML)

Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Florette Treurnicht (F)

Division of Virology, Faculty of Health Sciences, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.

Nicole Wolter (N)

Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa.
School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Anne von Gottberg (A)

Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa.
School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Kathleen Kahn (K)

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, Johannesburg, South Africa.

Adam L Cohen (AL)

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.

Halima Dawood (H)

Department of Medicine, Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa.
Caprisa, University of KwaZulu-Natal, Pietermaritzburg, South Africa.

Ebrahim Variava (E)

Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa.
Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.

Cheryl Cohen (C)

Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa. cherylc@nicd.ac.za.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. cherylc@nicd.ac.za.

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