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

• Published in: BMC medicine Vol. 21; no. 1; pp. 139 - 10
• Main Authors: Moyes, Jocelyn, Tempia, Stefano, Walaza, Sibongile, McMorrow, Meredith L, Treurnicht, Florette, Wolter, Nicole, von Gottberg, Anne, Kahn, Kathleen, Cohen, Adam L, Dawood, Halima, Variava, Ebrahim, Cohen, Cheryl
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.04.2023; BioMed Central; BMC
• Subjects: Age; Age groups; Air pollution; Birth weight; Breastfeeding & lactation; Burden; Censuses; Child; Children; Children & youth; Communicable Diseases; Cost analysis; Dosage and administration; Ecological effects; Estimates; Health aspects; Health care; HIV; Hospital care; Hospitalization; Hospitals; Human immunodeficiency virus; Humans; Illnesses; Incidence; Indoor air quality; Infant; Infant mortality; Infant, Newborn; Infants; Infections; Malnutrition; Monoclonal antibodies; Pharmacy; Pneumonia; Polymerase chain reaction; Population; Prevention; Provinces; Respiratory diseases; Respiratory illness; Respiratory syncytial virus; Respiratory syncytial virus infection; Respiratory Syncytial Virus Infections - epidemiology; Respiratory Syncytial Virus Infections - prevention & control; Respiratory Syncytial Viruses; Risk factors; South Africa - epidemiology; Surveillance; Testing; Vaccines; South Africa; Respiratory illness; Respiratory syncytial virus; Burden; Children
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-023-02853-3

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.