Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis
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, inf...
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Published in | The Lancet (British edition) Vol. 378; no. 9807; pp. 1917 - 1930 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Kidlington
Elsevier Ltd
03.12.2011
Elsevier Elsevier Limited |
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Abstract | 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by age, with data from a systematic review of studies published between Jan 1, 1995, and Oct 31, 2010, and 16 unpublished population-based studies.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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AbstractList | Background: 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. Methods: 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. Findings: 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 28a} 00-111a one fourth 00 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. Interpretation: 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. Funding: WHO; Bill & Melinda Gates Foundation. 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. 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. BACKGROUND: 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. METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: WHO; Bill & Melinda Gates Foundation. 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.BACKGROUNDThe 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.METHODSWe 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.FINDINGSWe 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.INTERPRETATIONInfluenza 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.FUNDINGWHO; Bill & Melinda Gates Foundation. Summary Background 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. Methods 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. Findings 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. Interpretation 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. Funding WHO; Bill & Melinda Gates Foundation. |
Author | Lucero, Marilla Ochieng, Walter Tokarz, Rafal Carosone-Link, Phyllis Olsen, Sonja J Campbell, Harry Madhi, Shabir A Breiman, Robert F Berkley, James A Ope, Maurice Katayose, Masahiko Gessner, Bradford D Nair, Harish Vong, Sirenda Chimah, Osaretin Mounts, Anthony W Roca, Anna Harris, Eva Gordon, Aubree Wright, Peter F Dueger, Erica O'Callaghan-Gordo, Cristina Sato, Masatoki Goswami, Doli Krishnan, Anand Bhat, Niranjan Rudan, Igor Brooks, W Abdullah Evans, Valerie Arvelo, Wences Simmerman, James Mark Howie, Stephen Simões, Eric AF Buchy, Philippe Briese, Thomas Gaur, Bharti Katz, Mark Kamimoto, Laurie Klugman, Keith P Theodoratou, Evropi Venter, Marietjie Widdowson, Marc-Alain Balmaseda, Angel Feikin, Daniel R Lindblade, Kim A Chittaganpitch, Malinee Broor, Shobha |
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surname: Madhi fullname: Madhi, Shabir A organization: Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology, and National Research Foundation: Vaccine Preventable Diseases; University of the Witwatersrand, South Africa – sequence: 7 givenname: James Mark surname: Simmerman fullname: Simmerman, James Mark organization: Influenza Division and International Emerging Infections Program, US Centers for Disease Control and Prevention—Thailand MOPH Collaboration, Nonthaburi, Thailand – sequence: 8 givenname: Aubree surname: Gordon fullname: Gordon, Aubree organization: Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA – sequence: 9 givenname: Masatoki surname: Sato fullname: Sato, Masatoki organization: Department of Paediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan – sequence: 10 givenname: Stephen surname: Howie fullname: Howie, Stephen organization: Medical Research Council (UK) Laboratories, Banjul, The Gambia – sequence: 11 givenname: Anand surname: Krishnan fullname: Krishnan, Anand organization: All India Institute of Medical Sciences, New Delhi, India – sequence: 12 givenname: Maurice surname: Ope fullname: Ope, Maurice organization: Division of Disease Surveillance and Response, Ministry of Public Health and Sanitation, Kenya – sequence: 13 givenname: Kim A surname: Lindblade fullname: Lindblade, Kim A organization: Global Disease Detection Program, Centers for Disease Control and Prevention Regional Office for Central America and Panama, Guatemala City, Guatemala – sequence: 14 givenname: Phyllis surname: Carosone-Link fullname: Carosone-Link, Phyllis organization: University of Colorado Denver and Children's Hospital Colorado, Denver, CO, USA – sequence: 15 givenname: Marilla surname: Lucero fullname: Lucero, Marilla organization: Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa, Philippines – sequence: 16 givenname: Walter surname: Ochieng fullname: Ochieng, Walter organization: Kenya Medical Research Institute, Center for Virus Research, Nairobi, Kenya – sequence: 17 givenname: Laurie surname: Kamimoto fullname: Kamimoto, Laurie organization: Influenza Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA – sequence: 18 givenname: Erica surname: Dueger fullname: Dueger, Erica organization: Global Disease Detection and Response Center, Naval Medical Research Unit 3, Cairo, Egypt – sequence: 19 givenname: Niranjan surname: Bhat fullname: Bhat, Niranjan organization: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – sequence: 20 givenname: Sirenda surname: Vong fullname: Vong, Sirenda organization: Institut Pasteur du Cambodge, Phnom Penh, Cambodia – sequence: 21 givenname: Evropi surname: Theodoratou fullname: Theodoratou, Evropi organization: Centre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK – sequence: 22 givenname: Malinee surname: Chittaganpitch fullname: Chittaganpitch, Malinee organization: Thai National Institutes of Health, Ministry of Public Health, Nonthaburi, Thailand – sequence: 23 givenname: Osaretin surname: Chimah fullname: Chimah, Osaretin organization: Medical Research Council (UK) Laboratories, Banjul, The Gambia – sequence: 24 givenname: Angel surname: Balmaseda fullname: Balmaseda, Angel organization: Departamento de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua – sequence: 25 givenname: Philippe surname: Buchy fullname: Buchy, Philippe organization: Institut Pasteur du Cambodge, Phnom Penh, Cambodia – sequence: 26 givenname: Eva surname: Harris fullname: Harris, Eva organization: Division of Infectious Diseases and Vaccinology, University of California, Berkeley, CA, USA – sequence: 27 givenname: Valerie surname: Evans fullname: Evans, Valerie organization: Centre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK – sequence: 28 givenname: Masahiko surname: Katayose fullname: Katayose, Masahiko organization: Department of Paediatrics, Soma General Hospital, Soma, Japan – sequence: 29 givenname: Bharti surname: Gaur fullname: Gaur, Bharti organization: All India Institute of Medical Sciences, New Delhi, India – sequence: 30 givenname: Cristina surname: O'Callaghan-Gordo fullname: O'Callaghan-Gordo, Cristina organization: Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain – sequence: 31 givenname: Doli surname: Goswami fullname: Goswami, Doli organization: International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh – sequence: 32 givenname: Wences surname: Arvelo fullname: Arvelo, Wences organization: Global Disease Detection Program, Centers for Disease Control and Prevention Regional Office for Central America and Panama, Guatemala City, Guatemala – sequence: 33 givenname: Marietjie surname: Venter fullname: Venter, Marietjie organization: Respiratory Virus Unit, National Influenza Centre, National Institute for Communicable Diseases, National Health Laboratory Services, Sandringham, South Africa – sequence: 34 givenname: Thomas surname: Briese fullname: Briese, Thomas organization: Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA – sequence: 35 givenname: Rafal surname: Tokarz fullname: Tokarz, Rafal organization: Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA – sequence: 36 givenname: Marc-Alain surname: Widdowson fullname: Widdowson, Marc-Alain organization: Influenza Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA – sequence: 37 givenname: Anthony W surname: Mounts fullname: Mounts, Anthony W organization: Global Influenza Program, World Health Organization, Geneva, Switzerland – sequence: 38 givenname: Robert F surname: Breiman fullname: Breiman, Robert F organization: Kenya Medical Research Institute and Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya – sequence: 39 givenname: Daniel R surname: Feikin fullname: Feikin, Daniel R organization: Kenya Medical Research Institute and Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya – sequence: 40 givenname: Keith P surname: Klugman fullname: Klugman, Keith P organization: Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology, and National Research Foundation: Vaccine Preventable Diseases; University of the Witwatersrand, South Africa – sequence: 41 givenname: Sonja J surname: Olsen fullname: Olsen, Sonja J organization: Influenza Division and International Emerging Infections Program, US Centers for Disease Control and Prevention—Thailand MOPH Collaboration, Nonthaburi, Thailand – sequence: 42 givenname: Bradford D surname: Gessner fullname: Gessner, Bradford D organization: Agence de Médecine Préventive, Paris, France – sequence: 43 givenname: Peter F surname: Wright fullname: Wright, Peter F organization: Division of Infectious Disease and International Health, Dartmouth Medical School, Lebanon, NH, USA – sequence: 44 givenname: Igor surname: Rudan fullname: Rudan, Igor organization: Centre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK – sequence: 45 givenname: Shobha surname: Broor fullname: Broor, Shobha organization: All India Institute of Medical Sciences, New Delhi, India – sequence: 46 givenname: Eric AF surname: Simões fullname: Simões, Eric AF organization: University of Colorado Denver and Children's Hospital Colorado, Denver, CO, USA – sequence: 47 givenname: Harry surname: Campbell fullname: Campbell, Harry email: harry.campbell@ed.ac.uk organization: Centre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK |
BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25250327$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/22078723$$D View this record in MEDLINE/PubMed |
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CODEN | LANCAO |
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Issue | 9807 |
Keywords | Human Infection Preschool age Medicine Respiratory disease Seasonal variation Viral disease Influenza A Systematic review Respiratory system infection Child Metaanalysis |
Language | English |
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Snippet | 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... Summary Background The global burden of disease attributable to seasonal influenza virus in children is unknown. We aimed to estimate the global incidence of... BACKGROUND: The global burden of disease attributable to seasonal influenza virus in children is unknown. We aimed to estimate the global incidence of and... Background: The global burden of disease attributable to seasonal influenza virus in children is unknown. We aimed to estimate the global incidence of and... |
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SubjectTerms | Age Biological and medical sciences burden of disease Child, Preschool childhood Children Children & youth Data processing Developing countries Disease control General aspects Global Health health services Human viral diseases Humans Incidence Infant Infection Infectious diseases Influenza Influenza virus Influenza, Human - complications Influenza, Human - epidemiology Internal Medicine LDCs Medical research Medical sciences meta-analysis Mortality Orthomyxoviridae Pathogens Pediatrics Population studies Respiratory Tract Infections - complications Respiratory Tract Infections - epidemiology Reviews Seasonal variations Seasons Streptococcus infections Studies Systematic review Viral diseases Viral diseases of the respiratory system and ent viral diseases World Health Organization |
Title | Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis |
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