Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982-2012: A Systematic Analysis

• Published in: PLoS medicine Vol. 13; no. 3; p. e1001977
• Main Authors: Lafond, Kathryn E, Nair, Harish, Rasooly, Mohammad Hafiz, Valente, Fátima, Booy, Robert, Rahman, Mahmudur, Kitsutani, Paul, Yu, Hongjie, Guzman, Guiselle, Coulibaly, Daouda, Armero, Julio, Jima, Daddi, Howie, Stephen R C, Ampofo, William, Mena, Ricardo, Chadha, Mandeep, Sampurno, Ondri Dwi, Emukule, Gideon O, Nurmatov, Zuridin, Corwin, Andrew, Heraud, Jean Michel, Noyola, Daniel E, Cojocaru, Radu, Nymadawa, Pagbajabyn, Barakat, Amal, Adedeji, Adebayo, von Horoch, Marta, Olveda, Remigio, Nyatanyi, Thierry, Venter, Marietjie, Mmbaga, Vida, Chittaganpitch, Malinee, Nguyen, Tran Hien, Theo, Andros, Whaley, Melissa, Azziz-Baumgartner, Eduardo, Bresee, Joseph, Campbell, Harry, Widdowson, Marc-Alain
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.03.2016; Public Library of Science (PLoS)
• Subjects: Adolescent; Analysis; Biochemistry, Molecular Biology; Biology and life sciences; Child; Child, Preschool; Children; Collaboration; Diagnosis; Disease control; Disease prevention; Emerging diseases; Epidemiological Monitoring; Estimates; Female; Global Health; Health aspects; Health surveillance; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Human health and pathology; Humans; Illnesses; Immunization; Infant; Infectious diseases; Influenza; Influenza, Human; Influenza, Human - epidemiology; Life Sciences; Male; Medicine and Health Sciences; Microbiology and Parasitology; Molecular biology; Pediatrics; People and Places; Public health; Researchers; Respiratory diseases; Respiratory Tract Diseases; Respiratory Tract Diseases - epidemiology; Respiratory Tract Diseases - virology; Risk factors; Santé publique et épidémiologie; Streptococcus infections; Studies; Viral infections; Virology; Viruses; Womens health; United States; Finland; India; Influenza viruses; Pediatrics; Influenza; Respiratory infections; Infectious disease surveillance; Pediatric infections; Vaccination and immunization; Age groups
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1001977

The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide. We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (<6 mo, <1 y, <2 y, <5 y, 5-17 y, and <18 y). We applied this proportion to global estimates of acute lower respiratory infection hospitalizations among children aged <1 y and <5 y, to obtain the number and per capita rate of influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%-11%) of respiratory hospitalizations in children <18 y worldwide, ranging from 5% (95% CI 3%-7%) among children <6 mo to 16% (95% CI 14%-20%) among children 5-17 y. On average, we estimated that influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children <1 y-of which 228,000 (95% CI 150,000 to 344,000) occur in children <6 mo-and 870,000 (95% CI 610,000 to 1,237,000) hospitalizations in children <5 y annually. Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings. Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo.