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Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis
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...
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Published in: | The Lancet (British edition) 2011-12, Vol.378 (9807), p.1917-1930 |
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creator | Nair, Harish, Dr Brooks, W Abdullah, MD Katz, Mark, MD Roca, Anna, PhD Berkley, James A, FRCPCH Madhi, Shabir A, Prof Simmerman, James Mark, PhD Gordon, Aubree, PhD Sato, Masatoki, MD Howie, Stephen, FRACP Krishnan, Anand, MD Ope, Maurice, MD Lindblade, Kim A, PhD Carosone-Link, Phyllis, MSPH Lucero, Marilla, MD Ochieng, Walter, MD Kamimoto, Laurie, MD Dueger, Erica, PhD Bhat, Niranjan, MD Vong, Sirenda, MD Theodoratou, Evropi, PhD Chittaganpitch, Malinee, MSc Chimah, Osaretin, FWACP Balmaseda, Angel, MD Buchy, Philippe, MD Harris, Eva, Prof Evans, Valerie, MSc Katayose, Masahiko, MD Gaur, Bharti, MSc O'Callaghan-Gordo, Cristina, BSc Goswami, Doli, MPH Arvelo, Wences, MD Venter, Marietjie, PhD Briese, Thomas, PhD Tokarz, Rafal, PhD Widdowson, Marc-Alain, VetMB Mounts, Anthony W, MD Breiman, Robert F, MD Feikin, Daniel R, MD Klugman, Keith P, Prof Olsen, Sonja J, PhD Gessner, Bradford D, MD Wright, Peter F, Prof Rudan, Igor, Prof Broor, Shobha, Prof Simões, Eric AF, Prof Campbell, Harry, Prof |
description | 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by age, with data from a systematic review of studies published between Jan 1, 1995, and Oct 31, 2010, and 16 unpublished population-based studies.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. |
doi_str_mv | 10.1016/S0140-6736(11)61051-9 |
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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.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(11)61051-9</identifier><identifier>PMID: 22078723</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>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</subject><ispartof>The Lancet (British edition), 2011-12, Vol.378 (9807), p.1917-1930</ispartof><rights>Elsevier Ltd</rights><rights>2011 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 3-Dec 9, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c650t-106919030662134d25fde712e35fd15f0a5ad59afb344fb4df67c04ce4789c6b3</citedby><cites>FETCH-LOGICAL-c650t-106919030662134d25fde712e35fd15f0a5ad59afb344fb4df67c04ce4789c6b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25250327$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22078723$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nair, Harish, Dr</creatorcontrib><creatorcontrib>Brooks, W Abdullah, MD</creatorcontrib><creatorcontrib>Katz, Mark, MD</creatorcontrib><creatorcontrib>Roca, Anna, PhD</creatorcontrib><creatorcontrib>Berkley, James A, FRCPCH</creatorcontrib><creatorcontrib>Madhi, Shabir A, Prof</creatorcontrib><creatorcontrib>Simmerman, James Mark, PhD</creatorcontrib><creatorcontrib>Gordon, Aubree, PhD</creatorcontrib><creatorcontrib>Sato, Masatoki, MD</creatorcontrib><creatorcontrib>Howie, Stephen, FRACP</creatorcontrib><creatorcontrib>Krishnan, Anand, MD</creatorcontrib><creatorcontrib>Ope, Maurice, MD</creatorcontrib><creatorcontrib>Lindblade, Kim A, PhD</creatorcontrib><creatorcontrib>Carosone-Link, Phyllis, MSPH</creatorcontrib><creatorcontrib>Lucero, Marilla, MD</creatorcontrib><creatorcontrib>Ochieng, Walter, MD</creatorcontrib><creatorcontrib>Kamimoto, Laurie, MD</creatorcontrib><creatorcontrib>Dueger, Erica, PhD</creatorcontrib><creatorcontrib>Bhat, Niranjan, MD</creatorcontrib><creatorcontrib>Vong, Sirenda, MD</creatorcontrib><creatorcontrib>Theodoratou, Evropi, PhD</creatorcontrib><creatorcontrib>Chittaganpitch, Malinee, MSc</creatorcontrib><creatorcontrib>Chimah, Osaretin, FWACP</creatorcontrib><creatorcontrib>Balmaseda, Angel, MD</creatorcontrib><creatorcontrib>Buchy, Philippe, MD</creatorcontrib><creatorcontrib>Harris, Eva, Prof</creatorcontrib><creatorcontrib>Evans, Valerie, MSc</creatorcontrib><creatorcontrib>Katayose, Masahiko, MD</creatorcontrib><creatorcontrib>Gaur, Bharti, MSc</creatorcontrib><creatorcontrib>O'Callaghan-Gordo, Cristina, BSc</creatorcontrib><creatorcontrib>Goswami, Doli, MPH</creatorcontrib><creatorcontrib>Arvelo, Wences, MD</creatorcontrib><creatorcontrib>Venter, Marietjie, PhD</creatorcontrib><creatorcontrib>Briese, Thomas, PhD</creatorcontrib><creatorcontrib>Tokarz, Rafal, PhD</creatorcontrib><creatorcontrib>Widdowson, Marc-Alain, VetMB</creatorcontrib><creatorcontrib>Mounts, Anthony W, MD</creatorcontrib><creatorcontrib>Breiman, Robert F, MD</creatorcontrib><creatorcontrib>Feikin, Daniel R, MD</creatorcontrib><creatorcontrib>Klugman, Keith P, Prof</creatorcontrib><creatorcontrib>Olsen, Sonja J, PhD</creatorcontrib><creatorcontrib>Gessner, Bradford D, MD</creatorcontrib><creatorcontrib>Wright, Peter F, Prof</creatorcontrib><creatorcontrib>Rudan, Igor, Prof</creatorcontrib><creatorcontrib>Broor, Shobha, Prof</creatorcontrib><creatorcontrib>Simões, Eric AF, Prof</creatorcontrib><creatorcontrib>Campbell, Harry, Prof</creatorcontrib><title>Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>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.</description><subject>Age</subject><subject>Biological and medical sciences</subject><subject>burden of disease</subject><subject>Child, Preschool</subject><subject>childhood</subject><subject>Children</subject><subject>Children & youth</subject><subject>Data processing</subject><subject>Developing countries</subject><subject>Disease control</subject><subject>General aspects</subject><subject>Global Health</subject><subject>health services</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infection</subject><subject>Infectious diseases</subject><subject>Influenza</subject><subject>Influenza virus</subject><subject>Influenza, Human - complications</subject><subject>Influenza, Human - epidemiology</subject><subject>Internal Medicine</subject><subject>LDCs</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>meta-analysis</subject><subject>Mortality</subject><subject>Orthomyxoviridae</subject><subject>Pathogens</subject><subject>Pediatrics</subject><subject>Population studies</subject><subject>Respiratory Tract Infections - complications</subject><subject>Respiratory Tract Infections - epidemiology</subject><subject>Reviews</subject><subject>Seasonal variations</subject><subject>Seasons</subject><subject>Streptococcus infections</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Viral diseases</subject><subject>Viral diseases of the respiratory system and ent viral diseases</subject><subject>World Health 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burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis</title><author>Nair, Harish, Dr ; Brooks, W Abdullah, MD ; Katz, Mark, MD ; Roca, Anna, PhD ; Berkley, James A, FRCPCH ; Madhi, Shabir A, Prof ; Simmerman, James Mark, PhD ; Gordon, Aubree, PhD ; Sato, Masatoki, MD ; Howie, Stephen, FRACP ; Krishnan, Anand, MD ; Ope, Maurice, MD ; Lindblade, Kim A, PhD ; Carosone-Link, Phyllis, MSPH ; Lucero, Marilla, MD ; Ochieng, Walter, MD ; Kamimoto, Laurie, MD ; Dueger, Erica, PhD ; Bhat, Niranjan, MD ; Vong, Sirenda, MD ; Theodoratou, Evropi, PhD ; Chittaganpitch, Malinee, MSc ; Chimah, Osaretin, FWACP ; Balmaseda, Angel, MD ; Buchy, Philippe, MD ; Harris, Eva, Prof ; Evans, Valerie, MSc ; Katayose, Masahiko, MD ; Gaur, Bharti, MSc ; O'Callaghan-Gordo, Cristina, BSc ; Goswami, Doli, MPH ; Arvelo, Wences, MD ; Venter, Marietjie, PhD ; Briese, Thomas, PhD ; Tokarz, Rafal, PhD ; Widdowson, Marc-Alain, VetMB ; Mounts, Anthony W, MD ; Breiman, Robert F, MD ; Feikin, Daniel R, MD ; Klugman, Keith P, Prof ; Olsen, Sonja J, PhD ; Gessner, Bradford D, MD ; Wright, Peter F, Prof ; Rudan, Igor, Prof ; Broor, Shobha, Prof ; Simões, Eric AF, Prof ; Campbell, Harry, Prof</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c650t-106919030662134d25fde712e35fd15f0a5ad59afb344fb4df67c04ce4789c6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age</topic><topic>Biological and medical sciences</topic><topic>burden of disease</topic><topic>Child, Preschool</topic><topic>childhood</topic><topic>Children</topic><topic>Children & youth</topic><topic>Data processing</topic><topic>Developing countries</topic><topic>Disease control</topic><topic>General aspects</topic><topic>Global Health</topic><topic>health services</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infection</topic><topic>Infectious diseases</topic><topic>Influenza</topic><topic>Influenza virus</topic><topic>Influenza, Human - complications</topic><topic>Influenza, Human - epidemiology</topic><topic>Internal Medicine</topic><topic>LDCs</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>meta-analysis</topic><topic>Mortality</topic><topic>Orthomyxoviridae</topic><topic>Pathogens</topic><topic>Pediatrics</topic><topic>Population studies</topic><topic>Respiratory Tract Infections - complications</topic><topic>Respiratory Tract Infections - epidemiology</topic><topic>Reviews</topic><topic>Seasonal variations</topic><topic>Seasons</topic><topic>Streptococcus infections</topic><topic>Studies</topic><topic>Systematic review</topic><topic>Viral diseases</topic><topic>Viral diseases of the respiratory system and ent viral diseases</topic><topic>World Health Organization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nair, Harish, Dr</creatorcontrib><creatorcontrib>Brooks, W Abdullah, MD</creatorcontrib><creatorcontrib>Katz, Mark, MD</creatorcontrib><creatorcontrib>Roca, Anna, PhD</creatorcontrib><creatorcontrib>Berkley, James A, FRCPCH</creatorcontrib><creatorcontrib>Madhi, Shabir A, Prof</creatorcontrib><creatorcontrib>Simmerman, James Mark, PhD</creatorcontrib><creatorcontrib>Gordon, Aubree, PhD</creatorcontrib><creatorcontrib>Sato, Masatoki, MD</creatorcontrib><creatorcontrib>Howie, Stephen, FRACP</creatorcontrib><creatorcontrib>Krishnan, Anand, MD</creatorcontrib><creatorcontrib>Ope, Maurice, MD</creatorcontrib><creatorcontrib>Lindblade, Kim A, PhD</creatorcontrib><creatorcontrib>Carosone-Link, Phyllis, MSPH</creatorcontrib><creatorcontrib>Lucero, Marilla, MD</creatorcontrib><creatorcontrib>Ochieng, Walter, MD</creatorcontrib><creatorcontrib>Kamimoto, Laurie, MD</creatorcontrib><creatorcontrib>Dueger, Erica, PhD</creatorcontrib><creatorcontrib>Bhat, Niranjan, MD</creatorcontrib><creatorcontrib>Vong, Sirenda, MD</creatorcontrib><creatorcontrib>Theodoratou, Evropi, PhD</creatorcontrib><creatorcontrib>Chittaganpitch, Malinee, MSc</creatorcontrib><creatorcontrib>Chimah, Osaretin, FWACP</creatorcontrib><creatorcontrib>Balmaseda, Angel, MD</creatorcontrib><creatorcontrib>Buchy, Philippe, MD</creatorcontrib><creatorcontrib>Harris, Eva, Prof</creatorcontrib><creatorcontrib>Evans, Valerie, MSc</creatorcontrib><creatorcontrib>Katayose, Masahiko, MD</creatorcontrib><creatorcontrib>Gaur, Bharti, MSc</creatorcontrib><creatorcontrib>O'Callaghan-Gordo, Cristina, BSc</creatorcontrib><creatorcontrib>Goswami, Doli, MPH</creatorcontrib><creatorcontrib>Arvelo, Wences, MD</creatorcontrib><creatorcontrib>Venter, Marietjie, PhD</creatorcontrib><creatorcontrib>Briese, Thomas, PhD</creatorcontrib><creatorcontrib>Tokarz, Rafal, PhD</creatorcontrib><creatorcontrib>Widdowson, Marc-Alain, VetMB</creatorcontrib><creatorcontrib>Mounts, Anthony W, MD</creatorcontrib><creatorcontrib>Breiman, Robert F, MD</creatorcontrib><creatorcontrib>Feikin, Daniel R, MD</creatorcontrib><creatorcontrib>Klugman, Keith P, Prof</creatorcontrib><creatorcontrib>Olsen, Sonja J, PhD</creatorcontrib><creatorcontrib>Gessner, Bradford D, MD</creatorcontrib><creatorcontrib>Wright, Peter F, Prof</creatorcontrib><creatorcontrib>Rudan, Igor, Prof</creatorcontrib><creatorcontrib>Broor, Shobha, Prof</creatorcontrib><creatorcontrib>Simões, Eric AF, Prof</creatorcontrib><creatorcontrib>Campbell, Harry, Prof</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>News 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nair, Harish, Dr</au><au>Brooks, W Abdullah, MD</au><au>Katz, Mark, MD</au><au>Roca, Anna, PhD</au><au>Berkley, James A, FRCPCH</au><au>Madhi, Shabir A, Prof</au><au>Simmerman, James Mark, PhD</au><au>Gordon, Aubree, PhD</au><au>Sato, Masatoki, MD</au><au>Howie, Stephen, FRACP</au><au>Krishnan, Anand, MD</au><au>Ope, Maurice, MD</au><au>Lindblade, Kim A, PhD</au><au>Carosone-Link, Phyllis, MSPH</au><au>Lucero, Marilla, MD</au><au>Ochieng, Walter, MD</au><au>Kamimoto, Laurie, MD</au><au>Dueger, Erica, PhD</au><au>Bhat, Niranjan, MD</au><au>Vong, Sirenda, MD</au><au>Theodoratou, Evropi, PhD</au><au>Chittaganpitch, Malinee, MSc</au><au>Chimah, Osaretin, FWACP</au><au>Balmaseda, Angel, MD</au><au>Buchy, Philippe, MD</au><au>Harris, Eva, Prof</au><au>Evans, Valerie, MSc</au><au>Katayose, Masahiko, MD</au><au>Gaur, Bharti, MSc</au><au>O'Callaghan-Gordo, Cristina, BSc</au><au>Goswami, Doli, MPH</au><au>Arvelo, Wences, MD</au><au>Venter, Marietjie, PhD</au><au>Briese, Thomas, PhD</au><au>Tokarz, Rafal, PhD</au><au>Widdowson, Marc-Alain, VetMB</au><au>Mounts, Anthony W, MD</au><au>Breiman, Robert F, MD</au><au>Feikin, Daniel R, MD</au><au>Klugman, Keith P, Prof</au><au>Olsen, Sonja J, PhD</au><au>Gessner, Bradford D, MD</au><au>Wright, Peter F, Prof</au><au>Rudan, Igor, Prof</au><au>Broor, Shobha, Prof</au><au>Simões, Eric AF, Prof</au><au>Campbell, Harry, Prof</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2011-12-03</date><risdate>2011</risdate><volume>378</volume><issue>9807</issue><spage>1917</spage><epage>1930</epage><pages>1917-1930</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>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.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>22078723</pmid><doi>10.1016/S0140-6736(11)61051-9</doi><tpages>14</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0140-6736 |
ispartof | The Lancet (British edition), 2011-12, Vol.378 (9807), p.1917-1930 |
issn | 0140-6736 1474-547X |
language | eng |
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source | ScienceDirect Journals |
subjects | 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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