Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis

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• 作者：Harish  ; Nair DrDNB^a ;   ; ^b ;   ; ^&Dagger ; ;   ; ^{harish.nair@ed.ac.uk} ; W Abdullah  ; Brooks MD^c ; Mark  ; Katz MD^d ; Anna  ; Roca PhD^e ;   ; ^f ; James A  ; Berkley FRCPCH^g ;   ; ^h ; Shabir A  ; Madhi ProfMDⁱ ; James Mark  ; Simmerman PhD^j ; Aubree  ; Gordon PhD^k ;   ; ^l ; Masatoki  ; Sato MD^m ; Stephen  ; Howie FRACPⁿ ; Anand  ; Krishnan MD^o ; Maurice  ; Ope MD^p ; Kim A  ; Lindblade PhD^q ; Phyllis  ; Carosone-Link MSPH^r ; Marilla  ; Lucero MD^s ; Walter  ; Ochieng MD^t ; Laurie  ; Kamimoto MD^u ; Erica  ; Dueger PhD^v ; Niranjan  ; Bhat MD^w ; Sirenda  ; Vong MD^x ; Evropi  ; Theodoratou PhD^a ; Malinee  ; Chittaganpitch MSc^y ; Osaretin  ; Chimah FWACPⁿ ;   ; ^z ; Angel  ; Balmaseda MD^aa ; Philippe  ; Buchy MD^x ; Eva  ; Harris ProfMD^k ; Valerie  ; Evans MSc^a ; Masahiko  ; Katayose MD^ab ; Bharti  ; Gaur MSc^o ; Cristina  ; O'Callaghan-Gordo BSc^e ;   ; ^f ; Doli  ; Goswami MPH^c ; Wences  ; Arvelo MD^q ; Marietjie  ; Venter PhD^ac ;   ; ^ad ; Thomas  ; Briese PhD^ae ; Rafal  ; Tokarz PhD^ae ; Marc-Alain  ; Widdowson VetMB^u ; Anthony W  ; Mounts MD^af ; Robert F  ; Breiman MD^d ; Daniel R  ; Feikin MD^d ;   ; ^ag ; Keith P  ; Klugman ProfMDⁱ ;   ; ^ah ; Sonja J  ; Olsen PhD^j ; Bradford D  ; Gessner MD^ai ; Peter F  ; Wright ProfMD^aj ; Igor  ; Rudan ProfMD^a ;   ; ^ak ; Shobha  ; Broor ProfMD^o ; Eric AF  ; Simõ ; es ProfMD^r ;   ; ^al ; Harry  ; Campbell ProfMD^a ;   ; ^&Dagger ; ;   ; ^{harry.campbell@ed.ac.uk}
• 刊名：The Lancet
• 出版年：2011
• 出版时间：3-9 December 2011
• 年：2011
• 卷：378
• 期：9807
• 页码：1917-1930
• 全文大小：812 K

文摘

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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by age, with data from a systematic review of studies published between Jan 1, 1995, and Oct 31, 2010, and 16 unpublished population-based studies.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?62 million) new cases of influenza (data from nine studies), 20 million (13?2 million) cases of influenza-associated ALRI (13 % of all cases of paediatric ALRI; data from six studies), and 1 million (1? 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?00?11?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.