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

Harish Nair; W Abdullah Brooks; Mark Katz; Anna Roca; James A Berkley; Shabir A Madhi; James Mark Simmerman; Aubree Gordon; Masatoki Sato; Stephen Howie; Anand Krishnan; Maurice Ope; Kim A Lindblade; Phyllis Carosone-Link; Marilla Lucero; Walter Ochieng; Laurie Kamimoto; Erica Dueger; Niranjan Bhat; Sirenda Vong; Evropi Theodoratou; Malinee Chittaganpitch; Osaretin Chimah; Angel Balmaseda; Philippe Buchy; Eva Harris; Valerie Evans; Masahiko Katayose; Bharti Gaur; Cristina O'Callaghan-Gordo; Doli Goswami; Wences Arvelo; Marietjie Venter; Thomas Briese; Rafal Tokarz; Marc-Alain Widdowson; Anthony W Mounts; Robert F Breiman; Daniel R Feikin; Keith P Klugman; Sonja J Olsen; Bradford D Gessner; Peter F Wright; Igor Rudan; Shobha Broor; Eric A F Simões; Harry Campbell

doi:10.1016/S0140-6736(11)61051-9

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

Harish Nair, W Abdullah Brooks, Mark Katz, Anna Roca, James A Berkley, Shabir A Madhi, James Mark Simmerman, Aubree Gordon, Masatoki Sato, Stephen Howie, Anand Krishnan, Maurice Ope, Kim A Lindblade, Phyllis Carosone-Link, Marilla Lucero, Walter Ochieng, Laurie Kamimoto, Erica Dueger, Niranjan Bhat, Sirenda VongEvropi Theodoratou, Malinee Chittaganpitch, Osaretin Chimah, Angel Balmaseda, Philippe Buchy, Eva Harris, Valerie Evans, Masahiko Katayose, Bharti Gaur, Cristina O'Callaghan-Gordo, Doli Goswami, Wences Arvelo, Marietjie Venter, Thomas Briese, Rafal Tokarz, Marc-Alain Widdowson, Anthony W Mounts, Robert F Breiman, Daniel R Feikin, Keith P Klugman, Sonja J Olsen, Bradford D Gessner, Peter F Wright, Igor Rudan, Shobha Broor, Eric A F Simões, Harry Campbell

Institute of Tropical Medicine

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

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.

Original language	English
Journal	Lancet
Volume	378
Issue number	9807
Pages (from-to)	1917-30
Number of pages	14
ISSN	0140-6736
DOIs	https://doi.org/10.1016/S0140-6736(11)61051-9
Publication status	Published - 2011

Keywords

Child, Preschool
Global Health
Humans
Incidence
Infant
Influenza, Human/complications
Respiratory Tract Infections/complications
Seasons

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10.1016/S0140-6736(11)61051-9

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Nair, H., Brooks, W. A., Katz, M., Roca, A., Berkley, J. A., Madhi, S. A., Simmerman, J. M., Gordon, A., Sato, M., Howie, S., Krishnan, A., Ope, M., Lindblade, K. A., Carosone-Link, P., Lucero, M., Ochieng, W., Kamimoto, L., Dueger, E., Bhat, N., ... Campbell, H. (2011). Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet, 378(9807), 1917-30. https://doi.org/10.1016/S0140-6736(11)61051-9

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

abstract = "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.",

keywords = "Child, Preschool, Global Health, Humans, Incidence, Infant, Influenza, Human/complications, Respiratory Tract Infections/complications, Seasons",

author = "Harish Nair and Brooks, {W Abdullah} and Mark Katz and Anna Roca and Berkley, {James A} and Madhi, {Shabir A} and Simmerman, {James Mark} and Aubree Gordon and Masatoki Sato and Stephen Howie and Anand Krishnan and Maurice Ope and Lindblade, {Kim A} and Phyllis Carosone-Link and Marilla Lucero and Walter Ochieng and Laurie Kamimoto and Erica Dueger and Niranjan Bhat and Sirenda Vong and Evropi Theodoratou and Malinee Chittaganpitch and Osaretin Chimah and Angel Balmaseda and Philippe Buchy and Eva Harris and Valerie Evans and Masahiko Katayose and Bharti Gaur and Cristina O'Callaghan-Gordo and Doli Goswami and Wences Arvelo and Marietjie Venter and Thomas Briese and Rafal Tokarz and Marc-Alain Widdowson and Mounts, {Anthony W} and Breiman, {Robert F} and Feikin, {Daniel R} and Klugman, {Keith P} and Olsen, {Sonja J} and Gessner, {Bradford D} and Wright, {Peter F} and Igor Rudan and Shobha Broor and Sim{\~o}es, {Eric A F} and Harry Campbell",

year = "2011",

doi = "10.1016/S0140-6736(11)61051-9",

language = "English",

volume = "378",

pages = "1917--30",

journal = "Lancet",

issn = "0140-6736",

publisher = "Elsevier",

number = "9807",

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Nair, H, Brooks, WA, Katz, M, Roca, A, Berkley, JA, Madhi, SA, Simmerman, JM, Gordon, A, Sato, M, Howie, S, Krishnan, A, Ope, M, Lindblade, KA, Carosone-Link, P, Lucero, M, Ochieng, W, Kamimoto, L, Dueger, E, Bhat, N, Vong, S, Theodoratou, E, Chittaganpitch, M, Chimah, O, Balmaseda, A, Buchy, P, Harris, E, Evans, V, Katayose, M, Gaur, B, O'Callaghan-Gordo, C, Goswami, D, Arvelo, W, Venter, M, Briese, T, Tokarz, R, Widdowson, M-A, Mounts, AW, Breiman, RF, Feikin, DR, Klugman, KP, Olsen, SJ, Gessner, BD, Wright, PF, Rudan, I, Broor, S, Simões, EAF & Campbell, H 2011, 'Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis', Lancet, vol. 378, no. 9807, pp. 1917-30. https://doi.org/10.1016/S0140-6736(11)61051-9

TY - JOUR

T1 - Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis

AU - Nair, Harish

AU - Brooks, W Abdullah

AU - Katz, Mark

AU - Roca, Anna

AU - Berkley, James A

AU - Madhi, Shabir A

AU - Simmerman, James Mark

AU - Gordon, Aubree

AU - Sato, Masatoki

AU - Howie, Stephen

AU - Krishnan, Anand

AU - Ope, Maurice

AU - Lindblade, Kim A

AU - Carosone-Link, Phyllis

AU - Lucero, Marilla

AU - Ochieng, Walter

AU - Kamimoto, Laurie

AU - Dueger, Erica

AU - Bhat, Niranjan

AU - Vong, Sirenda

AU - Theodoratou, Evropi

AU - Chittaganpitch, Malinee

AU - Chimah, Osaretin

AU - Balmaseda, Angel

AU - Buchy, Philippe

AU - Harris, Eva

AU - Evans, Valerie

AU - Katayose, Masahiko

AU - Gaur, Bharti

AU - O'Callaghan-Gordo, Cristina

AU - Goswami, Doli

AU - Arvelo, Wences

AU - Venter, Marietjie

AU - Briese, Thomas

AU - Tokarz, Rafal

AU - Widdowson, Marc-Alain

AU - Mounts, Anthony W

AU - Breiman, Robert F

AU - Feikin, Daniel R

AU - Klugman, Keith P

AU - Olsen, Sonja J

AU - Gessner, Bradford D

AU - Wright, Peter F

AU - Rudan, Igor

AU - Broor, Shobha

AU - Simões, Eric A F

AU - Campbell, Harry

PY - 2011

Y1 - 2011

N2 - 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.

AB - 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.

KW - Child, Preschool

KW - Global Health

KW - Humans

KW - Incidence

KW - Infant

KW - Influenza, Human/complications

KW - Respiratory Tract Infections/complications

KW - Seasons

U2 - 10.1016/S0140-6736(11)61051-9

DO - 10.1016/S0140-6736(11)61051-9

M3 - A1: Web of Science-article

C2 - 22078723

SN - 0140-6736

VL - 378

SP - 1917

EP - 1930

JO - Lancet

JF - Lancet

IS - 9807

ER -

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

Abstract

Keywords

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