Deaths Attributed to Respiratory Syncytial Virus in Young Children in High–Mortality Rate Settings: Report from Child Health and Mortality Prevention Surveillance (CHAMPS)
Author:
Blau Dianna M1, Baillie Vicky L2, Els Toyah2, Mahtab Sana2, Mutevedzi Portia2, Keita Adama Mamby3, Kotloff Karen L4, Mehta Ashka4, Sow Samba O3, Tapia Milagritos D4, Tippett Barr Beth A5, Oluoch Benard O6, Onyango Clayton5, Revathi Gunturu7, Verani Jennifer R8, Abayneh Mahlet9, Assefa Nega10, Madrid Lola1011, Oundo Joseph O11, Scott J Anthony G11, Bassat Quique1213141516, Mandomando Inacio1317, Sitoe Antonio13, Valente Marta12, Varo Rosauro1213, Bassey Ima-Abasi18, Cain Carrie Jo19, Jambai Amara20, Ogbuanu Ikechukwu21, Ojulong Julius18, Alam Muntasir22, El Arifeen Shams22, Gurley Emily S2223, Rahman Afruna22, Rahman Mustafizur22, Waller Jessica L24, Dewey Betsy25, Breiman Robert F25, Whitney Cynthia G25, Madhi Shabir A2, Adam Yasmin, Agaya Janet, Ajanovic Sara, Alemu Addisu, Ali Solomon, Aol George, Badji Henry, Bari Sanwarul, Bramugy Justina, Bunn James, Chawana Richard, Chowdhury Atique Iqbal, Fairchild Karen D, Fentaw Surafel, Flora Meerjady Sabrina, Gethi Dickson, Govender Nelesh P, Greene Carol L, Gure Tadesse, Hale Martin, Hurtado Juan Carlos, Igunza Kitiezo Aggrey, Islam Farzana, Kristie Johnson J, Keita Tatiana, Khagayi Sammy, Khan Iqbal Ansary, Koka Rima, Kone Diakaridia, Kourouma Nana, Kuria Magdalene N, Lako Sandra, Lala Sanjay G, Lombaard Hennie, Luke Ronita, Misore Thomas, Mitei Paul K, Ibrahim Alexander M, Moultrie Andrew, Murila Florence V, Myburgh Nellie, Nyamthimba Peter, Oliech Richard, Omore Richard, Onwuchekwa Uma U, Orlien Stian M S, Othieno Louis, Otieno Peter, Otieno Kephas, Ouma Gregory, Owuor Benard, Parveen Shahana, Petersen Karen L, Rahman Mahbubur, Rakislova Natalia, Rogena Emily A, Sanogo Doh, Shirin Tahmina, Sidibe Diakaridia, Sissoko Seydou, Solomon Fatima, Sorour Gillian, Sylvester Squire James, Swart Peter J, Temesgen Fikremelekot, Tennant Sharon M, Thwala Bukiwe Nana, Traore Cheick Bougadari, Velaphi Sithembiso, Vitorino Pio, Wadula Jeannette, Yeshi Melisachew Mulatu,
Affiliation:
1. Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2. South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa 3. Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali 4. Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA 5. Centers for Disease Control and Prevention, Kenya, Kisumu, Kenya 6. Kenya Medical Research Institute, Kisumu, Kenya 7. Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya 8. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 9. Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 10. St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia 11. College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia 12. Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, United Kingdom 13. ISGlobal–Hospital Clínic, Unversitat de Barcelona, Barcelona, Spain 14. Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique 15. Institutó Catalana de Recerca I Estudis Avançats (ICREA), Barcelona, Spain 16. Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain 17. Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain 18. Instituto Nacional de Saúde, Maputo, Mozambique 19. ICAP–Columbia University, Makeni, Sierra Leone 20. World Hope International, Makeni, Sierra Leone 21. Ministry of Health and Sanitation, Freetown, Sierra Leone 22. Crown Agents, Freetown, Sierra Leone 23. International Center for Diarrhoeal Diseases Research (icddr,b), Dhaka, Bangladesh 24. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA 25. Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
Abstract
Abstract
Background
Lower respiratory tract infections are a leading cause of death in young children, but few studies have collected the specimens needed to define the role of specific causes. The Child Health and Mortality Prevention Surveillance (CHAMPS) platform aims to investigate causes of death in children aged <5 years in high–mortality rate settings, using postmortem minimally invasive tissue sampling and other advanced diagnostic techniques. We examined findings for deaths identified in CHAMPS sites in 7 countries in sub-Saharan Africa and south Asia to evaluate the role of respiratory syncytial virus (RSV).
Methods
We included deaths that occurred between December 2016 and December 2019. Panels determined causes of deaths by reviewing all available data including pathological results from minimally invasive tissue sampling, polymerase chain reaction screening for multiple infectious pathogens in lung tissue, nasopharyngeal swab, blood, and cerebrospinal fluid samples, clinical information from medical records, and verbal autopsies.
Results
We evaluated 1213 deaths, including 695 in neonates (aged <28 days), 283 in infants (28 days to <12 months), and 235 in children (12–59 months). RSV was detected in postmortem specimens in 67 of 1213 deaths (5.5%); in 24 deaths (2.0% of total), RSV was determined to be a cause of death, and it contributed to 5 other deaths. Younger infants (28 days to <6 months of age) accounted for half of all deaths attributed to RSV; 6.5% of all deaths in younger infants were attributed to RSV. RSV was the underlying and only cause in 4 deaths; the remainder (n = 20) had a median of 2 (range, 1–5) other conditions in the causal chain. Birth defects (n = 8) and infections with other pathogens (n = 17) were common comorbid conditions.
Conclusions
RSV is an important cause of child deaths, particularly in young infants. These findings add to the substantial body of literature calling for better treatment and prevention options for RSV in high–mortality rate settings.
Funder
Bill and Melinda Gates Foundation
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
24 articles.
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