Global Respiratory Syncytial Virus–Related Infant Community Deaths

Author:

Mazur Natalie I1,Löwensteyn Yvette N1,Willemsen Joukje E1,Gill Christopher J2,Forman Leah2,Mwananyanda Lawrence M2,Blau Dianna M3,Breiman Robert F4,Madhi Shabir A56,Mahtab Sana6,Gurley Emily S78,El Arifeen Shams8,Assefa Nega9,Scott J Anthony G10,Onyango Dickens11,Tippet Barr Beth A12,Kotloff Karen L13,Sow Samba O14,Mandomando Inacio1516,Ogbuanu Ikechukwu17,Jambai Amara18,Bassat Quique1519202122,Thamthitiwat Somsak23,Gentile Angela24,Lucion Maria Florencia24,Pires Márcia Rosane25,de-Paris Fernanda25,Gordon Aubree26,Sánchez José Félix27,Lucero Marilla G28,Lupisan Socorro P28,Gessner Bradford D29,Tall Haoua29,Halasa Natasha30,Khuri-Bulos Najwa31,Nokes D James32,Munywoki Patrick K32,Otieno Grieven P32,O’Brien Katherine L33,Oshitani Katherine L34,da Costa Oliveira Maria Tereza35,de Freitas Lázaro Emediato Carla Cecília35,Ali Asad36,Aamir Uzma Bashir37,Noyola Daniel E38,Cohen Cheryl39,Moyes Jocelyn39,Giamberardino Heloisa Ihle Garcia40,Webler Jane Melissa40,de Matos Bezerra Patricia Gomes41,Bezerra Duarte Maria do Carmo Menezes41,Chu Helen Y42,Das Rashmi Ranjan43,Weber Martin W4445,Homaira Nusrat468,Jaffe Adam46,Sturm-Ramirez Katharine M83,Su Wei47,Yuan Chiang Chun47,Chaves Sandra48,Emukule Gideon O48,de Andrade Nishioka Sergio4950,de Carvalho Felipe Cotrim49,Gökçe Şule51,Raboni Sonia M52,Hawkes Michael53,Messaoudi Melina54,Bryant Juliet54,Dbaibo Ghassan S55,Hanna-Wakim Rima55,Sampath Jayaweera J A A56,Stolyarov Kirill57,Suntarattiwong Piyarat58,Mussá Tufária59,Bruno Alfredo6061,de Mora Domenica60,Wanlapakorn Nasamon62,de Xie Zheng63,Ai Junhong63,Ojeda Jenny64,Zamora Lida64,Obodai Evangeline6566,Odoom John Kofi65,Ismail Maha Talaat67,Buchwald Andrea68,O’Callaghan-Gordo Cristina691570,Fernandez-Sarmiento Jaime71,Obando-Belalcazar Evelyn72,Dhole Tapan73,Verma Sheetal74,Eşki Aykut75,Ozturk Kartal G75,Al Amad Mohammed76,Al Serouri Abdul Wahed76,FunChan Yoke77,Sam Jamal I-Ching77,Jarovsky Daniel78,da Silva Daniella Gregória Bomfim Prado79,Perales José Gareca80,Toh Teck-Hock81,Yit Jeffrey Lee Soon81,Kendirli Tanil82,Gun Emrah82,Sagna Tani83,Diagbouga Serge83,Chowdhury Fahmida84,Islam Md Ariful84,Venter Marietjie85,Visser Adele85,Pham Minh-Hong86,Vásquez-Hoyos Pablo878889,González-Dambrauskas Sebastián878890,Rubio Franco Díaz879192,Karsies Todd8893,Zemanate Eliana878894,Izquierdo Ledys878895,Palomino Rubén Lasso878896,Pardo-Carrero Rosalba8797,Grigolli-Cesar Reginna8798,Menta Soledad8799,Monteverde Nicolás87100,Duyu Muhterem101,Saha Senjuti102,Saha Samir K102,Kelly Matthew103,Echavarria Marcela104,Tran Tuan105,Borgi Aida106,Ayari Ahmed107,Caballero Mauricio T108109,Polack Fernando P108109,Omer Saad110111,Kazi Abdul Momin112,Simões Eric A F113,Satav Ashish114,Bont Louis J1115,

Affiliation:

1. Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, The Netherlands

2. Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA

3. Centers for Disease Control and Prevention, Atlanta, Georgia, USA

4. Emory University, Global Health Institute, Child Health and Mortality Prevention Surveillance (CHAMPS) Network, Atlanta, Georgia, USA

5. South African Medical Research Council—Vaccines and Infectious Diseases Analytics Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

6. Department of Science and Technology/National Research Foundation—Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa

7. Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

8. International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh

9. College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia

10. London School of Hygiene and Tropical Medicine, London, United Kingdom

11. Kisumu County Department of Health, Kisumu, Kenya

12. Centers for Disease Control, Kisumu, Kenya

13. Department of Pediatrics, Center for Vaccine Development and Global Health and Division of Infectious Disease and Tropical Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA

14. Center for Vaccine Development, Bamako, Mali

15. Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique

16. Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique

17. Crown Agents Sierra Leone, Freetown, Sierra Leone

18. Ministry of Health and Sanitation, Freetown, Sierra Leone

19. ISGlobal, Hospital Clínic–Universitat de Barcelona, Barcelona, Spain

20. Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluís Companys 23, Barcelona, Spain

21. Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain

22. Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

23. Division of Global Health Protection, Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand

24. Department of Epidemiology, Ricardo Gutiérrez Children Hospital, Buenos Aires, Argentina

25. Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

26. Department of Epidemiology, School of Public Health, University of Michigan, Michigan, USA

27. Department of Medicine, Hospital de Referencia Manuel de Jesús, Managua, Nicaragua

28. Research Institute for Tropical Medicine, Muntinlupa City, Philippines

29. Agence de Médecine Préventive, Paris, France

30. Vanderbilt University Medical Center, Nashville, Tennessee, USA

31. Department of Pediatrics, University of Jordan, Aljubeiha, Amman, Jordan

32. Kenya Medical Research Institute, Wellcome Trust Research Programme, Centre for Geographic Medicine Research—Coast, Kilifi, Kenya

33. International Vaccine Access Center, Pneumonia Etiology Research for Child Health (PERCH), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

34. Department of Virology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Miyagi, Japan

35. Health Secretariat of the City of Belo Horizonte, Belo Horizonte, Brazil

36. Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan

37. Department of Virology, National Institute of Health, Islamabad, Pakistan

38. Faculty of Medicine, Department of Microbiology, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico

39. Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa

40. Hospital Pequeno Príncipe, Curitiba, Brazil

41. Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil

42. Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA

43. All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India

44. Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland

45. Medical Research Council Laboratories, Fajara, The Gambia

46. School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia

47. Can Am International Medical Center, Guangzhou, China

48. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Nairobi, Kenya

49. Department of Transmissible Diseases, Ministry of Health, Brasília, Brazil

50. Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brazil

51. Department of Pediatrics, General Pediatrics Unit, Ege University, Izmir, Turkey

52. Virology Laboratory, Department of Infectious Diseases, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil

53. Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada

54. Emerging Pathogens Laboratory—Fondation Mérieux, Centre International de Recherche en Infectiologie, Lyon, France

55. Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon

56. Department of Microbiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka

57. Research Institute of Influenza, St. Petersburg, Russian Federation

58. Queen Sirikit National Institute of Child Health, Bangkok, Thailand

59. Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

60. Instituto Nacional de Investigación en Salud Publica, Guayaquil, Ecuador

61. Universidad Agraria del Ecuador, Guayaquil, Ecuador

62. Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

63. Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health,

64. Ministerio de Salud Pública del Ecuador, Quito, Ecuador

65. Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana

66. Department of Microbiology, University of Ghana Medical School, Accra, Ghana

67. Global Disease Detection Center, Global Disease Detection and Response Program, US Naval Medical Research Unit, US Centers for Disease Control and Prevention, Cairo, Egypt

68. Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA

69. Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain

70. ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain

71. Department of Pediatrics and Intensive Care, Fundación Cardioinfantil-Instituto de Cardiología, Universidad de La Sabana, Bogotá, Colombia

72. Department of Pediatric Critical Care Medicine, Instituto Roosevelt, Bogotá, Colombia

73. Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Uttar Pradesh, India

74. Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India

75. University of Health Sciences, Department of Pediatric Pulmonology, Dr Gazi Yaşargil Women’s and Children’s Health, Education and Research Hospital, Diyarbakır, Turkey

76. Yemen Field Epidemiology Training Program (Yemen-FETP), Sana’a, Yemen

77. Tropical Infectious Diseases Research and Education Centre, Department of Medical Microbiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

78. Pediatric Infectious Diseases Unit, Santa Casa de Sao Paulo, Sao Paulo, Brazil

79. Department of Pediatrics, Santa Casa de Sao Paulo, Sao Paulo, Brazil

80. Centro de Pediatria Especializada “CRECER”, Santa Cruz de la Sierra, Bolivia

81. Department of Paediatrics, Sibu Hospital, Sibu, Sarawak, Malaysia

82. Division of Pediatric Critical Care, Ankara University School of Medicine, Ankara, Turkey

83. Institut de Recherche en Sciences de la Sante (IRSS), Bobo-Dioulasso, Burkina Faso

84. Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh

85. Department of Medical Virology, University of Pretoria, National Health Laboratory Services, Tshwane Academic Division, Pretoria, South Africa

86. Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

87. Red Colaborativa Pediátrica de Latinoamericá (LARed Network)

88. Bronchiolitis and Co-Detection (BACON) study, Red Colaborativa Pediátrica de Latinoamericá (LARed Network)

89. Hospital de Montevideo, Uruguay, San José, Bogotá, Colombia

90. Cuidados Intensivos Pediátricos Especializados (CIPe), Casa de Galicia, Montevideo, Uruguay

91. Hospital El Carmen de Maipú, Santiago, Chile

92. Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile

93. Department of Pediatric Critical Care, Nationwide Children’s Hospital, Columbus, Ohio, USA

94. Hospital Susana López de Valencia E.S.E., Popoyán, Colombia

95. Hospital Militar Central, Bogotá, Colombia

96. Fundación Valle de Lili, Cali, Colombia

97. Clínica Infantil Colsubsidio, Bogotá, Colombia

98. Hospital Infantil Sabará, Sao Paulo, Brazil

99. Hospital Tacuarembó, Tacuarembo, Uruguay

100. Pediatric Intensive Care Unit, Médica Uruguaya, Montevideo, Uruguay

101. Istanbul Medeniyet University, Goztepe Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey

102. Child Health Research Foundation (CHRF), Dhaka, Bangladesh

103. Division of Pediatric Infectious Diseases, Duke University, Durham, North Carolina, USA

104. Clinical Virology Unit, CEMIC—CONICET, Instituto Universitario CEMIC, Buenos Aires, Argentina

105. Children’s Hospital No. 1, Ho Chi Minh City, Vietnam

106. Pediatric Intensive Care Unit, Children’s Hospital of Tunis, Tunis, Tunisia

107. L’Hôpital d’Enfants Béchir-Hamza, Tunis, Tunisia

108. Fundación Infant, Buenos Aires, Argentina

109. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina

110. Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut, USA

111. Yale Institute for Global Health, New Haven, Connecticut, USA

112. The Aga Khan University, Karachi, Pakistan

113. Department of Pediatrics and Center for Global Health, University of Colorado, Children’s Hospital Colorado, Aurora, Colorado, USA

114. Mahatma Gandhi Tribal Hospital, Kadhava, Maharashtra, India

115. Respiratory Syncytial Virus Network (ReSViNET) Foundation, Zeist, The Netherlands

Abstract

Abstract Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P < .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P < 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines.

Funder

Bill and Melinda Gates Foundation

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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