| Autor: |
Wang, Xin, Li, You, Deloria-Knoll, Maria, Madhi, Shabir A., Cohen, Cheryl, Ali, Asad, Basnet, Sudha, Bassat, Quique, Brooks, W. Abdullah, Chittaganpitch, Malinee, Echavarria, Marcela, Fasce, Rodrigo A., Goswami, Doli, Hirve, Siddhivinayak, Homaira, Nusrat, Howie, Stephen R. C., Kotloff, Karen L., Khuri-Bulos, Najwa, Krishnan, Anand, Lucero, Marilla G., Lupisan, Socorro, Mira-Iglesias, Ainara, Moore, David P., Moraleda, Cinta, Nunes, Marta, Oshitani, Histoshi, Owor, Betty E., Polack, Fernando P., O'Brien, Katherine L., Rasmussen, Zeba A., Rath, Barbara A., Salimi, Vahid, Scott, J Anthony G., Simões, Eric A. F., Strand, Tor A., Thea, Donald M., Treurnicht, Florette K., Vaccari, Linda C., Yoshida, Lay-Myint, Zar, Heather J., Campbell, Harry, Nair, Harish |
| Přispěvatelé: |
Respiratory Virus Global Epidemiology Network, Nokes, D. James |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| ISSN: |
2214-109X |
| Popis: |
Summary:\ud Human metapneumovirus (hMPV) is one of several important viruses associated with childhood acute lower respiratory infection (ALRI). However, there are currently no global burden estimates for ALRI associated with hMPV in children, and there are no licenced vaccines or drugs for hMPV infections. We estimated age–stratified global morbidity and mortality burden of hMPV–associated ALRI among children under five years using data on laboratory–confirmed hMPV burden from different geographic regions. \ud Methods: We performed a systematic review of hMPV burden studies published between 1 January 2001 and 31 December 2019 and identified a further 40 high–quality unpublished studies. We assessed the risk of bias using a modified Newcastle–Ottawa Scale. Incidence rates, hospital admission rates, and in–hospital case–fatality ratios (hCFRs) of hMPV–associated ALRI (defined as ALRI with laboratory–confirmed hMPV) were analysed using a generalized linear mixed model. We applied incidence and hospital admission rates of hMPV–associated ALRI to population estimates to yield the morbidity burden estimates. We estimated hMPV–associated ALRI in–hospital deaths by combining hospital admissions and hCFRs of hMPV–associated ALRI. We estimated the overall hMPV–associated ALRI deaths (both in–hospital and out–hospital deaths) using the number of in–hospital deaths, population–based childhood pneumonia mortality, and care–seeking for child pneumonia. We also estimated hMPV–attributable ALRI cases, hospital admissions, and deaths (ALRI burden that are causally attributable to hMPV) by combining hMPV–associated burden estimates and attributable fractions of hMPV in laboratory–confirmed hMPV cases and deaths. \ud Findings: We estimated in 2018 that hMPV could be detected in 14.2 million (UR 10.2–20.1) ALRI cases, 643,000 (UR 425,000–977,000) hospital admissions, 7,700 (UR 2,600–48,800) in–hospital deaths, and 16,100 (UR 5,700–88,000) overall ALRI deaths among children under five years globally. Of these cases and deaths, an estimated 11.1 million (UR 8.0–15.7) ALRI cases, 502,000 (UR 332,000–762,000) ALRI hospital admissions, and 11,300 (UR 4,000–61,600) ALRI deaths could be causally attributable to hMPV. hMPV–associated ALRI incidence rate in the community setting did not vary much by age strata, while about 58% of hospital admissions were in infants less than 12 months; 64% of in–hospital deaths occurred 6 in the first six months of life, of which 80% occurred in low– and lower–middle income countries. \ud Interpretation: Infants younger than one year have disproportionately high risks of severe hMPV infections across settings, similar to respiratory syncytial virus and influenza virus. Infants younger than 6 months in low– and lower–middle income countries are at greater risk of death from hMPV–associated ALRI compared with other countries. Our mortality estimates, though likely to be conservative and underestimate the true hMPV mortality burden, demonstrate the importance of intervention strategies for infants across all settings, and warrant continued efforts to improve the outcome of hMPV–associated ALRI among young infants in low– and lower–middle income countries. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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