Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982– 2012: A Systematic Analysis

Kathryn Lafond 1, 2, * Harish Nair 3, 4 Mohammad Rasooly 5 Fátima Valente 6 Robert Booy 7 Mahmudur Rahman 8 Paul Kitsutani 1 Hongjie Yu 9 Guiselle Guzman 10 Daouda Coulibaly 11 Julio Armero 12 Daddi Jima 13 Stephen Howie 14, 15 William Ampofo 16 Ricardo Mena 17 Mandeep Chadha 18 Ondri Sampurno 19 Gideon Emukule 20 Zuridin Nurmatov 21 Andrew Corwin 1 Jean-Michel Heraud 22 Daniel Noyola 23 Radu Cojocaru 24 Pagbajabyn Nymadawa 25 Amal Barakat 26 Adebayo Adedeji 27 Marta von Horoch 28 Remigio Olveda 29 Thierry Nyatanyi 30 Marietjie Venter 31, 32, 1 Vida Mmbaga 33 Malinee Chittaganpitch 34 Tran Nguyen 35 Andros Theo 36 Melissa Whaley 1 Eduardo Azziz-Baumgartner 1 Joseph Bresee 1 Harry Campbell 3 Marc-Alain Widdowson 1, *
Abstract : BACKGROUND: The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide. METHODS AND FINDINGS: We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (<6 mo, <1 y, <2 y, <5 y, 5-17 y, and <18 y). We applied this proportion to global estimates of acute lower respiratory infection hospitalizations among children aged <1 y and <5 y, to obtain the number and per capita rate of influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%-11%) of respiratory hospitalizations in children <18 y worldwide, ranging from 5% (95% CI 3%-7%) among children <6 mo to 16% (95% CI 14%-20%) among children 5-17 y. On average, we estimated that influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children <1 y-of which 228,000 (95% CI 150,000 to 344,000) occur in children <6 mo-and 870,000 (95% CI 610,000 to 1,237,000) hospitalizations in children <5 y annually. Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings. CONCLUSIONS: Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo.
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Kathryn Lafond, Harish Nair, Mohammad Rasooly, Fátima Valente, Robert Booy, et al.. Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982– 2012: A Systematic Analysis. PLoS Medicine, Public Library of Science, 2016, 13 (3), pp.e1001977. ⟨10.1371/journal.pmed.1001977⟩. ⟨pasteur-01675331⟩

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