Global respiratory syncytial virus–related infant community deaths

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Authors

Mazur, Natalie I.
Lowensteyn, Yvette N.
Willemsen, Joukje E.
Gill, Christopher J.
Forman, Leah
Mwananyanda, Lawrence M.
Blau, Dianna M.
Breiman, Robert F.
Madhi, Shabir A.
Mahtab, Sana

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Oxford University Press

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.

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Keywords

Community death, Respiratory syncytial virus (RSV), Lower respiratory tract infection (LRTI), Low- and middle-income countries (LMICs), Pediatric death

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Citation

Mazur, N.I., Lowensteyn, Y.N., Willemsen, J.E. 2021, 'Global respiratory syncytial virus–related infant community deaths', Clinical Infectious Diseases, vol. 73, supp. 3, pp. S229-S237, doi : 10.1093/cid/ciab528.