Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis

被引:536
作者
Nair, Harish [1 ,2 ]
Simoes, Eric A. F. [3 ,4 ,5 ]
Rudan, Igor [1 ]
Gessner, Bradford D. [6 ]
Azziz-Baumgartner, Eduardo [7 ]
Zhang, Jian Shayne F. [8 ]
Feikin, Daniel R. [9 ,10 ]
Mackenzie, Grant A. [11 ]
Moisi, Jennifer C. [12 ]
Roca, Anna [13 ,14 ]
Baggett, Henry C. [15 ]
Zaman, Syed M. A. [11 ,16 ]
Singleton, Rosalyn J. [17 ,18 ]
Lucero, Marilla G. [19 ]
Chandran, Aruna [10 ]
Gentile, Angela [20 ]
Cohen, Cheryl [21 ,22 ]
Krishnan, Anand [26 ]
Bhutta, Zulfiqar A. [27 ]
Arguedas, Adriano [28 ]
Clara, Alexey Wilfrido [29 ]
Andrade, Ana Lucia [30 ]
Ope, Maurice [31 ]
Ruvinsky, Raul Oscar [32 ]
Hortal, Maria [33 ]
McCracken, John P. [34 ]
Madhi, Shabir A. [21 ,23 ,24 ,25 ]
Bruce, Nigel [35 ]
Qazi, Shamim A. [36 ]
Morris, Saul S. [37 ]
El Arifeen, Shams [38 ]
Weber, Martin W. [39 ]
Scott, J. Anthony G. [12 ]
Brooks, W. Abdullah [38 ]
Breiman, Robert F. [9 ]
Campbell, Harry [1 ]
机构
[1] Univ Edinburgh, Global Hlth Acad, Ctr Populat Hlth Sci, Edinburgh EH8 9AG, Midlothian, Scotland
[2] Publ Hlth Fdn India, New Delhi, India
[3] Univ Colorado Denver, Denver, CO USA
[4] Childrens Hosp, Denver, CO 80218 USA
[5] Padjadjaran State Univ, Bandung, Indonesia
[6] Agence Med Prevent, Paris, France
[7] Ctr Dis Control & Prevent CDC, Influenza Div, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA
[8] Univ Melbourne, Sch Populat Hlth, Melbourne, Vic 3010, Australia
[9] Ctr Dis Control & Prevent, Nairobi, Kenya
[10] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
[11] Gambia Unit, MRC, Banjul, Gambia
[12] Wellcome Trust Res Programme, Kenya Med Res Inst, Kilifi, Kenya
[13] Univ Barcelona, IDIBAPS, Hosp Clin, Barcelona Ctr Int Hlth Res CRESIB, Barcelona, Spain
[14] Minist Saude, Ctr Invest Saude Manhica, Maputo, Mozambique
[15] Thailand MOPH US CDC Collaborat, Global Dis Detect Reg Ctr, Int Emerging Infect Program, Nonthaburi, Thailand
[16] Hlth Protect Agcy, Hlth Protect Serv Colindale, London, England
[17] CDC, Arctic Invest Program, Natl Ctr Emerging & Zoonot Infect Dis, Anchorage, AK USA
[18] Alaska Native Tribal Hlth Consortium, Anchorage, AK USA
[19] Res Inst Trop Med, Dept Hlth, Alabang, Muntinlupa, Philippines
[20] Ricardo Gutierrez Childrens Hosp, Buenos Aires, DF, Argentina
[21] Natl Inst Communicable Dis, Ctr Resp Dis & Meningitis, Johannesburg, South Africa
[22] Univ Witwatersrand, Sch Publ Hlth, Johannesburg, South Africa
[23] Univ Witwatersrand, MRC, Resp & Meningeal Pathogens Res Unit, Johannesburg, South Africa
[24] Univ Witwatersrand, Dept Sci & Technol, Johannesburg, South Africa
[25] Univ Witwatersrand, Natl Res Fdn Vaccine Preventable Dis, Johannesburg, South Africa
[26] All India Inst Med Sci, Ctr Community Med, New Delhi, India
[27] Aga Khan Univ, Div Women & Child Hlth, Karachi, Pakistan
[28] Univ Ciencias Med Ctr Amer, Inst Atenc Pediat, San Jose, Costa Rica
[29] CDC Cent Amer Reg, Guatemala City, Guatemala
[30] Univ Fed Goias, Goiania, Go, Brazil
[31] East African Community Secretariat, Arusha, Tanzania
[32] Natl Univ Buenos Aires, Buenos Aires, DF, Argentina
[33] Natl Univ PNUD, Program Basic Sci Dev, Montevideo, Uruguay
[34] Univ Valle Guatemala, Ctr Hlth Studies, Guatemala City, Guatemala
[35] Univ Liverpool, Liverpool L69 3BX, Merseyside, England
[36] WHO, Dept Maternal Neonatal & Child & Adolescent Hlth, CH-1211 Geneva, Switzerland
[37] Bill & Melinda Gates Fdn, Seattle, WA USA
[38] Int Ctr Diarrhoeal Dis Res, Dhaka 1000, Bangladesh
[39] WHO, Indonesia Country Off, Jakarta, Indonesia
基金
比尔及梅琳达.盖茨基金会;
关键词
INVASIVE PNEUMOCOCCAL DISEASE; COMMUNITY CASE-MANAGEMENT; AGED; 2-59; MONTHS; SEVERE PNEUMONIA; TRACT INFECTIONS; CONJUGATE VACCINE; ORAL AMOXICILLIN; SYNCYTIAL VIRUS; TIME TRENDS; POPULATION;
D O I
10.1016/S0140-6736(12)61901-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The annual number of hospital admissions and in-hospital deaths due to severe acute lower respiratory infections (ALRI) in young children worldwide is unknown. We aimed to estimate the incidence of admissions and deaths for such infections in children younger than 5 years in 2010. Methods We estimated the incidence of admissions for severe and very severe ALRI in children younger than 5 years, stratified by age and region, with data from a systematic review of studies published between Jan 1, 1990, and March 31, 2012, and from 28 unpublished population-based studies. We applied these incidence estimates to population estimates for 2010, to calculate the global and regional burden in children admitted with severe ALRI in that year. We estimated in-hospital mortality due to severe and very severe ALRI by combining incidence estimates with case fatality ratios from hospital-based studies. Findings We identified 89 eligible studies and estimated that in 2010, 11.9 million (95% CI 10.3-13.9 million) episodes of severe and 3.0 million (2.1-4.2 million) episodes of very severe ALRI resulted in hospital admissions in young children worldwide. Incidence was higher in boys than in girls, the sex disparity being greatest in South Asian studies. On the basis of data from 37 hospital studies reporting case fatality ratios for severe ALRI, we estimated that roughly 265 000 (95% CI 160 000-450 000) in-hospital deaths took place in young children, with 99% of these deaths in developing countries. Therefore, the data suggest that although 62% of children with severe ALRI are treated in hospitals, 81% of deaths happen outside hospitals. Interpretation Severe ALRI is a substantial burden on health services worldwide and a major cause of hospital referral and admission in young children. Improved hospital access and reduced inequities, such as those related to sex and rural status, could substantially decrease mortality related to such infection. Community-based management of severe disease could be an important complementary strategy to reduce pneumonia mortality and health inequities.
引用
收藏
页码:1380 / 1390
页数:11
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