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\n  \n 2024\n \n \n (13)\n \n \n
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\n \n\n \n \n \n \n \n Burden of Respiratory Syncytial Virus-Associated Acute Respiratory Infections During Pregnancy.\n \n \n \n\n\n \n Kenmoe, S.; Chu, H. Y.; Dawood, F. S.; Milucky, J.; Kittikraisak, W.; Matthewson, H.; Kulkarni, D.; Suntarattiwong, P.; Frivold, C.; Mohanty, S.; Havers, F.; Li, Y.; Nair, H.; and PROMISE Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases, 229(Supplement_1): S51–S60. March 2024.\n \n\n\n\n
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@article{kenmoe_burden_2024,\n\ttitle = {Burden of {Respiratory} {Syncytial} {Virus}-{Associated} {Acute} {Respiratory} {Infections} {During} {Pregnancy}},\n\tvolume = {229},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiad449},\n\tabstract = {BACKGROUND: With the licensure of maternal respiratory syncytial virus (RSV) vaccines in Europe and the United States, data are needed to better characterize the burden of RSV-associated acute respiratory infections (ARI) in pregnancy. The current study aimed to determine among pregnant individuals the proportion of ARI testing positive for RSV and the RSV incidence rate, RSV-associated hospitalizations, deaths, and perinatal outcomes.\nMETHODS: We conducted a systematic review, following PRISMA 2020 guidelines, using 5 databases (Medline, Embase, Global Health, Web of Science, and Global Index Medicus), and including additional unpublished data. Pregnant individuals with ARI who had respiratory samples tested for RSV were included. We used a random-effects meta-analysis to generate overall proportions and rate estimates across studies.\nRESULTS: Eleven studies with pregnant individuals recruited between 2010 and 2022 were identified, most of which recruited pregnant individuals in community, inpatient and outpatient settings. Among 8126 pregnant individuals, the proportion with ARI that tested positive for RSV ranged from 0.9\\% to 10.7\\%, with a meta-estimate of 3.4\\% (95\\% confidence interval [CI], 1.9\\%-54\\%). The pooled incidence rate of RSV among pregnant individuals was 26.0 (95\\% CI, 15.8-36.2) per 1000 person-years. RSV hospitalization rates reported in 2 studies were 2.4 and 3.0 per 1000 person-years. In 5 studies that ascertained RSV-associated deaths among 4708 pregnant individuals, no deaths were reported. Three studies comparing RSV-positive and RSV-negative pregnant individuals found no difference in the odds of miscarriage, stillbirth, low birth weight, and small size for gestational age. RSV-positive pregnant individuals had higher odds of preterm delivery (odds ratio, 3.6 [95\\% CI, 1.3-10.3]).\nCONCLUSIONS: Data on RSV-associated hospitalization rates are limited, but available estimates are lower than those reported in older adults and young children. As countries debate whether to include RSV vaccines in maternal vaccination programs, which are primarily intended to protect infants, this information could be useful in shaping vaccine policy decisions.},\n\tlanguage = {eng},\n\tnumber = {Supplement\\_1},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Kenmoe, Sebastien and Chu, Helen Y. and Dawood, Fatimah S. and Milucky, Jennifer and Kittikraisak, Wanitchaya and Matthewson, Hamish and Kulkarni, Durga and Suntarattiwong, Piyarat and Frivold, Collrane and Mohanty, Sarita and Havers, Fiona and Li, You and Nair, Harish and {PROMISE Investigators\n}},\n\tmonth = mar,\n\tyear = {2024},\n\tpmid = {37824420},\n\tkeywords = {Female, Humans, Pregnancy, Databases, Factual, Europe, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, Respiratory Syncytial Virus Infections, Pregnancy Complications, Infectious, disease burden, pregnancy, respiratory syncytial virus},\n\tpages = {S51--S60},\n}\n\n
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\n BACKGROUND: With the licensure of maternal respiratory syncytial virus (RSV) vaccines in Europe and the United States, data are needed to better characterize the burden of RSV-associated acute respiratory infections (ARI) in pregnancy. The current study aimed to determine among pregnant individuals the proportion of ARI testing positive for RSV and the RSV incidence rate, RSV-associated hospitalizations, deaths, and perinatal outcomes. METHODS: We conducted a systematic review, following PRISMA 2020 guidelines, using 5 databases (Medline, Embase, Global Health, Web of Science, and Global Index Medicus), and including additional unpublished data. Pregnant individuals with ARI who had respiratory samples tested for RSV were included. We used a random-effects meta-analysis to generate overall proportions and rate estimates across studies. RESULTS: Eleven studies with pregnant individuals recruited between 2010 and 2022 were identified, most of which recruited pregnant individuals in community, inpatient and outpatient settings. Among 8126 pregnant individuals, the proportion with ARI that tested positive for RSV ranged from 0.9% to 10.7%, with a meta-estimate of 3.4% (95% confidence interval [CI], 1.9%-54%). The pooled incidence rate of RSV among pregnant individuals was 26.0 (95% CI, 15.8-36.2) per 1000 person-years. RSV hospitalization rates reported in 2 studies were 2.4 and 3.0 per 1000 person-years. In 5 studies that ascertained RSV-associated deaths among 4708 pregnant individuals, no deaths were reported. Three studies comparing RSV-positive and RSV-negative pregnant individuals found no difference in the odds of miscarriage, stillbirth, low birth weight, and small size for gestational age. RSV-positive pregnant individuals had higher odds of preterm delivery (odds ratio, 3.6 [95% CI, 1.3-10.3]). CONCLUSIONS: Data on RSV-associated hospitalization rates are limited, but available estimates are lower than those reported in older adults and young children. As countries debate whether to include RSV vaccines in maternal vaccination programs, which are primarily intended to protect infants, this information could be useful in shaping vaccine policy decisions.\n
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\n \n\n \n \n \n \n \n Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis.\n \n \n \n\n\n \n Cong, B.; Koç, U.; Bandeira, T.; Bassat, Q.; Bont, L.; Chakhunashvili, G.; Cohen, C.; Desnoyers, C.; Hammitt, L. L.; Heikkinen, T.; Huang, Q. S.; Markić, J.; Mira-Iglesias, A.; Moyes, J.; Nokes, D. J.; Ploin, D.; VRS study group in Lyon; Seo, E.; Singleton, R.; Wolter, N.; Fu Yung, C.; Zar, H. J.; Feikin, D. R.; Sparrow, E. G.; Respiratory Virus Global Epidemiology Network; Nair, H.; Li, Y.; and PROMISE investigators\n\n\n \n\n\n\n The Lancet. Infectious Diseases, 24(4): 361–374. April 2024.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{cong_changes_2024,\n\ttitle = {Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the {COVID}-19 pandemic: a systematic analysis},\n\tvolume = {24},\n\tissn = {1474-4457},\n\tshorttitle = {Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the {COVID}-19 pandemic},\n\tdoi = {10.1016/S1473-3099(23)00630-8},\n\tabstract = {BACKGROUND: The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective.\nMETHODS: We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged {\\textless}5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019.\nFINDINGS: We included 61 studies from 19 countries, of which 14 (23\\%) studies were from the published literature (4052 identified records) and 47 (77\\%) were from unpublished datasets. Most (51 [84\\%]) studies were from high-income countries; nine (15\\%) were from upper-middle-income countries, one (2\\%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0-60 months) in 2020 decreased by 79·7\\% (325 000 cases vs 66 000 cases) in high-income countries, 13·8\\% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3\\% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95\\% uncertainty interval 5·4-6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6-6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7-6·1] in April, 2021, to March, 2022, vs 3·4 [1·2-9·7] in 2019; for Kenya, 2·2 cases [1·8-2·7] in 2021 vs 4·1 [3·5-4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to {\\textless}3 months) and decreased with increasing age. A significantly higher proportion of children aged 12-24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95\\% uncertainty interval 1·07-1·59) to 2·05 (1·66-2·54). No consistent changes in disease severity were observed.\nINTERPRETATION: The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries.\nFUNDING: EU Innovative Medicines Initiative Preparing for RSV Immunisation and Surveillance in Europe (PROMISE), Bill \\& Melinda Gates Foundation, and WHO.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {The Lancet. Infectious Diseases},\n\tauthor = {Cong, Bingbing and Koç, Uğurcan and Bandeira, Teresa and Bassat, Quique and Bont, Louis and Chakhunashvili, Giorgi and Cohen, Cheryl and Desnoyers, Christine and Hammitt, Laura L. and Heikkinen, Terho and Huang, Q. Sue and Markić, Joško and Mira-Iglesias, Ainara and Moyes, Jocelyn and Nokes, D. James and Ploin, Dominique and {VRS study group in Lyon} and Seo, Euri and Singleton, Rosalyn and Wolter, Nicole and Fu Yung, Chee and Zar, Heather J. and Feikin, Daniel R. and Sparrow, Erin G. and {Respiratory Virus Global Epidemiology Network} and Nair, Harish and Li, You and {PROMISE investigators}},\n\tmonth = apr,\n\tyear = {2024},\n\tpmid = {38141633},\n\tkeywords = {Infant, Child, Humans, Child, Preschool, Pandemics, COVID-19, Hospitalization, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, Respiratory Syncytial Virus Infections},\n\tpages = {361--374},\n}\n\n
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\n BACKGROUND: The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective. METHODS: We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged \\textless5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019. FINDINGS: We included 61 studies from 19 countries, of which 14 (23%) studies were from the published literature (4052 identified records) and 47 (77%) were from unpublished datasets. Most (51 [84%]) studies were from high-income countries; nine (15%) were from upper-middle-income countries, one (2%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0-60 months) in 2020 decreased by 79·7% (325 000 cases vs 66 000 cases) in high-income countries, 13·8% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95% uncertainty interval 5·4-6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6-6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7-6·1] in April, 2021, to March, 2022, vs 3·4 [1·2-9·7] in 2019; for Kenya, 2·2 cases [1·8-2·7] in 2021 vs 4·1 [3·5-4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to \\textless3 months) and decreased with increasing age. A significantly higher proportion of children aged 12-24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95% uncertainty interval 1·07-1·59) to 2·05 (1·66-2·54). No consistent changes in disease severity were observed. INTERPRETATION: The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries. FUNDING: EU Innovative Medicines Initiative Preparing for RSV Immunisation and Surveillance in Europe (PROMISE), Bill & Melinda Gates Foundation, and WHO.\n
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\n \n\n \n \n \n \n \n Global disease burden of and risk factors for acute lower respiratory infections caused by respiratory syncytial virus in preterm infants and young children in 2019: a systematic review and meta-analysis of aggregated and individual participant data.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Shi, T.; Bont, L. J.; Chu, H. Y.; Zar, H. J.; Wahi-Singh, B.; Ma, Y.; Cong, B.; Sharland, E.; Riley, R. D.; Deng, J.; Figueras-Aloy, J.; Heikkinen, T.; Jones, M. H.; Liese, J. G.; Markić, J.; Mejias, A.; Nunes, M. C.; Resch, B.; Satav, A.; Yeo, K. T.; Simões, E. A. F.; Nair, H.; Respiratory Virus Global Epidemiology Network; and RESCEU investigators\n\n\n \n\n\n\n Lancet (London, England), 403(10433): 1241–1253. March 2024.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{wang_global_2024,\n\ttitle = {Global disease burden of and risk factors for acute lower respiratory infections caused by respiratory syncytial virus in preterm infants and young children in 2019: a systematic review and meta-analysis of aggregated and individual participant data},\n\tvolume = {403},\n\tissn = {1474-547X},\n\tshorttitle = {Global disease burden of and risk factors for acute lower respiratory infections caused by respiratory syncytial virus in preterm infants and young children in 2019},\n\tdoi = {10.1016/S0140-6736(24)00138-7},\n\tabstract = {BACKGROUND: Infants and young children born prematurely are at high risk of severe acute lower respiratory infection (ALRI) caused by respiratory syncytial virus (RSV). In this study, we aimed to assess the global disease burden of and risk factors for RSV-associated ALRI in infants and young children born before 37 weeks of gestation.\nMETHODS: We conducted a systematic review and meta-analysis of aggregated data from studies published between Jan 1, 1995, and Dec 31, 2021, identified from MEDLINE, Embase, and Global Health, and individual participant data shared by the Respiratory Virus Global Epidemiology Network on respiratory infectious diseases. We estimated RSV-associated ALRI incidence in community, hospital admission, in-hospital mortality, and overall mortality among children younger than 2 years born prematurely. We conducted two-stage random-effects meta-regression analyses accounting for chronological age groups, gestational age bands (early preterm, {\\textless}32 weeks gestational age [wGA], and late preterm, 32 to {\\textless}37 wGA), and changes over 5-year intervals from 2000 to 2019. Using individual participant data, we assessed perinatal, sociodemographic, and household factors, and underlying medical conditions for RSV-associated ALRI incidence, hospital admission, and three severity outcome groups (longer hospital stay [{\\textgreater}4 days], use of supplemental oxygen and mechanical ventilation, or intensive care unit admission) by estimating pooled odds ratios (ORs) through a two-stage meta-analysis (multivariate logistic regression and random-effects meta-analysis). This study is registered with PROSPERO, CRD42021269742.\nFINDINGS: We included 47 studies from the literature and 17 studies with individual participant-level data contributed by the participating investigators. We estimated that, in 2019, 1 650 000 (95\\% uncertainty range [UR] 1 350 000-1 990 000) RSV-associated ALRI episodes, 533 000 (385 000-730 000) RSV-associated hospital admissions, 3050 (1080-8620) RSV-associated in-hospital deaths, and 26 760 (11 190-46 240) RSV-attributable deaths occurred in preterm infants worldwide. Among early preterm infants, the RSV-associated ALRI incidence rate and hospitalisation rate were significantly higher (rate ratio [RR] ranging from 1·69 to 3·87 across different age groups and outcomes) than for all infants born at any gestational age. In the second year of life, early preterm infants and young children had a similar incidence rate but still a significantly higher hospitalisation rate (RR 2·26 [95\\% UR 1·27-3·98]) compared with all infants and young children. Although late preterm infants had RSV-associated ALRI incidence rates similar to that of all infants younger than 1 year, they had higher RSV-associated ALRI hospitalisation rate in the first 6 months (RR 1·93 [1·11-3·26]). Overall, preterm infants accounted for 25\\% (95\\% UR 16-37) of RSV-associated ALRI hospitalisations in all infants of any gestational age. RSV-associated ALRI in-hospital case fatality ratio in preterm infants was similar to all infants. The factors identified to be associated with RSV-associated ALRI incidence were mainly perinatal and sociodemographic characteristics, and factors associated with severe outcomes from infection were mainly underlying medical conditions including congenital heart disease, tracheostomy, bronchopulmonary dysplasia, chronic lung disease, or Down syndrome (with ORs ranging from 1·40 to 4·23).\nINTERPRETATION: Preterm infants face a disproportionately high burden of RSV-associated disease, accounting for 25\\% of RSV hospitalisation burden. Early preterm infants have a substantial RSV hospitalisation burden persisting into the second year of life. Preventive products for RSV can have a substantial public health impact by preventing RSV-associated ALRI and severe outcomes from infection in preterm infants.\nFUNDING: EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe.},\n\tlanguage = {eng},\n\tnumber = {10433},\n\tjournal = {Lancet (London, England)},\n\tauthor = {Wang, Xin and Li, You and Shi, Ting and Bont, Louis J. and Chu, Helen Y. and Zar, Heather J. and Wahi-Singh, Bhanu and Ma, Yiming and Cong, Bingbing and Sharland, Emma and Riley, Richard D. and Deng, Jikui and Figueras-Aloy, Josep and Heikkinen, Terho and Jones, Marcus H. and Liese, Johannes G. and Markić, Joško and Mejias, Asuncion and Nunes, Marta C. and Resch, Bernhard and Satav, Ashish and Yeo, Kee Thai and Simões, Eric A. F. and Nair, Harish and {Respiratory Virus Global Epidemiology Network} and {RESCEU investigators}},\n\tmonth = mar,\n\tyear = {2024},\n\tpmid = {38367641},\n\tkeywords = {Infant, Child, Infant, Newborn, Humans, Child, Preschool, Infant, Premature, Global Burden of Disease, Respiratory Tract Infections, Hospitalization, Respiratory Syncytial Virus Infections, Pneumonia, Respiratory Syncytial Virus, Human, Risk Factors},\n\tpages = {1241--1253},\n}\n\n
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\n BACKGROUND: Infants and young children born prematurely are at high risk of severe acute lower respiratory infection (ALRI) caused by respiratory syncytial virus (RSV). In this study, we aimed to assess the global disease burden of and risk factors for RSV-associated ALRI in infants and young children born before 37 weeks of gestation. METHODS: We conducted a systematic review and meta-analysis of aggregated data from studies published between Jan 1, 1995, and Dec 31, 2021, identified from MEDLINE, Embase, and Global Health, and individual participant data shared by the Respiratory Virus Global Epidemiology Network on respiratory infectious diseases. We estimated RSV-associated ALRI incidence in community, hospital admission, in-hospital mortality, and overall mortality among children younger than 2 years born prematurely. We conducted two-stage random-effects meta-regression analyses accounting for chronological age groups, gestational age bands (early preterm, \\textless32 weeks gestational age [wGA], and late preterm, 32 to \\textless37 wGA), and changes over 5-year intervals from 2000 to 2019. Using individual participant data, we assessed perinatal, sociodemographic, and household factors, and underlying medical conditions for RSV-associated ALRI incidence, hospital admission, and three severity outcome groups (longer hospital stay [\\textgreater4 days], use of supplemental oxygen and mechanical ventilation, or intensive care unit admission) by estimating pooled odds ratios (ORs) through a two-stage meta-analysis (multivariate logistic regression and random-effects meta-analysis). This study is registered with PROSPERO, CRD42021269742. FINDINGS: We included 47 studies from the literature and 17 studies with individual participant-level data contributed by the participating investigators. We estimated that, in 2019, 1 650 000 (95% uncertainty range [UR] 1 350 000-1 990 000) RSV-associated ALRI episodes, 533 000 (385 000-730 000) RSV-associated hospital admissions, 3050 (1080-8620) RSV-associated in-hospital deaths, and 26 760 (11 190-46 240) RSV-attributable deaths occurred in preterm infants worldwide. Among early preterm infants, the RSV-associated ALRI incidence rate and hospitalisation rate were significantly higher (rate ratio [RR] ranging from 1·69 to 3·87 across different age groups and outcomes) than for all infants born at any gestational age. In the second year of life, early preterm infants and young children had a similar incidence rate but still a significantly higher hospitalisation rate (RR 2·26 [95% UR 1·27-3·98]) compared with all infants and young children. Although late preterm infants had RSV-associated ALRI incidence rates similar to that of all infants younger than 1 year, they had higher RSV-associated ALRI hospitalisation rate in the first 6 months (RR 1·93 [1·11-3·26]). Overall, preterm infants accounted for 25% (95% UR 16-37) of RSV-associated ALRI hospitalisations in all infants of any gestational age. RSV-associated ALRI in-hospital case fatality ratio in preterm infants was similar to all infants. The factors identified to be associated with RSV-associated ALRI incidence were mainly perinatal and sociodemographic characteristics, and factors associated with severe outcomes from infection were mainly underlying medical conditions including congenital heart disease, tracheostomy, bronchopulmonary dysplasia, chronic lung disease, or Down syndrome (with ORs ranging from 1·40 to 4·23). INTERPRETATION: Preterm infants face a disproportionately high burden of RSV-associated disease, accounting for 25% of RSV hospitalisation burden. Early preterm infants have a substantial RSV hospitalisation burden persisting into the second year of life. Preventive products for RSV can have a substantial public health impact by preventing RSV-associated ALRI and severe outcomes from infection in preterm infants. FUNDING: EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe.\n
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\n \n\n \n \n \n \n \n Characterising the changes in RSV epidemiology in Beijing, China during 2015-2023: results from a prospective, multi-centre, hospital-based surveillance and serology study.\n \n \n \n\n\n \n Li, M.; Cong, B.; Wei, X.; Wang, Y.; Kang, L.; Gong, C.; Huang, Q.; Wang, X.; Li, Y.; and Huang, F.\n\n\n \n\n\n\n The Lancet Regional Health. Western Pacific, 45: 101050. April 2024.\n \n\n\n\n
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@article{li_characterising_2024,\n\ttitle = {Characterising the changes in {RSV} epidemiology in {Beijing}, {China} during 2015-2023: results from a prospective, multi-centre, hospital-based surveillance and serology study},\n\tvolume = {45},\n\tissn = {2666-6065},\n\tshorttitle = {Characterising the changes in {RSV} epidemiology in {Beijing}, {China} during 2015-2023},\n\tdoi = {10.1016/j.lanwpc.2024.101050},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) has posed substantial morbidity and mortality burden to young children and older adults globally. The coronavirus disease 2019 (COVID-19) pandemic was reported to have altered RSV epidemiology and could have important implications for RSV prevention and control strategies. We aimed to compare RSV epidemiology in different phases of the COVID-19 pandemic with the pre-pandemic period by leveraging epidemiological, molecular, and serological data collected from a prospective respiratory pathogen surveillance and serology study.\nMETHODS: This study was based on the data during July 1, 2015 to November 30, 2023 from the Respiratory Pathogen Surveillance System (RPSS), a sentinel-hospital based surveillance system of acute respiratory infections consisting of 35 hospitals that represent residents of all ages from all 16 districts in Beijing, China. RSV infection status was tested by RT-PCR and gene sequencing and phylogenetic analysis was conducted among the identified RSV strains. We further supplemented RPSS data with three serology surveys conducted during 2017-2023 that tested RSV IgG levels from serum specimens. RSV detection rate was calculated by calendar month and compared across RSV seasons (defined as the July 1 through June 30 of the following year). RSV IgG positivity proportion was calculated by quarter of the year and was correlated with quarterly aggregated RSV detection rate for understanding the relationship between infection and immunity at the population level.\nFINDINGS: Overall, a total of 52,931 respiratory specimens were collected and tested over the study period. RSV detection rates ranged from 1.24\\% (94/7594) in the 2017-2018 season to 2.80\\% (219/7824) in the 2018-2019 season, and from 1.06\\% (55/5165) in the 2022-2023 season to 2.98\\% (147/4938) in the 2021-2022 season during the pre-pandemic and pandemic period, respectively. ON1 and BA9 remained the predominant genotypes during the pandemic period; no novel RSV strains were identified. RSV circulation followed a winter-months seasonal pattern in most seasons. One exception was the 2020-2021 season when an extensive year-round circulation was observed, possibly associated with partial relaxation of non-pharmaceutical interventions (NPIs). The other exception was the 2022-2023 season when very low RSV activity was observed during the usual winter months (possibly due to the concurrent local COVID-19 epidemic), and followed by an out-of-season resurgence in the spring, with RSV detection persisting to the end of the study period (November 2023). During the two seasons above, we noted an age-group related asynchrony in the RSV detection rate; the RSV detection rate in young children remained similar (or even increased with borderline significance; 43/594, 7.24\\%, and 42/556, 7.55\\% vs 292/5293, 5.52\\%; P = 0.10 and P = 0.06, respectively) compared with the pre-pandemic seasons whereas the detection rate in older adults decreased significantly (8/1779, 0.45\\%, and 3/2021, 0.15\\% vs 160/10,348, 1.55\\%; P {\\textless} 0.001 in two comparisons). Results from serology surveys showed significantly declined RSV IgG positivity in the 2022-2023 season compared to the pre-pandemic seasons (9.32\\%, 29/311 vs 20.16\\%, 100/496; P {\\textless} 0.001); older adults had significantly higher RSV IgG positivity than young children in both pre-pandemic and pandemic periods (P values {\\textless} 0.001).\nINTERPRETATION: Our study documented the trajectory of RSV detection along with the changes in the stringency of NPIs, measured IgG positivity, and local COVID-19 epidemics. The findings suggest the interplay between contact patterns, immunity dynamics, and SARS-CoV-2 infection in shaping the RSV epidemics of population of different ages. These findings provide novel insights into the potential drivers of RSV circulating patterns and have important implications for RSV prevention and control strategies.\nFUNDING: The High-qualified Public Health Professionals Development Project, Capital's Funds for Health Improvement and Research, and the Public Health Personnel Training Support Program.},\n\tlanguage = {eng},\n\tjournal = {The Lancet Regional Health. Western Pacific},\n\tauthor = {Li, Maozhong and Cong, Bingbing and Wei, Xiaofeng and Wang, Yiting and Kang, Lu and Gong, Cheng and Huang, Qi and Wang, Xin and Li, You and Huang, Fang},\n\tmonth = apr,\n\tyear = {2024},\n\tpmid = {38699290},\n\tpmcid = {PMC11064721},\n\tkeywords = {Covid-19, Epidemiology, Prospective studies, Respiratory syncytial virus, Sentinel surveillance, Serology},\n\tpages = {101050},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) has posed substantial morbidity and mortality burden to young children and older adults globally. The coronavirus disease 2019 (COVID-19) pandemic was reported to have altered RSV epidemiology and could have important implications for RSV prevention and control strategies. We aimed to compare RSV epidemiology in different phases of the COVID-19 pandemic with the pre-pandemic period by leveraging epidemiological, molecular, and serological data collected from a prospective respiratory pathogen surveillance and serology study. METHODS: This study was based on the data during July 1, 2015 to November 30, 2023 from the Respiratory Pathogen Surveillance System (RPSS), a sentinel-hospital based surveillance system of acute respiratory infections consisting of 35 hospitals that represent residents of all ages from all 16 districts in Beijing, China. RSV infection status was tested by RT-PCR and gene sequencing and phylogenetic analysis was conducted among the identified RSV strains. We further supplemented RPSS data with three serology surveys conducted during 2017-2023 that tested RSV IgG levels from serum specimens. RSV detection rate was calculated by calendar month and compared across RSV seasons (defined as the July 1 through June 30 of the following year). RSV IgG positivity proportion was calculated by quarter of the year and was correlated with quarterly aggregated RSV detection rate for understanding the relationship between infection and immunity at the population level. FINDINGS: Overall, a total of 52,931 respiratory specimens were collected and tested over the study period. RSV detection rates ranged from 1.24% (94/7594) in the 2017-2018 season to 2.80% (219/7824) in the 2018-2019 season, and from 1.06% (55/5165) in the 2022-2023 season to 2.98% (147/4938) in the 2021-2022 season during the pre-pandemic and pandemic period, respectively. ON1 and BA9 remained the predominant genotypes during the pandemic period; no novel RSV strains were identified. RSV circulation followed a winter-months seasonal pattern in most seasons. One exception was the 2020-2021 season when an extensive year-round circulation was observed, possibly associated with partial relaxation of non-pharmaceutical interventions (NPIs). The other exception was the 2022-2023 season when very low RSV activity was observed during the usual winter months (possibly due to the concurrent local COVID-19 epidemic), and followed by an out-of-season resurgence in the spring, with RSV detection persisting to the end of the study period (November 2023). During the two seasons above, we noted an age-group related asynchrony in the RSV detection rate; the RSV detection rate in young children remained similar (or even increased with borderline significance; 43/594, 7.24%, and 42/556, 7.55% vs 292/5293, 5.52%; P = 0.10 and P = 0.06, respectively) compared with the pre-pandemic seasons whereas the detection rate in older adults decreased significantly (8/1779, 0.45%, and 3/2021, 0.15% vs 160/10,348, 1.55%; P \\textless 0.001 in two comparisons). Results from serology surveys showed significantly declined RSV IgG positivity in the 2022-2023 season compared to the pre-pandemic seasons (9.32%, 29/311 vs 20.16%, 100/496; P \\textless 0.001); older adults had significantly higher RSV IgG positivity than young children in both pre-pandemic and pandemic periods (P values \\textless 0.001). INTERPRETATION: Our study documented the trajectory of RSV detection along with the changes in the stringency of NPIs, measured IgG positivity, and local COVID-19 epidemics. The findings suggest the interplay between contact patterns, immunity dynamics, and SARS-CoV-2 infection in shaping the RSV epidemics of population of different ages. These findings provide novel insights into the potential drivers of RSV circulating patterns and have important implications for RSV prevention and control strategies. FUNDING: The High-qualified Public Health Professionals Development Project, Capital's Funds for Health Improvement and Research, and the Public Health Personnel Training Support Program.\n
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\n \n\n \n \n \n \n \n Unveiling the viral aetiologies of lower respiratory infections.\n \n \n \n\n\n \n Li, Y.; and Wang, X.\n\n\n \n\n\n\n The Lancet. Infectious Diseases,S1473–3099(24)00209–3. April 2024.\n \n\n\n\n
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@article{li_unveiling_2024,\n\ttitle = {Unveiling the viral aetiologies of lower respiratory infections},\n\tissn = {1474-4457},\n\tdoi = {10.1016/S1473-3099(24)00209-3},\n\tlanguage = {eng},\n\tjournal = {The Lancet. Infectious Diseases},\n\tauthor = {Li, You and Wang, Xin},\n\tmonth = apr,\n\tyear = {2024},\n\tpmid = {38636535},\n\tpages = {S1473--3099(24)00209--3},\n}\n\n
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\n \n\n \n \n \n \n \n Respiratory syncytial virus seasonality, transmission zones, and implications for seasonal prevention strategy in China: a systematic analysis.\n \n \n \n\n\n \n Guo, L.; Deng, S.; Sun, S.; Wang, X.; and Li, Y.\n\n\n \n\n\n\n The Lancet. Global Health,S2214–109X(24)00090–1. April 2024.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{guo_respiratory_2024,\n\ttitle = {Respiratory syncytial virus seasonality, transmission zones, and implications for seasonal prevention strategy in {China}: a systematic analysis},\n\tissn = {2214-109X},\n\tshorttitle = {Respiratory syncytial virus seasonality, transmission zones, and implications for seasonal prevention strategy in {China}},\n\tdoi = {10.1016/S2214-109X(24)00090-1},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) represents a substantial global health challenge, with a disproportionately high disease burden in low-income and middle-income countries. RSV exhibits seasonality in most areas globally, and a comprehensive understanding of within-country variations in RSV seasonality could help to define the timing of RSV immunisation programmes. This study focused on China, and aimed to describe the geographical distribution of RSV seasonality, identify distinct RSV transmission zones, and evaluate the potential suitability of a seasonal RSV prevention strategy.\nMETHODS: We did a systematic analysis of RSV seasonality in China, with use of data on RSV activity extracted from a systematic review of studies published on Embase, MEDLINE, Web of Science, China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP Information, and SinoMed, from database inception until May 5, 2023. We included studies of any design in China reporting at least 25 RSV cases, which aggregated RSV case number by calendar month or week at the province level, and with data covering at least 12 consecutive months before the year 2020 (prior to the COVID-19 pandemic). Studies that used only serology for RSV testing were excluded. We also included weekly data on RSV activity from open-access online databases of the Taiwan National Infection Disease Statistics System and Hong Kong Centre for Health Protection, applying the same eligiblity requirements. Across all datasets, we excluded data on RSV activity from Jan 1, 2020, onwards. We estimated RSV seasonal epidemic onset and duration using the annual average percentage (AAP) approach, and summarised seasonality at the provincial level. We used Pearson's partial correlation analysis to assess the correlation between RSV season duration and the latitude and longitude of the individual provinces. To define transmission zones, we used two independent approaches, an infant-passive-immunisation-driven approach (the moving interval approach, 6-month interval) and a data-driven approach (k-means), to identify groups of provinces with similar RSV seasonality. The systematic review was registered on PROSPERO, CRD42022376993.\nFINDINGS: A total of 157 studies were included along with the two online datasets, reporting data on 194 596 RSV cases over 442 study-years (covering the period from Jan 1, 1993 to Dec 31, 2019), from 52 sites in 23 provinces. Among 21 provinces with sufficient data (≥100 reported cases), the median duration of RSV seasonal epidemics was 4·6 months (IQR 4·1-5·4), with a significant latitudinal gradient (r=-0·69, p{\\textless}0·0007), in that provinces on or near the Tropic of Cancer had the longest epidemic duration. We found no correlation between longitude and epidemic duration (r=-0·15, p=0·53). 15 (71\\%) of 21 provinces had RSV epidemics from November to March. 13 (62\\%) of 21 provinces had clear RSV seasonality (epidemic duration ≤5 months). The moving interval approach categorised the 21 provinces into four RSV transmission zones. The first zone, consisting of five provinces (Fujian, Guangdong, Hong Kong, Taiwan, and Yunnan), was assessed as unsuitable for seasonal RSV immunisation strategies; the other three zones were considered suitable for seasonal RSV immunisation strategies with the optimal start month varying between September (Hebei), October (Anhui, Chongqing, Henan, Hubei, Jiangsu, Shaanxi, Shandong, Shanghai, Sichuan, and Xinjiang), and November (Beijing, Gansu, Guizhou, Hunan, and Zhejiang). The k-means approach identified two RSV transmission zones, primarily differentiated by whether the province was on or near the Tropic of Cancer (Fujian, Guangdong, Hong Kong, Taiwan, Yunan, and Hunan) or not (the remaining 15 provinces).\nINTERPRETATION: Although substantial variations in RSV seasonality were observed across provinces of China, our study identified distinct transmission zones with shared RSV circulating patterns. These findings could have important implications for decision making on RSV passive immunisation strategy. Furthermore, the methodological framework in this study for defining RSV seasons and identifying RSV transmission zones is potentially applicable to other countries or regions.\nFUNDING: Nanjing Medical University.\nTRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.},\n\tlanguage = {eng},\n\tjournal = {The Lancet. Global Health},\n\tauthor = {Guo, Ling and Deng, Shuyu and Sun, Shiqi and Wang, Xin and Li, You},\n\tmonth = apr,\n\tyear = {2024},\n\tpmid = {38670132},\n\tpages = {S2214--109X(24)00090--1},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) represents a substantial global health challenge, with a disproportionately high disease burden in low-income and middle-income countries. RSV exhibits seasonality in most areas globally, and a comprehensive understanding of within-country variations in RSV seasonality could help to define the timing of RSV immunisation programmes. This study focused on China, and aimed to describe the geographical distribution of RSV seasonality, identify distinct RSV transmission zones, and evaluate the potential suitability of a seasonal RSV prevention strategy. METHODS: We did a systematic analysis of RSV seasonality in China, with use of data on RSV activity extracted from a systematic review of studies published on Embase, MEDLINE, Web of Science, China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP Information, and SinoMed, from database inception until May 5, 2023. We included studies of any design in China reporting at least 25 RSV cases, which aggregated RSV case number by calendar month or week at the province level, and with data covering at least 12 consecutive months before the year 2020 (prior to the COVID-19 pandemic). Studies that used only serology for RSV testing were excluded. We also included weekly data on RSV activity from open-access online databases of the Taiwan National Infection Disease Statistics System and Hong Kong Centre for Health Protection, applying the same eligiblity requirements. Across all datasets, we excluded data on RSV activity from Jan 1, 2020, onwards. We estimated RSV seasonal epidemic onset and duration using the annual average percentage (AAP) approach, and summarised seasonality at the provincial level. We used Pearson's partial correlation analysis to assess the correlation between RSV season duration and the latitude and longitude of the individual provinces. To define transmission zones, we used two independent approaches, an infant-passive-immunisation-driven approach (the moving interval approach, 6-month interval) and a data-driven approach (k-means), to identify groups of provinces with similar RSV seasonality. The systematic review was registered on PROSPERO, CRD42022376993. FINDINGS: A total of 157 studies were included along with the two online datasets, reporting data on 194 596 RSV cases over 442 study-years (covering the period from Jan 1, 1993 to Dec 31, 2019), from 52 sites in 23 provinces. Among 21 provinces with sufficient data (≥100 reported cases), the median duration of RSV seasonal epidemics was 4·6 months (IQR 4·1-5·4), with a significant latitudinal gradient (r=-0·69, p\\textless0·0007), in that provinces on or near the Tropic of Cancer had the longest epidemic duration. We found no correlation between longitude and epidemic duration (r=-0·15, p=0·53). 15 (71%) of 21 provinces had RSV epidemics from November to March. 13 (62%) of 21 provinces had clear RSV seasonality (epidemic duration ≤5 months). The moving interval approach categorised the 21 provinces into four RSV transmission zones. The first zone, consisting of five provinces (Fujian, Guangdong, Hong Kong, Taiwan, and Yunnan), was assessed as unsuitable for seasonal RSV immunisation strategies; the other three zones were considered suitable for seasonal RSV immunisation strategies with the optimal start month varying between September (Hebei), October (Anhui, Chongqing, Henan, Hubei, Jiangsu, Shaanxi, Shandong, Shanghai, Sichuan, and Xinjiang), and November (Beijing, Gansu, Guizhou, Hunan, and Zhejiang). The k-means approach identified two RSV transmission zones, primarily differentiated by whether the province was on or near the Tropic of Cancer (Fujian, Guangdong, Hong Kong, Taiwan, Yunan, and Hunan) or not (the remaining 15 provinces). INTERPRETATION: Although substantial variations in RSV seasonality were observed across provinces of China, our study identified distinct transmission zones with shared RSV circulating patterns. These findings could have important implications for decision making on RSV passive immunisation strategy. Furthermore, the methodological framework in this study for defining RSV seasons and identifying RSV transmission zones is potentially applicable to other countries or regions. FUNDING: Nanjing Medical University. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.\n
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\n \n\n \n \n \n \n \n Impact of Subgroup Distribution on Seasonality of Human Respiratory Syncytial Virus: A Global Systematic Analysis.\n \n \n \n\n\n \n Deng, S.; Guo, L.; Cohen, C.; Meijer, A.; Moyes, J.; Pasittungkul, S.; Poovorawan, Y.; Teirlinck, A.; van Boven, M.; Wanlapakorn, N.; Wolter, N.; Paget, J.; Nair, H.; Li, Y.; Respiratory Virus Global Epidemiology Network; and , t. P. I.\n\n\n \n\n\n\n The Journal of Infectious Diseases, 229(Supplement_1): S25–S33. March 2024.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{deng_impact_2024,\n\ttitle = {Impact of {Subgroup} {Distribution} on {Seasonality} of {Human} {Respiratory} {Syncytial} {Virus}: {A} {Global} {Systematic} {Analysis}},\n\tvolume = {229},\n\tissn = {1537-6613},\n\tshorttitle = {Impact of {Subgroup} {Distribution} on {Seasonality} of {Human} {Respiratory} {Syncytial} {Virus}},\n\tdoi = {10.1093/infdis/jiad192},\n\tabstract = {BACKGROUND: Previous studies reported inconsistent findings regarding the association between respiratory syncytial virus (RSV) subgroup distribution and timing of RSV season. We aimed to further understand the association by conducting a global-level systematic analysis.\nMETHODS: We compiled published data on RSV seasonality through a systematic literature review, and unpublished data shared by international collaborators. Using annual cumulative proportion (ACP) of RSV-positive cases, we defined RSV season onset and offset as ACP reaching 10\\% and 90\\%, respectively. Linear regression models accounting for meteorological factors were constructed to analyze the association of proportion of RSV-A with the corresponding RSV season onset and offset.\nRESULTS: We included 36 study sites from 20 countries, providing data for 179 study-years in 1995-2019. Globally, RSV subgroup distribution was not significantly associated with RSV season onset or offset globally, except for RSV season offset in the tropics in 1 model, possibly by chance. Models that included RSV subgroup distribution and meteorological factors explained only 2\\%-4\\% of the variations in timing of RSV season.\nCONCLUSIONS: Year-on-year variations in RSV season onset and offset are not well explained by RSV subgroup distribution or meteorological factors. Factors including population susceptibility, mobility, and viral interference should be examined in future studies.},\n\tlanguage = {eng},\n\tnumber = {Supplement\\_1},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Deng, Shuyu and Guo, Ling and Cohen, Cheryl and Meijer, Adam and Moyes, Jocelyn and Pasittungkul, Siripat and Poovorawan, Yong and Teirlinck, Anne and van Boven, Michiel and Wanlapakorn, Nasamon and Wolter, Nicole and Paget, John and Nair, Harish and Li, You and {Respiratory Virus Global Epidemiology Network and the PROMISE Investigators\n}},\n\tmonth = mar,\n\tyear = {2024},\n\tpmid = {37249267},\n\tkeywords = {Humans, Respiratory Syncytial Virus, Human, Linear Models, Seasons, Viral Interference, meteorological factors, respiratory syncytial virus, seasonality, subgroup},\n\tpages = {S25--S33},\n}\n\n
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\n BACKGROUND: Previous studies reported inconsistent findings regarding the association between respiratory syncytial virus (RSV) subgroup distribution and timing of RSV season. We aimed to further understand the association by conducting a global-level systematic analysis. METHODS: We compiled published data on RSV seasonality through a systematic literature review, and unpublished data shared by international collaborators. Using annual cumulative proportion (ACP) of RSV-positive cases, we defined RSV season onset and offset as ACP reaching 10% and 90%, respectively. Linear regression models accounting for meteorological factors were constructed to analyze the association of proportion of RSV-A with the corresponding RSV season onset and offset. RESULTS: We included 36 study sites from 20 countries, providing data for 179 study-years in 1995-2019. Globally, RSV subgroup distribution was not significantly associated with RSV season onset or offset globally, except for RSV season offset in the tropics in 1 model, possibly by chance. Models that included RSV subgroup distribution and meteorological factors explained only 2%-4% of the variations in timing of RSV season. CONCLUSIONS: Year-on-year variations in RSV season onset and offset are not well explained by RSV subgroup distribution or meteorological factors. Factors including population susceptibility, mobility, and viral interference should be examined in future studies.\n
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\n \n\n \n \n \n \n \n External Validation of the Discriminative Validity of the ReSVinet Score and Development of Simplified ReSVinet Scores in Secondary Care.\n \n \n \n\n\n \n Sheikh, Z.; Potter, E.; Li, Y.; Drysdale, S. B.; Wildenbeest, J. G.; Robinson, H.; McGinley, J.; Lin, G.; Öner, D.; Aerssens, J.; Justicia-Grande, A. J.; Martinón-Torres, F.; Pollard, A. J.; Bont, L.; and Nair, H.\n\n\n \n\n\n\n The Journal of Infectious Diseases, 229(Supplement_1): S18–S24. March 2024.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{sheikh_external_2024,\n\ttitle = {External {Validation} of the {Discriminative} {Validity} of the {ReSVinet} {Score} and {Development} of {Simplified} {ReSVinet} {Scores} in {Secondary} {Care}},\n\tvolume = {229},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiad388},\n\tabstract = {BACKGROUND: There is no consensus on how to best quantify disease severity in infants with respiratory syncytial virus (RSV) and/or bronchiolitis; this lack of a sufficiently validated score complicates the provision of clinical care and, the evaluation of trials of therapeutics and vaccines. The ReSVinet score appears to be one of the most promising; however, it is too time consuming to be incorporated into routine clinical care. We aimed to develop and externally validate simplified versions of this score.\nMETHODS: Data from a multinational (the Netherlands, Spain, and United Kingdom) multicenter case-control study of infants with RSV were used to develop simplified versions of the ReSVinet score by conducting a grid search to determine the best combination of equally weighted parameters to maximize for the discriminative ability (measured by area under the receiver operating characteristic curve [AUROC]) across a range of outcomes (hospitalization, intensive care unit admission, ventilation requirement). Subsequently discriminative validity of the score for a range of secondary care outcomes was externally validated by secondary analysis of datasets from Rwanda and Colombia.\nRESULTS: Three candidate simplified scores were identified using the development dataset; they were excellent (AUROC {\\textgreater}0.9) at discriminating for a range of outcomes, and their performance was not significantly different from the original ReSVinet score despite having fewer parameters. In the external validation datasets, the simplified scores were moderate to excellent (AUROC, 0.7-1) across a range of outcomes. In all outcomes, except in a single dataset for predicting admission to the high-dependency unit, they performed at least as well as the original ReSVinet score.\nCONCLUSIONS: The candidate simplified scores developed require further external validation in larger datasets, ideally from resource-limited settings before any recommendation regarding their use.},\n\tlanguage = {eng},\n\tnumber = {Supplement\\_1},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Sheikh, Zakariya and Potter, Ellie and Li, You and Drysdale, Simon B. and Wildenbeest, Joanne G. and Robinson, Hannah and McGinley, Joseph and Lin, Gu-Lung and Öner, Deniz and Aerssens, Jeroen and Justicia-Grande, Antonio José and Martinón-Torres, Federico and Pollard, Andrew J. and Bont, Louis and Nair, Harish},\n\tmonth = mar,\n\tyear = {2024},\n\tpmid = {37712125},\n\tkeywords = {Infant, Humans, Case-Control Studies, Secondary Care, Respiratory Syncytial Virus, Human, Area Under Curve, Colombia, RSV, severity score, validity},\n\tpages = {S18--S24},\n}\n\n
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\n BACKGROUND: There is no consensus on how to best quantify disease severity in infants with respiratory syncytial virus (RSV) and/or bronchiolitis; this lack of a sufficiently validated score complicates the provision of clinical care and, the evaluation of trials of therapeutics and vaccines. The ReSVinet score appears to be one of the most promising; however, it is too time consuming to be incorporated into routine clinical care. We aimed to develop and externally validate simplified versions of this score. METHODS: Data from a multinational (the Netherlands, Spain, and United Kingdom) multicenter case-control study of infants with RSV were used to develop simplified versions of the ReSVinet score by conducting a grid search to determine the best combination of equally weighted parameters to maximize for the discriminative ability (measured by area under the receiver operating characteristic curve [AUROC]) across a range of outcomes (hospitalization, intensive care unit admission, ventilation requirement). Subsequently discriminative validity of the score for a range of secondary care outcomes was externally validated by secondary analysis of datasets from Rwanda and Colombia. RESULTS: Three candidate simplified scores were identified using the development dataset; they were excellent (AUROC \\textgreater0.9) at discriminating for a range of outcomes, and their performance was not significantly different from the original ReSVinet score despite having fewer parameters. In the external validation datasets, the simplified scores were moderate to excellent (AUROC, 0.7-1) across a range of outcomes. In all outcomes, except in a single dataset for predicting admission to the high-dependency unit, they performed at least as well as the original ReSVinet score. CONCLUSIONS: The candidate simplified scores developed require further external validation in larger datasets, ideally from resource-limited settings before any recommendation regarding their use.\n
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\n \n\n \n \n \n \n \n Validity of Clinical Severity Scores for Respiratory Syncytial Virus: A Systematic Review.\n \n \n \n\n\n \n Sheikh, Z.; Potter, E.; Li, Y.; Cohen, R. A.; Dos Santos, G.; Bont, L.; Nair, H.; and PROMISE Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases, 229(Supplement_1): S8–S17. March 2024.\n \n\n\n\n
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@article{sheikh_validity_2024,\n\ttitle = {Validity of {Clinical} {Severity} {Scores} for {Respiratory} {Syncytial} {Virus}: {A} {Systematic} {Review}},\n\tvolume = {229},\n\tissn = {1537-6613},\n\tshorttitle = {Validity of {Clinical} {Severity} {Scores} for {Respiratory} {Syncytial} {Virus}},\n\tdoi = {10.1093/infdis/jiad436},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) is a widespread respiratory pathogen, and RSV-related acute lower respiratory tract infections are the most common cause of respiratory hospitalization in children {\\textless}2 years of age. Over the last 2 decades, a number of severity scores have been proposed to quantify disease severity for RSV in children, yet there remains no overall consensus on the most clinically useful score.\nMETHODS: We conducted a systematic review of English-language publications in peer-reviewed journals published since January 2000 assessing the validity of severity scores for children (≤24 months of age) with RSV and/or bronchiolitis, and identified the most promising scores. For included articles, (1) validity data were extracted, (2) quality of reporting was assessed using the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis checklist (TRIPOD), and (3) quality was assessed using the Prediction Model Risk Of Bias Assessment Tool (PROBAST). To guide the assessment of the validity data, standardized cutoffs were employed, and an explicit definition of what we required to determine a score was sufficiently validated.\nRESULTS: Our searches identified 8541 results, of which 1779 were excluded as duplicates. After title and abstract screening, 6670 references were excluded. Following full-text screening and snowballing, 32 articles, including 31 scores, were included. The most frequently assessed scores were the modified Tal score and the Wang Bronchiolitis Severity Score; none of the scores were found to be sufficiently validated according to our definition. The reporting and/or design of all the included studies was poor. The best validated score was the Bronchiolitis Score of Sant Joan de Déu, and a number of other promising scores were identified.\nCONCLUSIONS: No scores were found to be sufficiently validated. Further work is warranted to validate the existing scores, ideally in much larger datasets.},\n\tlanguage = {eng},\n\tnumber = {Supplement\\_1},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Sheikh, Zakariya and Potter, Ellie and Li, You and Cohen, Rachel A. and Dos Santos, Gaël and Bont, Louis and Nair, Harish and {PROMISE Investigators\n}},\n\tmonth = mar,\n\tyear = {2024},\n\tpmid = {37797314},\n\tkeywords = {Child, Humans, Bronchiolitis, Consensus, Hospitalization, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, Respiratory Syncytial Virus Infections, RSV, severity score, systematic review, validity},\n\tpages = {S8--S17},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) is a widespread respiratory pathogen, and RSV-related acute lower respiratory tract infections are the most common cause of respiratory hospitalization in children \\textless2 years of age. Over the last 2 decades, a number of severity scores have been proposed to quantify disease severity for RSV in children, yet there remains no overall consensus on the most clinically useful score. METHODS: We conducted a systematic review of English-language publications in peer-reviewed journals published since January 2000 assessing the validity of severity scores for children (≤24 months of age) with RSV and/or bronchiolitis, and identified the most promising scores. For included articles, (1) validity data were extracted, (2) quality of reporting was assessed using the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis checklist (TRIPOD), and (3) quality was assessed using the Prediction Model Risk Of Bias Assessment Tool (PROBAST). To guide the assessment of the validity data, standardized cutoffs were employed, and an explicit definition of what we required to determine a score was sufficiently validated. RESULTS: Our searches identified 8541 results, of which 1779 were excluded as duplicates. After title and abstract screening, 6670 references were excluded. Following full-text screening and snowballing, 32 articles, including 31 scores, were included. The most frequently assessed scores were the modified Tal score and the Wang Bronchiolitis Severity Score; none of the scores were found to be sufficiently validated according to our definition. The reporting and/or design of all the included studies was poor. The best validated score was the Bronchiolitis Score of Sant Joan de Déu, and a number of other promising scores were identified. CONCLUSIONS: No scores were found to be sufficiently validated. Further work is warranted to validate the existing scores, ideally in much larger datasets.\n
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\n \n\n \n \n \n \n \n Effects of scheduled school breaks on the circulation of influenza in children, school-aged population, and adults in China: A spatio-temporal analysis.\n \n \n \n\n\n \n Qiao, M.; Zhu, F.; Chen, J.; Li, Y.; and Wang, X.\n\n\n \n\n\n\n International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases, 140: 78–85. March 2024.\n \n\n\n\n
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@article{qiao_effects_2024,\n\ttitle = {Effects of scheduled school breaks on the circulation of influenza in children, school-aged population, and adults in {China}: {A} spatio-temporal analysis},\n\tvolume = {140},\n\tissn = {1878-3511},\n\tshorttitle = {Effects of scheduled school breaks on the circulation of influenza in children, school-aged population, and adults in {China}},\n\tdoi = {10.1016/j.ijid.2024.01.005},\n\tabstract = {OBJECTIVES: To investigate the effect of scheduled school break on the circulation of influenza in young children, school-aged population, and adults.\nMETHODS: In a spatial-temporal analysis using influenza activity, school break dates, and meteorological covariates across mainland China during 2015-2018, we estimated age-specific, province-specific, and overall relative risk (RR) and effectiveness of school break on influenza.\nRESULTS: We included data in 24, 25, and 17 provinces for individuals aged 0-4 years, 5-19 years and 20+ years. We estimated a RR meta-estimate of 0.34 (95\\% confidence interval 0.29-0.40) and an effectiveness of 66\\% for school break in those aged 5-19 years. School break showed a lagged and smaller mitigation effect in those aged 0-4 years (RR meta-estimate: 0.73, 0.68-0.79) and 20+ years (RR meta-estimate: 0.89, 0.78-1.01) versus those aged 5-19 years.\nCONCLUSION: The results show heterogeneous effects of school break between population subgroups, a pattern likely to hold for other respiratory infectious diseases. Our study highlights the importance of anticipating age-specific effects of implementing school closure interventions and provides evidence for rational use of school closure interventions in future epidemics.},\n\tlanguage = {eng},\n\tjournal = {International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases},\n\tauthor = {Qiao, Mengling and Zhu, Fuyu and Chen, Junru and Li, You and Wang, Xin},\n\tmonth = mar,\n\tyear = {2024},\n\tpmid = {38218380},\n\tkeywords = {Child, Adult, Humans, Child, Preschool, Influenza, Human, China, Epidemics, Schools, Spatio-Temporal Analysis, Age-specific, China, Influenza, School break, Spatial-temporal analysis},\n\tpages = {78--85},\n}\n\n
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\n OBJECTIVES: To investigate the effect of scheduled school break on the circulation of influenza in young children, school-aged population, and adults. METHODS: In a spatial-temporal analysis using influenza activity, school break dates, and meteorological covariates across mainland China during 2015-2018, we estimated age-specific, province-specific, and overall relative risk (RR) and effectiveness of school break on influenza. RESULTS: We included data in 24, 25, and 17 provinces for individuals aged 0-4 years, 5-19 years and 20+ years. We estimated a RR meta-estimate of 0.34 (95% confidence interval 0.29-0.40) and an effectiveness of 66% for school break in those aged 5-19 years. School break showed a lagged and smaller mitigation effect in those aged 0-4 years (RR meta-estimate: 0.73, 0.68-0.79) and 20+ years (RR meta-estimate: 0.89, 0.78-1.01) versus those aged 5-19 years. CONCLUSION: The results show heterogeneous effects of school break between population subgroups, a pattern likely to hold for other respiratory infectious diseases. Our study highlights the importance of anticipating age-specific effects of implementing school closure interventions and provides evidence for rational use of school closure interventions in future epidemics.\n
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\n \n\n \n \n \n \n \n Determining the timing of respiratory syncytial virus (RSV) epidemics: a systematic review, 2016 to 2021; method categorisation and identification of influencing factors.\n \n \n \n\n\n \n Staadegaard, L.; Dückers, M.; van Summeren, J.; van Gameren, R.; Demont, C.; Bangert, M.; Li, Y.; Casalegno, J.; Caini, S.; and Paget, J.\n\n\n \n\n\n\n Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 29(5): 2300244. February 2024.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{staadegaard_determining_2024,\n\ttitle = {Determining the timing of respiratory syncytial virus ({RSV}) epidemics: a systematic review, 2016 to 2021; method categorisation and identification of influencing factors},\n\tvolume = {29},\n\tissn = {1560-7917},\n\tshorttitle = {Determining the timing of respiratory syncytial virus ({RSV}) epidemics},\n\tdoi = {10.2807/1560-7917.ES.2024.29.5.2300244},\n\tabstract = {BackgroundThere is currently no standardised approach to estimate respiratory syncytial virus (RSV) epidemics' timing (or seasonality), a critical information for their effective prevention and control.AimWe aimed to provide an overview of methods to define RSV seasonality and identify factors supporting method choice or interpretation/comparison of seasonal estimates.MethodsWe systematically searched PubMed and Embase (2016-2021) for studies using quantitative approaches to determine the start and end of RSV epidemics. Studies' features (data-collection purpose, location, regional/(sub)national scope), methods, and assessment characteristics (case definitions, sampled population's age, in/outpatient status, setting, diagnostics) were extracted. Methods were categorised by their need of a denominator (i.e. numbers of specimens tested) and their retrospective vs real-time application. Factors worth considering when choosing methods and assessing seasonal estimates were sought by analysing studies.ResultsWe included 32 articles presenting 49 seasonality estimates (18 thereof through the 10\\% positivity threshold method). Methods were classified into eight categories, two requiring a denominator (1 retrospective; 1 real-time) and six not (3 retrospective; 3 real-time). A wide range of assessment characteristics was observed. Several studies showed that seasonality estimates varied when methods differed, or data with dissimilar assessment characteristics were employed. Five factors (comprising study purpose, application time, assessment characteristics, healthcare system and policies, and context) were identified that could support method choice and result interpretation.ConclusionMethods and assessment characteristics used to define RSV seasonality are heterogeneous. Our categorisation of methods and proposed framework of factors may assist in choosing RSV seasonality methods and interpretating results.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin},\n\tauthor = {Staadegaard, Lisa and Dückers, Michel and van Summeren, Jojanneke and van Gameren, Rob and Demont, Clarisse and Bangert, Mathieu and Li, You and Casalegno, Jean-Sebastien and Caini, Saverio and Paget, John},\n\tmonth = feb,\n\tyear = {2024},\n\tpmid = {38304952},\n\tpmcid = {PMC10835753},\n\tkeywords = {Humans, Infant, Respiratory Syncytial Virus Infections, Retrospective Studies, Seasons, Respiratory Syncytial Virus, Human, Epidemics},\n\tpages = {2300244},\n}\n\n
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\n BackgroundThere is currently no standardised approach to estimate respiratory syncytial virus (RSV) epidemics' timing (or seasonality), a critical information for their effective prevention and control.AimWe aimed to provide an overview of methods to define RSV seasonality and identify factors supporting method choice or interpretation/comparison of seasonal estimates.MethodsWe systematically searched PubMed and Embase (2016-2021) for studies using quantitative approaches to determine the start and end of RSV epidemics. Studies' features (data-collection purpose, location, regional/(sub)national scope), methods, and assessment characteristics (case definitions, sampled population's age, in/outpatient status, setting, diagnostics) were extracted. Methods were categorised by their need of a denominator (i.e. numbers of specimens tested) and their retrospective vs real-time application. Factors worth considering when choosing methods and assessing seasonal estimates were sought by analysing studies.ResultsWe included 32 articles presenting 49 seasonality estimates (18 thereof through the 10% positivity threshold method). Methods were classified into eight categories, two requiring a denominator (1 retrospective; 1 real-time) and six not (3 retrospective; 3 real-time). A wide range of assessment characteristics was observed. Several studies showed that seasonality estimates varied when methods differed, or data with dissimilar assessment characteristics were employed. Five factors (comprising study purpose, application time, assessment characteristics, healthcare system and policies, and context) were identified that could support method choice and result interpretation.ConclusionMethods and assessment characteristics used to define RSV seasonality are heterogeneous. Our categorisation of methods and proposed framework of factors may assist in choosing RSV seasonality methods and interpretating results.\n
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\n \n\n \n \n \n \n \n Evolution of respiratory syncytial virus burden in young children following the COVID-19 pandemic: influence of concomitant changes in testing practices - Author's reply.\n \n \n \n\n\n \n Li, Y.\n\n\n \n\n\n\n The Lancet. Infectious Diseases, 24(4): e218. April 2024.\n \n\n\n\n
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@article{li_evolution_2024,\n\ttitle = {Evolution of respiratory syncytial virus burden in young children following the {COVID}-19 pandemic: influence of concomitant changes in testing practices - {Author}'s reply},\n\tvolume = {24},\n\tissn = {1474-4457},\n\tshorttitle = {Evolution of respiratory syncytial virus burden in young children following the {COVID}-19 pandemic},\n\tdoi = {10.1016/S1473-3099(24)00082-3},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {The Lancet. Infectious Diseases},\n\tauthor = {Li, You},\n\tmonth = apr,\n\tyear = {2024},\n\tpmid = {38368889},\n\tkeywords = {Child, Humans, Infant, Child, Preschool, Pandemics, COVID-19, Respiratory Syncytial Virus, Human, Respiratory Syncytial Virus Infections, Respiratory Tract Infections},\n\tpages = {e218},\n}\n\n
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\n \n\n \n \n \n \n \n Revisiting influenza-hospitalisation estimates from the Burden of Influenza and Respiratory Syncytial Virus Disease (BIRD) project using different extrapolation methods.\n \n \n \n\n\n \n Paget, J.; Chaves, S. S.; Li, Y.; Nair, H.; and Spreeuwenberg, P.\n\n\n \n\n\n\n Journal of Global Health, 14: 03017. April 2024.\n \n\n\n\n
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@article{paget_revisiting_2024,\n\ttitle = {Revisiting influenza-hospitalisation estimates from the {Burden} of {Influenza} and {Respiratory} {Syncytial} {Virus} {Disease} ({BIRD}) project using different extrapolation methods},\n\tvolume = {14},\n\tissn = {2047-2986},\n\tdoi = {10.7189/jogh.14.03017},\n\tlanguage = {eng},\n\tjournal = {Journal of Global Health},\n\tauthor = {Paget, John and Chaves, Sandra S. and Li, You and Nair, Harish and Spreeuwenberg, Peter},\n\tmonth = apr,\n\tyear = {2024},\n\tpmid = {38574354},\n\tpmcid = {PMC10994668},\n\tkeywords = {Humans, Infant, Influenza, Human, Respiratory Syncytial Virus Infections, Respiratory Syncytial Viruses, Hospitalization, Communicable Diseases, Respiratory Syncytial Virus, Human},\n\tpages = {03017},\n}\n\n
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\n \n\n \n \n \n \n \n The prevalence of influenza bacterial co-infection and its role in disease severity: A systematic review and meta-analysis.\n \n \n \n\n\n \n Qiao, M.; Moyes, G.; Zhu, F.; Li, Y.; and Wang, X.\n\n\n \n\n\n\n Journal of Global Health, 13: 04063. June 2023.\n \n\n\n\n
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@article{qiao_prevalence_2023,\n\ttitle = {The prevalence of influenza bacterial co-infection and its role in disease severity: {A} systematic review and meta-analysis},\n\tvolume = {13},\n\tissn = {2047-2986},\n\tshorttitle = {The prevalence of influenza bacterial co-infection and its role in disease severity},\n\tdoi = {10.7189/jogh.13.04063},\n\tabstract = {BACKGROUND: Evidence suggests that influenza bacterial co-infection is associated with severe diseases, but this association has not been systematically assessed. We aimed to assess the prevalence of influenza bacterial co-infection and its role in disease severity.\nMETHODS: We searched PubMed and Web of Science for studies published between 1 January 2010 and 31 December 2021. We performed a generalised linear mixed effects model to estimate the prevalence of bacterial co-infection in influenza patients, and the odds ratios (OR) of death, intensive care unit (ICU) admission, and requirement of mechanical ventilation (MV) for influenza bacterial co-infection compared to influenza single-infection. Using the estimates of OR and prevalence, we estimated the proportion of influenza deaths attributable to bacterial co-infection.\nRESULTS: We included 63 articles. The pooled prevalence of influenza bacterial co-infection was 20.3\\% (95\\% confidence interval (CI) = 16.0-25.4). Compared with influenza single-infection, bacterial co-infection increased the risk of death (OR = 2.55; 95\\% CI = 1.88-3.44), ICU admission (OR = 1.87; 95\\% CI = 1.04-3.38), and requirement for MV (OR = 1.78; 95\\% CI = 1.26-2.51). In the sensitivity analyses, we found broadly similar estimates between age groups, time periods, and health care settings. Likewise, while including studies with a low risk in confounding adjustment, the OR of death was 2.08 (95\\% CI = 1.44-3.00) for influenza bacterial co-infection. Based on these estimates, we found that approximately 23.8\\% (95\\% uncertainty range = 14.5-35.2) of influenza deaths were attributable to bacterial co-infection.\nCONCLUSIONS: We found that bacterial co-infection is associated with a higher risk of severe illnesses compared to influenza single-infection. Approximately one in four influenza deaths could be attributable to bacterial co-infection. These results should inform prevention, identification, and treatment for suspected bacterial co-infection in influenza patients.\nREGISTRATION: PROSPERO CRD42022314436.},\n\tlanguage = {eng},\n\tjournal = {Journal of Global Health},\n\tauthor = {Qiao, Mengling and Moyes, Gary and Zhu, Fuyu and Li, You and Wang, Xin},\n\tmonth = jun,\n\tyear = {2023},\n\tpmid = {37319008},\n\tpmcid = {PMC10270314},\n\tkeywords = {Humans, Influenza, Human, Prevalence, Coinfection, Bacterial Infections, Patient Acuity},\n\tpages = {04063},\n}\n\n
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\n BACKGROUND: Evidence suggests that influenza bacterial co-infection is associated with severe diseases, but this association has not been systematically assessed. We aimed to assess the prevalence of influenza bacterial co-infection and its role in disease severity. METHODS: We searched PubMed and Web of Science for studies published between 1 January 2010 and 31 December 2021. We performed a generalised linear mixed effects model to estimate the prevalence of bacterial co-infection in influenza patients, and the odds ratios (OR) of death, intensive care unit (ICU) admission, and requirement of mechanical ventilation (MV) for influenza bacterial co-infection compared to influenza single-infection. Using the estimates of OR and prevalence, we estimated the proportion of influenza deaths attributable to bacterial co-infection. RESULTS: We included 63 articles. The pooled prevalence of influenza bacterial co-infection was 20.3% (95% confidence interval (CI) = 16.0-25.4). Compared with influenza single-infection, bacterial co-infection increased the risk of death (OR = 2.55; 95% CI = 1.88-3.44), ICU admission (OR = 1.87; 95% CI = 1.04-3.38), and requirement for MV (OR = 1.78; 95% CI = 1.26-2.51). In the sensitivity analyses, we found broadly similar estimates between age groups, time periods, and health care settings. Likewise, while including studies with a low risk in confounding adjustment, the OR of death was 2.08 (95% CI = 1.44-3.00) for influenza bacterial co-infection. Based on these estimates, we found that approximately 23.8% (95% uncertainty range = 14.5-35.2) of influenza deaths were attributable to bacterial co-infection. CONCLUSIONS: We found that bacterial co-infection is associated with a higher risk of severe illnesses compared to influenza single-infection. Approximately one in four influenza deaths could be attributable to bacterial co-infection. These results should inform prevention, identification, and treatment for suspected bacterial co-infection in influenza patients. REGISTRATION: PROSPERO CRD42022314436.\n
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\n \n\n \n \n \n \n \n Understanding the age spectrum of respiratory syncytial virus associated hospitalisation and mortality burden based on statistical modelling methods: a systematic analysis.\n \n \n \n\n\n \n Cong, B.; Dighero, I.; Zhang, T.; Chung, A.; Nair, H.; and Li, Y.\n\n\n \n\n\n\n BMC medicine, 21(1): 224. June 2023.\n \n\n\n\n
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@article{cong_understanding_2023,\n\ttitle = {Understanding the age spectrum of respiratory syncytial virus associated hospitalisation and mortality burden based on statistical modelling methods: a systematic analysis},\n\tvolume = {21},\n\tissn = {1741-7015},\n\tshorttitle = {Understanding the age spectrum of respiratory syncytial virus associated hospitalisation and mortality burden based on statistical modelling methods},\n\tdoi = {10.1186/s12916-023-02932-5},\n\tabstract = {BACKGROUND: Statistical modelling studies based on excess morbidity and mortality are important for understanding RSV disease burden for age groups that are less frequently tested for RSV. We aimed to understand the full age spectrum of RSV morbidity and mortality burden based on statistical modelling studies, as well as the value of modelling studies in RSV disease burden estimation.\nMETHODS: The databases Medline, Embase and Global Health were searched to identify studies published between January 1, 1995, and December 31, 2021, reporting RSV-associated excess hospitalisation or mortality rates of any case definitions using a modelling approach. All reported rates were summarised using median, IQR (Interquartile range) and range by age group, outcome and country income group; where applicable, a random-effects meta-analysis was conducted to combine the reported rates. We further estimated the proportion of RSV hospitalisations that could be captured in clinical databases.\nRESULTS: A total of 32 studies were included, with 26 studies from high-income countries. RSV-associated hospitalisation and mortality rates both showed a U-shape age pattern. Lowest and highest RSV acute respiratory infection (ARI) hospitalisation rates were found in 5-17 years (median: 1.6/100,000 population, IQR: 1.3-18.5) and {\\textless} 1 year (2235.7/100,000 population, 1779.1-3552.5), respectively. Lowest and highest RSV mortality rates were found in 18-49 years (0.1/100,000 population, 0.06-0.2) and ≥ 75 years (80.0/100,000 population, 70.0-90.0) for high-income countries, respectively, and in 18-49 years (0.3/100,000 population, 0.1-2.4) and {\\textless} 1 year (143.4/100,000 population, 143.4-143.4) for upper-middle income countries. More than 70\\% of RSV hospitalisations in children {\\textless} 5 years could be captured in clinical databases whereas less than 10\\% of RSV hospitalisations could be captured in adults, especially for adults ≥ 50 years. Using pneumonia and influenza (P\\&I) mortality could potentially capture half of all RSV mortality in older adults but only 10-30\\% of RSV mortality in children.\nCONCLUSIONS: Our study provides insights into the age spectrum of RSV hospitalisation and mortality. RSV disease burden using laboratory records alone could be substantially severely underreported for age groups ≥ 5 years. Our findings confirm infants and older adults should be prioritised for RSV immunisation programmes.\nTRIAL REGISTRATION: PROSPERO CRD42020173430.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC medicine},\n\tauthor = {Cong, Bingbing and Dighero, Izzie and Zhang, Tiantian and Chung, Alexandria and Nair, Harish and Li, You},\n\tmonth = jun,\n\tyear = {2023},\n\tpmid = {37365569},\n\tpmcid = {PMC10294405},\n\tkeywords = {Infant, Child, Humans, Aged, Child, Preschool, Respiratory Syncytial Virus, Human, Respiratory Syncytial Virus Infections, Models, Statistical, Influenza, Human, Hospitalization, Burden of disease, Hospitalisation, Model, Mortality, Respiratory syncytial virus, Systematic reviews},\n\tpages = {224},\n}\n\n
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\n BACKGROUND: Statistical modelling studies based on excess morbidity and mortality are important for understanding RSV disease burden for age groups that are less frequently tested for RSV. We aimed to understand the full age spectrum of RSV morbidity and mortality burden based on statistical modelling studies, as well as the value of modelling studies in RSV disease burden estimation. METHODS: The databases Medline, Embase and Global Health were searched to identify studies published between January 1, 1995, and December 31, 2021, reporting RSV-associated excess hospitalisation or mortality rates of any case definitions using a modelling approach. All reported rates were summarised using median, IQR (Interquartile range) and range by age group, outcome and country income group; where applicable, a random-effects meta-analysis was conducted to combine the reported rates. We further estimated the proportion of RSV hospitalisations that could be captured in clinical databases. RESULTS: A total of 32 studies were included, with 26 studies from high-income countries. RSV-associated hospitalisation and mortality rates both showed a U-shape age pattern. Lowest and highest RSV acute respiratory infection (ARI) hospitalisation rates were found in 5-17 years (median: 1.6/100,000 population, IQR: 1.3-18.5) and \\textless 1 year (2235.7/100,000 population, 1779.1-3552.5), respectively. Lowest and highest RSV mortality rates were found in 18-49 years (0.1/100,000 population, 0.06-0.2) and ≥ 75 years (80.0/100,000 population, 70.0-90.0) for high-income countries, respectively, and in 18-49 years (0.3/100,000 population, 0.1-2.4) and \\textless 1 year (143.4/100,000 population, 143.4-143.4) for upper-middle income countries. More than 70% of RSV hospitalisations in children \\textless 5 years could be captured in clinical databases whereas less than 10% of RSV hospitalisations could be captured in adults, especially for adults ≥ 50 years. Using pneumonia and influenza (P&I) mortality could potentially capture half of all RSV mortality in older adults but only 10-30% of RSV mortality in children. CONCLUSIONS: Our study provides insights into the age spectrum of RSV hospitalisation and mortality. RSV disease burden using laboratory records alone could be substantially severely underreported for age groups ≥ 5 years. Our findings confirm infants and older adults should be prioritised for RSV immunisation programmes. TRIAL REGISTRATION: PROSPERO CRD42020173430.\n
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\n \n\n \n \n \n \n \n Cost-effectiveness of pharmaceutical strategies to prevent respiratory syncytial virus disease in young children: a decision-support model for use in low-income and middle-income countries.\n \n \n \n\n\n \n Mahmud, S.; Baral, R.; Sanderson, C.; Pecenka, C.; Jit, M.; Li, Y.; and Clark, A.\n\n\n \n\n\n\n BMC medicine, 21(1): 138. April 2023.\n Place: England\n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n  \n \n 1 download\n \n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{mahmud_cost-effectiveness_2023,\n\ttitle = {Cost-effectiveness of pharmaceutical strategies to prevent respiratory syncytial virus disease in young children: a decision-support model for use in low-income  and middle-income countries.},\n\tvolume = {21},\n\tcopyright = {© 2023. The Author(s).},\n\tissn = {1741-7015},\n\tdoi = {10.1186/s12916-023-02827-5},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of respiratory disease in young children. A number of mathematical models have been used to  assess the cost-effectiveness of RSV prevention strategies, but these have not  been designed for ease of use by multidisciplinary teams working in low-income  and middle-income countries (LMICs). METHODS: We describe the UNIVAC  decision-support model (a proportionate outcomes static cohort model) and its  approach to exploring the potential cost-effectiveness of two RSV prevention  strategies: a single-dose maternal vaccine and a single-dose long-lasting  monoclonal antibody (mAb) for infants. We identified model input parameters for  133 LMICs using evidence from the literature and selected national datasets. We  calculated the potential cost-effectiveness of each RSV prevention strategy  (compared to nothing and to each other) over the lifetimes of all children born  in the year 2025 and compared our results to a separate model published by PATH.  We ran sensitivity and scenario analyses to identify the inputs with the largest  influence on the cost-effectiveness results. RESULTS: Our illustrative results  assuming base case input assumptions for maternal vaccination (\\$3.50 per dose,  69\\% efficacy, 6 months protection) and infant mAb (\\$3.50 per dose, 77\\% efficacy,  5 months protection) showed that both interventions were cost-saving compared to  status quo in around one-third of 133 LMICs, and had a cost per DALY averted  below 0.5 times the national GDP per capita in the remaining LMICs. UNIVAC  generated similar results to a separate model published by PATH.  Cost-effectiveness results were most sensitive to changes in the price, efficacy  and duration of protection of each strategy, and the rate (and cost) of RSV  hospital admissions. CONCLUSIONS: Forthcoming RSV interventions (maternal  vaccines and infant mAbs) are worth serious consideration in LMICs, but there is  a good deal of uncertainty around several influential inputs, including  intervention price, efficacy, and duration of protection. The UNIVAC  decision-support model provides a framework for country teams to build consensus  on data inputs, explore scenarios, and strengthen the local ownership and  policy-relevance of results.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC medicine},\n\tauthor = {Mahmud, Sarwat and Baral, Ranju and Sanderson, Colin and Pecenka, Clint and Jit, Mark and Li, You and Clark, Andrew},\n\tmonth = apr,\n\tyear = {2023},\n\tpmid = {37038127},\n\tnote = {Place: England},\n\tkeywords = {Humans, Infant, Child, Preschool, Child, *Communicable Diseases, *Respiratory Syncytial Virus Infections/epidemiology/prevention \\& control, *Respiratory Syncytial Virus, Human, Antibodies, Monoclonal/therapeutic use, Cost-Benefit Analysis, Developing Countries, Economic evaluation, LMICs, Maternal vaccine, Monoclonal antibody, Pharmaceutical Preparations, RSV},\n\tpages = {138},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of respiratory disease in young children. A number of mathematical models have been used to assess the cost-effectiveness of RSV prevention strategies, but these have not been designed for ease of use by multidisciplinary teams working in low-income and middle-income countries (LMICs). METHODS: We describe the UNIVAC decision-support model (a proportionate outcomes static cohort model) and its approach to exploring the potential cost-effectiveness of two RSV prevention strategies: a single-dose maternal vaccine and a single-dose long-lasting monoclonal antibody (mAb) for infants. We identified model input parameters for 133 LMICs using evidence from the literature and selected national datasets. We calculated the potential cost-effectiveness of each RSV prevention strategy (compared to nothing and to each other) over the lifetimes of all children born in the year 2025 and compared our results to a separate model published by PATH. We ran sensitivity and scenario analyses to identify the inputs with the largest influence on the cost-effectiveness results. RESULTS: Our illustrative results assuming base case input assumptions for maternal vaccination ($3.50 per dose, 69% efficacy, 6 months protection) and infant mAb ($3.50 per dose, 77% efficacy, 5 months protection) showed that both interventions were cost-saving compared to status quo in around one-third of 133 LMICs, and had a cost per DALY averted below 0.5 times the national GDP per capita in the remaining LMICs. UNIVAC generated similar results to a separate model published by PATH. Cost-effectiveness results were most sensitive to changes in the price, efficacy and duration of protection of each strategy, and the rate (and cost) of RSV hospital admissions. CONCLUSIONS: Forthcoming RSV interventions (maternal vaccines and infant mAbs) are worth serious consideration in LMICs, but there is a good deal of uncertainty around several influential inputs, including intervention price, efficacy, and duration of protection. The UNIVAC decision-support model provides a framework for country teams to build consensus on data inputs, explore scenarios, and strengthen the local ownership and policy-relevance of results.\n
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\n \n\n \n \n \n \n \n Understanding the risk of transmission of respiratory viral infections in childcare centres: protocol for the DISeases TrANsmission in ChildcarE (DISTANCE) multicentre cohort study.\n \n \n \n\n\n \n Shi, C.; Wang, X.; Ye, S.; Deng, S.; Cong, B.; Lu, B.; and Li, Y.\n\n\n \n\n\n\n BMJ open respiratory research, 10(1). April 2023.\n Place: England\n\n\n\n
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@article{shi_understanding_2023,\n\ttitle = {Understanding the risk of transmission of respiratory viral infections in childcare centres: protocol for the {DISeases} {TrANsmission} in {ChildcarE} ({DISTANCE})  multicentre cohort study.},\n\tvolume = {10},\n\tcopyright = {© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.},\n\tissn = {2052-4439},\n\tdoi = {10.1136/bmjresp-2023-001617},\n\tabstract = {INTRODUCTION: Childcare centre is considered a high-risk setting for transmission of respiratory viruses. Further evidence is needed to understand the risk of  transmission in childcare centres. To this end, we established the DISeases  TrANsmission in ChildcarE (DISTANCE) study to understand the interaction among  contact patterns, detection of respiratory viruses from environment samples and  transmission of viral infections in childcare centres. METHODS AND ANALYSIS: The  DISTANCE study is a prospective cohort study in multiple childcare centres of  Jiangsu Province, China. Study subjects will be childcare attendees and teaching  staff of different grades. A range of information will be collected from the  study subjects and participating childcare centres, including attendance, contact  behaviours (collected by onsite observers), respiratory viral infection (weekly  respiratory throat swabs tested by multiplex PCR), presence of respiratory  viruses on touch surfaces of childcare centres and weekly follow-up survey on  respiratory symptoms and healthcare seeking among subjects tested positive for  any respiratory viruses. Detection patterns of respiratory viruses from study  subjects and environment samples, contact patterns, and transmission risk will be  analysed by developing statistical and mathematical models as appropriate. The  study has been initiated in September 2022 in 1 childcare centre in Wuxi City,  with a total of 104 children and 12 teaching staff included in the cohort; data  collection and follow-up is ongoing. One more childcare centre in Nanjing City  (anticipated to include 100 children and 10 teaching staff) will start  recruitment in 2023. ETHICS AND DISSEMINATION: The study has received ethics  approval from Nanjing Medical University Ethics Committee (No. 2022-936) and  ethics approval from Wuxi Center for Disease Control and Prevention Ethics  Committee (No. 2022-011). We plan to disseminate the study findings mainly  through publications in peer-reviewed journals and presentations in academic  conferences. Aggregated research data will be shared freely to researchers.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMJ open respiratory research},\n\tauthor = {Shi, Chao and Wang, Xin and Ye, Sheng and Deng, Shuyu and Cong, Bingbing and Lu, Bing and Li, You},\n\tmonth = apr,\n\tyear = {2023},\n\tpmid = {37028911},\n\tpmcid = {PMC10083867},\n\tnote = {Place: England},\n\tkeywords = {Humans, Prospective Studies, *Virus Diseases/diagnosis/epidemiology, *Viruses, Child, Child Care, Child Day Care Centers, Multicenter Studies as Topic, Respiratory Infection, Viral infection},\n}\n\n
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\n INTRODUCTION: Childcare centre is considered a high-risk setting for transmission of respiratory viruses. Further evidence is needed to understand the risk of transmission in childcare centres. To this end, we established the DISeases TrANsmission in ChildcarE (DISTANCE) study to understand the interaction among contact patterns, detection of respiratory viruses from environment samples and transmission of viral infections in childcare centres. METHODS AND ANALYSIS: The DISTANCE study is a prospective cohort study in multiple childcare centres of Jiangsu Province, China. Study subjects will be childcare attendees and teaching staff of different grades. A range of information will be collected from the study subjects and participating childcare centres, including attendance, contact behaviours (collected by onsite observers), respiratory viral infection (weekly respiratory throat swabs tested by multiplex PCR), presence of respiratory viruses on touch surfaces of childcare centres and weekly follow-up survey on respiratory symptoms and healthcare seeking among subjects tested positive for any respiratory viruses. Detection patterns of respiratory viruses from study subjects and environment samples, contact patterns, and transmission risk will be analysed by developing statistical and mathematical models as appropriate. The study has been initiated in September 2022 in 1 childcare centre in Wuxi City, with a total of 104 children and 12 teaching staff included in the cohort; data collection and follow-up is ongoing. One more childcare centre in Nanjing City (anticipated to include 100 children and 10 teaching staff) will start recruitment in 2023. ETHICS AND DISSEMINATION: The study has received ethics approval from Nanjing Medical University Ethics Committee (No. 2022-936) and ethics approval from Wuxi Center for Disease Control and Prevention Ethics Committee (No. 2022-011). We plan to disseminate the study findings mainly through publications in peer-reviewed journals and presentations in academic conferences. Aggregated research data will be shared freely to researchers.\n
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\n \n\n \n \n \n \n \n Adjusting for Case Under-Ascertainment in Estimating RSV Hospitalisation Burden of Older Adults in High-Income Countries: a Systematic Review and Modelling Study.\n \n \n \n\n\n \n Li, Y.; Kulkarni, D.; Begier, E.; Wahi-Singh, P.; Wahi-Singh, B.; Gessner, B.; and Nair, H.\n\n\n \n\n\n\n Infectious diseases and therapy,1–13. March 2023.\n Place: New Zealand\n\n\n\n
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@article{li_adjusting_2023,\n\ttitle = {Adjusting for {Case} {Under}-{Ascertainment} in {Estimating} {RSV} {Hospitalisation} {Burden} of {Older} {Adults} in {High}-{Income} {Countries}: a {Systematic} {Review} and {Modelling}  {Study}.},\n\tcopyright = {© 2023. The Author(s).},\n\tissn = {2193-8229 2193-6382},\n\tdoi = {10.1007/s40121-023-00792-3},\n\tabstract = {INTRODUCTION: Previous studies suggest diagnostic testing characteristics (i.e. variations in clinical specimens and diagnostic tests) can contribute to  underestimation of RSV disease burden. We aimed to improve the understanding of  RSV hospitalisation burden in older adults (aged ≥ 65 years) in high-income  countries through adjusting for case under-ascertainment. METHODS: We conducted a  systematic review to include data on RSV-associated acute respiratory infection  (ARI) hospitalisation burden in older adults in high-income countries. To adjust  for case under-ascertainment, we developed a two-step framework that incorporated  empirical data on the RSV detection proportion of different clinical specimens  and testing approaches as well as their statistical uncertainty. We estimated the  unadjusted and adjusted RSV-associated hospitalisation burden through multilevel  random-effects meta-analysis. We further explored RSV-associated in-hospital  mortality burden. RESULTS: We included 12 studies with eligible RSV  hospitalisation burden data. We estimated that pooled unadjusted hospitalisation  rate was 157 per 100,000 (95\\% CI 98-252) for adults aged ≥ 65 years; the rate was  adjusted to 347 per 100,000 (203-595) after accounting for under-ascertainment.  The adjusted rate could be translated into 787,000 (460,000-1,347,000)  RSV-associated hospitalisations in high-income countries in 2019, which was about  2.2 times the unadjusted estimate. Stratified analysis by age group showed that  the adjusted rate increased with age, from 231 per 100,000 in adults aged  65-74 years to 692 per 100,000 in adults aged {\\textgreater} 85 years. The in-hospital case  fatality ratio of RSV was 6.1\\% (3.3-11.0) and the total RSV-associated  in-hospital deaths in high-income countries in 2019 could be between 22,000 and  47,000. CONCLUSION: This study improves the understanding of RSV-associated  hospitalisation burden in older adults and shows that the true RSV-associated  hospitalisation burden could be 2.2 times what was reported in existing studies.  This study has implications for calculating the benefit of interventions to treat  and prevent RSV-associated disease.},\n\tlanguage = {eng},\n\tjournal = {Infectious diseases and therapy},\n\tauthor = {Li, You and Kulkarni, Durga and Begier, Elizabeth and Wahi-Singh, Pia and Wahi-Singh, Bhanu and Gessner, Bradford and Nair, Harish},\n\tmonth = mar,\n\tyear = {2023},\n\tpmid = {36941483},\n\tpmcid = {PMC10027261},\n\tnote = {Place: New Zealand},\n\tkeywords = {Disease burden, Hospitalisation, Mortality, Older adults, Respiratory syncytial virus, Sensitivity, Under-ascertainment},\n\tpages = {1--13},\n}\n\n
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\n INTRODUCTION: Previous studies suggest diagnostic testing characteristics (i.e. variations in clinical specimens and diagnostic tests) can contribute to underestimation of RSV disease burden. We aimed to improve the understanding of RSV hospitalisation burden in older adults (aged ≥ 65 years) in high-income countries through adjusting for case under-ascertainment. METHODS: We conducted a systematic review to include data on RSV-associated acute respiratory infection (ARI) hospitalisation burden in older adults in high-income countries. To adjust for case under-ascertainment, we developed a two-step framework that incorporated empirical data on the RSV detection proportion of different clinical specimens and testing approaches as well as their statistical uncertainty. We estimated the unadjusted and adjusted RSV-associated hospitalisation burden through multilevel random-effects meta-analysis. We further explored RSV-associated in-hospital mortality burden. RESULTS: We included 12 studies with eligible RSV hospitalisation burden data. We estimated that pooled unadjusted hospitalisation rate was 157 per 100,000 (95% CI 98-252) for adults aged ≥ 65 years; the rate was adjusted to 347 per 100,000 (203-595) after accounting for under-ascertainment. The adjusted rate could be translated into 787,000 (460,000-1,347,000) RSV-associated hospitalisations in high-income countries in 2019, which was about 2.2 times the unadjusted estimate. Stratified analysis by age group showed that the adjusted rate increased with age, from 231 per 100,000 in adults aged 65-74 years to 692 per 100,000 in adults aged \\textgreater 85 years. The in-hospital case fatality ratio of RSV was 6.1% (3.3-11.0) and the total RSV-associated in-hospital deaths in high-income countries in 2019 could be between 22,000 and 47,000. CONCLUSION: This study improves the understanding of RSV-associated hospitalisation burden in older adults and shows that the true RSV-associated hospitalisation burden could be 2.2 times what was reported in existing studies. This study has implications for calculating the benefit of interventions to treat and prevent RSV-associated disease.\n
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\n \n\n \n \n \n \n \n Association of Endocrine-Disrupting Chemicals with All-Cause and Cause-Specific Mortality in the U.S.: A Prospective Cohort Study.\n \n \n \n\n\n \n Fan, Y.; Tao, C.; Li, Z.; Huang, Y.; Yan, W.; Zhao, S.; Gao, B.; Xu, Q.; Qin, Y.; Wang, X.; Peng, Z.; Covaci, A.; Li, Y.; Xia, Y.; and Lu, C.\n\n\n \n\n\n\n Environmental science & technology, 57(7): 2877–2886. February 2023.\n Place: United States\n\n\n\n
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@article{fan_association_2023,\n\ttitle = {Association of {Endocrine}-{Disrupting} {Chemicals} with {All}-{Cause} and {Cause}-{Specific} {Mortality} in the {U}.{S}.: {A} {Prospective} {Cohort} {Study}.},\n\tvolume = {57},\n\tissn = {1520-5851 0013-936X},\n\tdoi = {10.1021/acs.est.2c07611},\n\tabstract = {Wide exposure to endocrine-disrupting chemicals (EDCs) poses a great risk on human health. However, few large-scale cohort studies have comprehensively  estimated the association between EDCs exposure and mortality risk. This study  aimed to investigate the association of urinary EDCs exposure with mortality risk  and quantify attributable mortality and economic loss. Multivariable Cox  proportional hazards regression models were performed to investigate the  association of 38 representative EDCs exposure with mortality risk in the  National Health and Nutrition Examination Survey (NHANES). During a median  follow-up of 7.7 years, 47,279 individuals were enrolled. All-cause mortality was  positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene, cadmium,  antimony, cobalt, and monobenzyl phthalate. Cancer mortality was positively  associated with cadmium. Cardiovascular disease (CVD) mortality was positively  associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene, and  2-hydroxyfluorene. Nonlinear U-shaped relationships were found between all-cause  mortality and cadmium and cobalt, which was also identified between  2-hydroxyfluorene and CVD mortality. J-shaped association of cadmium exposure  with cancer mortality was also determined. EDCs exposure may cause 56.52\\% of  total deaths (1,528,500 deaths) and around 1,897 billion USD in economic costs.  Exposure to certain phthalates, polycyclic aromatic hydrocarbons, phytoestrogens,  or toxic metals, even at substantially low levels, is significantly associated  with mortality and induces high economic costs.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {Environmental science \\& technology},\n\tauthor = {Fan, Yun and Tao, Chengzhe and Li, Zhi and Huang, Yuna and Yan, Wenkai and Zhao, Shuangshuang and Gao, Beibei and Xu, Qiaoqiao and Qin, Yufeng and Wang, Xinru and Peng, Zhihang and Covaci, Adrian and Li, You and Xia, Yankai and Lu, Chuncheng},\n\tmonth = feb,\n\tyear = {2023},\n\tpmid = {36728834},\n\tnote = {Place: United States},\n\tkeywords = {Humans, *Cardiovascular Diseases/chemically induced/epidemiology, *Endocrine Disruptors/toxicity, *Neoplasms, Cadmium, Cause of Death, Cobalt, Cohort Studies, death burden, dose−response, economic cost, endocrine-disrupting chemicals (EDCs), Environmental Exposure/analysis, mortality, NHANES, Nutrition Surveys, Prospective Studies},\n\tpages = {2877--2886},\n}\n\n
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\n Wide exposure to endocrine-disrupting chemicals (EDCs) poses a great risk on human health. However, few large-scale cohort studies have comprehensively estimated the association between EDCs exposure and mortality risk. This study aimed to investigate the association of urinary EDCs exposure with mortality risk and quantify attributable mortality and economic loss. Multivariable Cox proportional hazards regression models were performed to investigate the association of 38 representative EDCs exposure with mortality risk in the National Health and Nutrition Examination Survey (NHANES). During a median follow-up of 7.7 years, 47,279 individuals were enrolled. All-cause mortality was positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene, cadmium, antimony, cobalt, and monobenzyl phthalate. Cancer mortality was positively associated with cadmium. Cardiovascular disease (CVD) mortality was positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene, and 2-hydroxyfluorene. Nonlinear U-shaped relationships were found between all-cause mortality and cadmium and cobalt, which was also identified between 2-hydroxyfluorene and CVD mortality. J-shaped association of cadmium exposure with cancer mortality was also determined. EDCs exposure may cause 56.52% of total deaths (1,528,500 deaths) and around 1,897 billion USD in economic costs. Exposure to certain phthalates, polycyclic aromatic hydrocarbons, phytoestrogens, or toxic metals, even at substantially low levels, is significantly associated with mortality and induces high economic costs.\n
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\n \n\n \n \n \n \n \n Global and national influenza-associated hospitalisation rates: Estimates for 40 countries and administrative regions.\n \n \n \n\n\n \n Paget, J.; Staadegaard, L.; Wang, X.; Li, Y.; van Pomeren, T.; van Summeren, J.; Dückers, M.; Chaves, S. S.; Johnson, E. K.; Mahé, C.; Nair, H.; Viboud, C.; and Spreeuwenberg, P.\n\n\n \n\n\n\n Journal of global health, 13: 04003. January 2023.\n Place: Scotland\n\n\n\n
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@article{paget_global_2023,\n\ttitle = {Global and national influenza-associated hospitalisation rates: {Estimates} for 40 countries and administrative regions.},\n\tvolume = {13},\n\tcopyright = {Copyright © 2023 by the Journal of Global Health. All rights reserved.},\n\tissn = {2047-2986 2047-2978},\n\tdoi = {10.7189/jogh.13.04003},\n\tabstract = {BACKGROUND: WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness (hospitalisations) every year. We aimed to  improve the understanding of influenza-associated hospitalisation estimates at a  national and global level. METHODS: We performed a systematic literature review  of English- and Chinese-language studies published between 1995 and 2020  estimating influenza-associated hospitalisation. We included a total of 127  studies (seven in Chinese) in the meta-analysis and analyzed their data using a  logit-logistic regression model to understand the influence of five study factors  and produce national and global estimates by age groups. The five study factors  assessed were: 1) the method used to calculate the influenza-associated  hospitalisation estimates (rate- or time series regression-based), 2) the outcome  measure (divided into three envelopes: narrow, medium, or wide), 3) whether every  case was laboratory-confirmed or not, 4) whether the estimates were national or  sub-national, 5) whether the rates were based on a single year or multiple years.  RESULTS: The overall pooled influenza-associated hospitalisation rate was 40.5  (95\\% confidence interval (CI) = 24.3-67.4) per 100 000 persons, with rates  varying substantially by age: 224.0 (95\\% CI = 118.8-420.0) in children aged 0-4  years and 96.8 (95\\% CI = 57.0-164.3) in the elderly aged {\\textgreater}65 years. The overall  pooled hospitalisation rates varied by calculation method; for all ages, the  rates were significantly higher when they were based on rate-based methods or  calculated on a single season and significantly lower when cases were  laboratory-confirmed. The national hospitalisation rates (all ages) varied  considerably, ranging from 11.7 (95\\% CI = 3.8-36.3) per 100 000 in New Zealand to  122.1 (95\\% CI = 41.5-358.4) per 100 000 in India (all age estimates).  CONCLUSIONS: Using the pooled global influenza-associated hospitalisation rate,  we estimate that seasonal influenza epidemics result in 3.2 million cases of  severe illness (hospitalisations) per annum. More extensive analyses are required  to assess the influence of other factors on the estimates (e.g. vaccination and  dominant virus (sub)types) and efforts to harmonize the methods should be  encouraged. Our study highlights the high rates of influenza-associated  hospitalisations in children aged 0-4 years and the elderly aged 65+ years.},\n\tlanguage = {eng},\n\tjournal = {Journal of global health},\n\tauthor = {Paget, John and Staadegaard, Lisa and Wang, Xin and Li, You and van Pomeren, Tayma and van Summeren, Jojanneke and Dückers, Michel and Chaves, Sandra S. and Johnson, Emily K. and Mahé, Cédric and Nair, Harish and Viboud, Cecile and Spreeuwenberg, Peter},\n\tmonth = jan,\n\tyear = {2023},\n\tpmid = {36701368},\n\tpmcid = {PMC9879557},\n\tnote = {Place: Scotland},\n\tkeywords = {Humans, Infant, *Global Health/statistics \\& numerical data, *Influenza, Human/epidemiology, Aged, Child, Preschool, Hospitalization, Infant, Newborn, New Zealand/epidemiology, Seasons, Vaccination},\n\tpages = {04003},\n}\n\n
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\n BACKGROUND: WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness (hospitalisations) every year. We aimed to improve the understanding of influenza-associated hospitalisation estimates at a national and global level. METHODS: We performed a systematic literature review of English- and Chinese-language studies published between 1995 and 2020 estimating influenza-associated hospitalisation. We included a total of 127 studies (seven in Chinese) in the meta-analysis and analyzed their data using a logit-logistic regression model to understand the influence of five study factors and produce national and global estimates by age groups. The five study factors assessed were: 1) the method used to calculate the influenza-associated hospitalisation estimates (rate- or time series regression-based), 2) the outcome measure (divided into three envelopes: narrow, medium, or wide), 3) whether every case was laboratory-confirmed or not, 4) whether the estimates were national or sub-national, 5) whether the rates were based on a single year or multiple years. RESULTS: The overall pooled influenza-associated hospitalisation rate was 40.5 (95% confidence interval (CI) = 24.3-67.4) per 100 000 persons, with rates varying substantially by age: 224.0 (95% CI = 118.8-420.0) in children aged 0-4 years and 96.8 (95% CI = 57.0-164.3) in the elderly aged \\textgreater65 years. The overall pooled hospitalisation rates varied by calculation method; for all ages, the rates were significantly higher when they were based on rate-based methods or calculated on a single season and significantly lower when cases were laboratory-confirmed. The national hospitalisation rates (all ages) varied considerably, ranging from 11.7 (95% CI = 3.8-36.3) per 100 000 in New Zealand to 122.1 (95% CI = 41.5-358.4) per 100 000 in India (all age estimates). CONCLUSIONS: Using the pooled global influenza-associated hospitalisation rate, we estimate that seasonal influenza epidemics result in 3.2 million cases of severe illness (hospitalisations) per annum. More extensive analyses are required to assess the influence of other factors on the estimates (e.g. vaccination and dominant virus (sub)types) and efforts to harmonize the methods should be encouraged. Our study highlights the high rates of influenza-associated hospitalisations in children aged 0-4 years and the elderly aged 65+ years.\n
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\n \n\n \n \n \n \n \n Value profile for respiratory syncytial virus vaccines and monoclonal antibodies.\n \n \n \n\n\n \n Fleming, J. A.; Baral, R.; Higgins, D.; Khan, S.; Kochar, S.; Li, Y.; Ortiz, J. R.; Cherian, T.; Feikin, D.; Jit, M.; Karron, R. A.; Limaye, R. J.; Marshall, C.; Munywoki, P. K.; Nair, H.; Newhouse, L. C.; Nyawanda, B. O.; Pecenka, C.; Regan, K.; Srikantiah, P.; Wittenauer, R.; Zar, H. J.; and Sparrow, E.\n\n\n \n\n\n\n Vaccine, 41 Suppl 2: S7–S40. November 2023.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{fleming_value_2023,\n\ttitle = {Value profile for respiratory syncytial virus vaccines and monoclonal antibodies},\n\tvolume = {41 Suppl 2},\n\tissn = {1873-2518},\n\tdoi = {10.1016/j.vaccine.2022.09.081},\n\tabstract = {Respiratory syncytial virus (RSV) is the predominant cause of acute lower respiratory infection (ALRI) in young children worldwide, yet no licensed RSV vaccine exists to help prevent the millions of illnesses and hospitalizations and tens of thousands of young lives taken each year. Monoclonal antibody (mAb) prophylaxis exists for prevention of RSV in a small subset of very high-risk infants and young children, but the only currently licensed product is impractical, requiring multiple doses and expensive for the low-income settings where the RSV disease burden is greatest. A robust candidate pipeline exists to one day prevent RSV disease in infant and pediatric populations, and it focuses on two promising passive immunization approaches appropriate for low-income contexts: maternal RSV vaccines and long-acting infant mAbs. Licensure of one or more candidates is feasible over the next one to three years and, depending on final product characteristics, current economic models suggest both approaches are likely to be cost-effective. Strong coordination between maternal and child health programs and the Expanded Program on Immunization will be needed for effective, efficient, and equitable delivery of either intervention. This 'Vaccine Value Profile' (VVP) for RSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations, and in collaboration with stakeholders from the WHO headquarters. All contributors have extensive expertise on various elements of the RSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.},\n\tlanguage = {eng},\n\tjournal = {Vaccine},\n\tauthor = {Fleming, Jessica A. and Baral, Ranju and Higgins, Deborah and Khan, Sadaf and Kochar, Sonali and Li, You and Ortiz, Justin R. and Cherian, Thomas and Feikin, Daniel and Jit, Mark and Karron, Ruth A. and Limaye, Rupali J. and Marshall, Caroline and Munywoki, Patrick K. and Nair, Harish and Newhouse, Lauren C. and Nyawanda, Bryan O. and Pecenka, Clint and Regan, Katie and Srikantiah, Padmini and Wittenauer, Rachel and Zar, Heather J. and Sparrow, Erin},\n\tmonth = nov,\n\tyear = {2023},\n\tpmid = {37422378},\n\tkeywords = {Infant, Child, Humans, Child, Preschool, Respiratory Syncytial Virus Vaccines, Antibodies, Monoclonal, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Immunization, Passive, Respiratory Tract Infections},\n\tpages = {S7--S40},\n}\n\n
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\n Respiratory syncytial virus (RSV) is the predominant cause of acute lower respiratory infection (ALRI) in young children worldwide, yet no licensed RSV vaccine exists to help prevent the millions of illnesses and hospitalizations and tens of thousands of young lives taken each year. Monoclonal antibody (mAb) prophylaxis exists for prevention of RSV in a small subset of very high-risk infants and young children, but the only currently licensed product is impractical, requiring multiple doses and expensive for the low-income settings where the RSV disease burden is greatest. A robust candidate pipeline exists to one day prevent RSV disease in infant and pediatric populations, and it focuses on two promising passive immunization approaches appropriate for low-income contexts: maternal RSV vaccines and long-acting infant mAbs. Licensure of one or more candidates is feasible over the next one to three years and, depending on final product characteristics, current economic models suggest both approaches are likely to be cost-effective. Strong coordination between maternal and child health programs and the Expanded Program on Immunization will be needed for effective, efficient, and equitable delivery of either intervention. This 'Vaccine Value Profile' (VVP) for RSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations, and in collaboration with stakeholders from the WHO headquarters. All contributors have extensive expertise on various elements of the RSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.\n
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\n \n\n \n \n \n \n \n Report of the WHO technical consultation on the evaluation of respiratory syncytial virus prevention cost effectiveness in low- and middle-income countries, April 7-8, 2022.\n \n \n \n\n\n \n Fitzpatrick, M. C.; Laufer, R. S.; Baral, R.; Driscoll, A. J.; Feikin, D. R.; Fleming, J. A.; Jit, M.; Kim, S.; Koltai, M.; Li, Y.; Li, X.; Nair, H.; Neuzil, K. M.; Pecenka, C.; Sparrow, E.; Srikantiah, P.; and Ortiz, J. R.\n\n\n \n\n\n\n Vaccine, 41(48): 7047–7059. November 2023.\n \n\n\n\n
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@article{fitzpatrick_report_2023,\n\ttitle = {Report of the {WHO} technical consultation on the evaluation of respiratory syncytial virus prevention cost effectiveness in low- and middle-income countries, {April} 7-8, 2022},\n\tvolume = {41},\n\tissn = {1873-2518},\n\tdoi = {10.1016/j.vaccine.2023.09.040},\n\tabstract = {Policymakers often rely on impact and cost-effectiveness evaluations to inform decisions about the introduction of health interventions in low- and middle-income countries (LMICs); however, cost-effectiveness results for the same health intervention can differ by the choice of parameter inputs, modelling assumptions, and geography. Anticipating the near-term availability of new respiratory syncytial virus (RSV) prevention products, WHO convened a two-day virtual consultation in April 2022 with stakeholder groups and global experts in health economics, epidemiology, and vaccine implementation. The objective was to review methods, parameterization, and results of existing cost-effectiveness analyses for RSV prevention in LMICs; identify the most influential inputs and data limitations; and recommend and prioritize future data gathering and research to improve RSV prevention impact estimates in LMICs. Epidemiological parameters identified as both influential and uncertain were those associated with RSV hospitalization and death, specifically setting-specific hospitalization rates and RSV-attributable death rates. Influential economic parameters included product price, delivery costs, willingness-to-pay for health on the part of potential donors, and the cost of RSV-associated hospitalization. Some of the influential parameters identified at this meeting should be more precisely measured by further research. Other influential economic parameters that are highly uncertain may not be resolved, and it is appropriate to use sensitivity analyses to explore these within cost-effectiveness evaluations. This report highlights the presentations and major discussions of the meeting.},\n\tlanguage = {eng},\n\tnumber = {48},\n\tjournal = {Vaccine},\n\tauthor = {Fitzpatrick, Meagan C. and Laufer, Rachel S. and Baral, Ranju and Driscoll, Amanda J. and Feikin, Daniel R. and Fleming, Jessica A. and Jit, Mark and Kim, Sonnie and Koltai, Mihaly and Li, You and Li, Xiao and Nair, Harish and Neuzil, Kathleen M. and Pecenka, Clint and Sparrow, Erin and Srikantiah, Padmini and Ortiz, Justin R.},\n\tmonth = nov,\n\tyear = {2023},\n\tpmid = {37777450},\n\tpmcid = {PMC10680976},\n\tkeywords = {Humans, Infant, Respiratory Syncytial Virus Infections, Developing Countries, Cost-Effectiveness Analysis, Respiratory Syncytial Virus, Human, Cost-Benefit Analysis, Referral and Consultation, Hospitalization, World Health Organization, Cost effectiveness, Global health, Monoclonal antibody, Respiratory syncytial virus, Vaccine},\n\tpages = {7047--7059},\n}\n\n
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\n Policymakers often rely on impact and cost-effectiveness evaluations to inform decisions about the introduction of health interventions in low- and middle-income countries (LMICs); however, cost-effectiveness results for the same health intervention can differ by the choice of parameter inputs, modelling assumptions, and geography. Anticipating the near-term availability of new respiratory syncytial virus (RSV) prevention products, WHO convened a two-day virtual consultation in April 2022 with stakeholder groups and global experts in health economics, epidemiology, and vaccine implementation. The objective was to review methods, parameterization, and results of existing cost-effectiveness analyses for RSV prevention in LMICs; identify the most influential inputs and data limitations; and recommend and prioritize future data gathering and research to improve RSV prevention impact estimates in LMICs. Epidemiological parameters identified as both influential and uncertain were those associated with RSV hospitalization and death, specifically setting-specific hospitalization rates and RSV-attributable death rates. Influential economic parameters included product price, delivery costs, willingness-to-pay for health on the part of potential donors, and the cost of RSV-associated hospitalization. Some of the influential parameters identified at this meeting should be more precisely measured by further research. Other influential economic parameters that are highly uncertain may not be resolved, and it is appropriate to use sensitivity analyses to explore these within cost-effectiveness evaluations. This report highlights the presentations and major discussions of the meeting.\n
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\n \n\n \n \n \n \n \n Changes following the Onset of the COVID-19 Pandemic in the Burden of Hospitalization for Respiratory Syncytial Virus Acute Lower Respiratory Infection in Children under Two Years: A Retrospective Study from Croatia.\n \n \n \n\n\n \n Mrcela, D.; Markic, J.; Zhao, C.; Viskovic, D. V.; Milic, P.; Copac, R.; and Li, Y.\n\n\n \n\n\n\n Viruses, 14(12). December 2022.\n Place: Switzerland\n\n\n\n
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@article{mrcela_changes_2022,\n\ttitle = {Changes following the {Onset} of the {COVID}-19 {Pandemic} in the {Burden} of {Hospitalization} for {Respiratory} {Syncytial} {Virus} {Acute} {Lower} {Respiratory} {Infection}  in {Children} under {Two} {Years}: {A} {Retrospective} {Study} from {Croatia}.},\n\tvolume = {14},\n\tissn = {1999-4915},\n\tdoi = {10.3390/v14122746},\n\tabstract = {To understand the changes in RSV hospitalization burden in children younger than two years following the onset of the COVID-19 pandemic, we reviewed hospital  records of children with acute lower respiratory infection (ALRI) between January  2018 and June 2022 in Split-Dalmatia County, Croatia. We compared RSV activity,  age-specific annualized hospitalization rate, and disease severity between  pre-COVID-19 and COVID-19 periods. A total of 942 ALRI hospital admissions were  included. RSV activity remained low for the typical RSV epidemic during 2020-2021  winter. An out-of-season RSV resurgence was observed in late spring and summer of  2021. Before the COVID-19 pandemic, the annualized hospitalization rate for  RSV-associated ALRI was 13.84/1000 (95\\% CI: 12.11-15.76) and highest among  infants under six months. After the resurgence of RSV in the second half of 2021,  the annualized hospitalization rate for RSV-associated ALRI in children younger  than two years returned to the pre-pandemic levels with similar age distribution  but a statistically higher proportion of severe cases. RSV immunization programs  targeting protection of infants under six months of age are expected to remain  impactful, although the optimal timing of administration would depend on RSV  seasonality that has not yet been established in the study setting since the  onset of the COVID-19 pandemic.},\n\tlanguage = {eng},\n\tnumber = {12},\n\tjournal = {Viruses},\n\tauthor = {Mrcela, Dina and Markic, Josko and Zhao, Chenkai and Viskovic, Daniela Veljacic and Milic, Petra and Copac, Roko and Li, You},\n\tmonth = dec,\n\tyear = {2022},\n\tpmid = {36560751},\n\tpmcid = {PMC9785187},\n\tnote = {Place: Switzerland},\n\tkeywords = {*COVID-19/epidemiology, *Hospitalization/statistics \\& numerical data, *Respiratory Syncytial Virus Infections/epidemiology/therapy, *Respiratory Tract Infections/therapy/virology, bronchiolitis, children, COVID-19, Croatia/epidemiology, Humans, Infant, Pandemics, respiratory syncytial virus, Respiratory Syncytial Virus, Human, Retrospective Studies, Risk Factors, severity},\n}\n\n
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\n To understand the changes in RSV hospitalization burden in children younger than two years following the onset of the COVID-19 pandemic, we reviewed hospital records of children with acute lower respiratory infection (ALRI) between January 2018 and June 2022 in Split-Dalmatia County, Croatia. We compared RSV activity, age-specific annualized hospitalization rate, and disease severity between pre-COVID-19 and COVID-19 periods. A total of 942 ALRI hospital admissions were included. RSV activity remained low for the typical RSV epidemic during 2020-2021 winter. An out-of-season RSV resurgence was observed in late spring and summer of 2021. Before the COVID-19 pandemic, the annualized hospitalization rate for RSV-associated ALRI was 13.84/1000 (95% CI: 12.11-15.76) and highest among infants under six months. After the resurgence of RSV in the second half of 2021, the annualized hospitalization rate for RSV-associated ALRI in children younger than two years returned to the pre-pandemic levels with similar age distribution but a statistically higher proportion of severe cases. RSV immunization programs targeting protection of infants under six months of age are expected to remain impactful, although the optimal timing of administration would depend on RSV seasonality that has not yet been established in the study setting since the onset of the COVID-19 pandemic.\n
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\n \n\n \n \n \n \n \n Short-term local predictions of COVID-19 in the United Kingdom using dynamic supervised machine learning algorithms.\n \n \n \n\n\n \n Wang, X.; Dong, Y.; Thompson, W. D.; Nair, H.; and Li, Y.\n\n\n \n\n\n\n Communications medicine, 2: 119. 2022.\n Place: England\n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n\n\n\n
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@article{wang_short-term_2022,\n\ttitle = {Short-term local predictions of {COVID}-19 in the {United} {Kingdom} using dynamic supervised machine learning algorithms.},\n\tvolume = {2},\n\tcopyright = {© The Author(s) 2022.},\n\tissn = {2730-664X},\n\tdoi = {10.1038/s43856-022-00184-7},\n\tabstract = {BACKGROUND: Short-term prediction of COVID-19 epidemics is crucial to decision making. We aimed to develop supervised machine-learning algorithms on multiple  digital metrics including symptom search trends, population mobility, and  vaccination coverage to predict local-level COVID-19 growth rates in the UK.  METHODS: Using dynamic supervised machine-learning algorithms based on log-linear  regression, we explored optimal models for 1-week, 2-week, and 3-week ahead  prediction of COVID-19 growth rate at lower tier local authority level over time.  Model performance was assessed by calculating mean squared error (MSE) of  prospective prediction, and naïve model and fixed-predictors model were used as  reference models. We assessed real-time model performance for eight  five-weeks-apart checkpoints between 1st March and 14th November 2021. We  developed an online application (COVIDPredLTLA) that visualised the real-time  predictions for the present week, and the next one and two weeks. RESULTS: Here  we show that the median MSEs of the optimal models for 1-week, 2-week, and 3-week  ahead prediction are 0.12 (IQR: 0.08-0.22), 0.29 (0.19-0.38), and 0.37  (0.25-0.47), respectively. Compared with naïve models, the optimal models  maintain increased accuracy (reducing MSE by a range of 21-35\\%), including  May-June 2021 when the delta variant spread across the UK. Compared with the  fixed-predictors model, the advantage of dynamic models is observed after several  iterations of update. CONCLUSIONS: With flexible data-driven predictors selection  process, our dynamic modelling framework shows promises in predicting short-term  changes in COVID-19 cases. The online application (COVIDPredLTLA) could assist  decision-making for control measures and planning of healthcare capacity in  future epidemic growths.},\n\tlanguage = {eng},\n\tjournal = {Communications medicine},\n\tauthor = {Wang, Xin and Dong, Yijia and Thompson, William David and Nair, Harish and Li, You},\n\tyear = {2022},\n\tpmid = {36168444},\n\tpmcid = {PMC9509378},\n\tnote = {Place: England},\n\tkeywords = {Disease prevention, Epidemiology},\n\tpages = {119},\n}\n\n
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\n BACKGROUND: Short-term prediction of COVID-19 epidemics is crucial to decision making. We aimed to develop supervised machine-learning algorithms on multiple digital metrics including symptom search trends, population mobility, and vaccination coverage to predict local-level COVID-19 growth rates in the UK. METHODS: Using dynamic supervised machine-learning algorithms based on log-linear regression, we explored optimal models for 1-week, 2-week, and 3-week ahead prediction of COVID-19 growth rate at lower tier local authority level over time. Model performance was assessed by calculating mean squared error (MSE) of prospective prediction, and naïve model and fixed-predictors model were used as reference models. We assessed real-time model performance for eight five-weeks-apart checkpoints between 1st March and 14th November 2021. We developed an online application (COVIDPredLTLA) that visualised the real-time predictions for the present week, and the next one and two weeks. RESULTS: Here we show that the median MSEs of the optimal models for 1-week, 2-week, and 3-week ahead prediction are 0.12 (IQR: 0.08-0.22), 0.29 (0.19-0.38), and 0.37 (0.25-0.47), respectively. Compared with naïve models, the optimal models maintain increased accuracy (reducing MSE by a range of 21-35%), including May-June 2021 when the delta variant spread across the UK. Compared with the fixed-predictors model, the advantage of dynamic models is observed after several iterations of update. CONCLUSIONS: With flexible data-driven predictors selection process, our dynamic modelling framework shows promises in predicting short-term changes in COVID-19 cases. The online application (COVIDPredLTLA) could assist decision-making for control measures and planning of healthcare capacity in future epidemic growths.\n
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\n \n\n \n \n \n \n \n The role of respiratory co-infection with influenza or respiratory syncytial virus in the clinical severity of COVID-19 patients: A systematic review and meta-analysis.\n \n \n \n\n\n \n Cong, B.; Deng, S.; Wang, X.; and Li, Y.\n\n\n \n\n\n\n Journal of Global Health, 12: 05040. September 2022.\n \n\n\n\n
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@article{cong_role_2022,\n\ttitle = {The role of respiratory co-infection with influenza or respiratory syncytial virus in the clinical severity of {COVID}-19 patients: {A} systematic review and meta-analysis},\n\tvolume = {12},\n\tissn = {2047-2986},\n\tshorttitle = {The role of respiratory co-infection with influenza or respiratory syncytial virus in the clinical severity of {COVID}-19 patients},\n\tdoi = {10.7189/jogh.12.05040},\n\tabstract = {Background: With the easing of COVID-19 non-pharmaceutical interventions, the resurgence of both influenza and respiratory syncytial virus (RSV) was observed in several countries globally after remaining low in activity for over a year. However, whether co-infection with influenza or RSV influences disease severity in COVID-19 patients has not yet been determined clearly. We aimed to understand the impact of influenza/RSV co-infection on clinical disease severity among COVID-19 patients.\nMethods: We conducted a systematic literature review of publications comparing the clinical severity between the co-infection group (ie, influenza/RSV with SARS-CoV-2) and mono-infection group (ie, SARS-CoV-2), using the following four outcomes: need or use of supplemental oxygen, intensive care unit (ICU) admission, mechanical ventilation, and deaths. We summarized the results by clinical outcome and conducted random-effect meta-analyses where applicable.\nResults: Twelve studies reporting a total of 7862 COVID-19 patients were included in the review. Influenza and SARS-CoV-2 co-infection were found to be associated with a higher risk of ICU admission (five studies, odds ratio (OR) = 2.09, 95\\% confidence interval (CI) = 1.64-2.68) and mechanical ventilation (five studies, OR = 2.31, 95\\% CI = 1.10-4.85). No significant association was found between influenza co-infection and need/use of supplemental oxygen or deaths among COVID-19 patients (four studies, OR = 1.04, 95\\% CI = 0.37-2.95; 11 studies, OR = 1.41, 95\\% CI = 0.65-3.08, respectively). For RSV co-infection, data were only sufficient to allow for analyses for the outcome of deaths, and no significant association was found between RSV co-infection and deaths among COVID-19 patients (three studies, OR = 5.27, 95\\% CI = 0.58-47.87).\nConclusions: Existing evidence suggests that co-infection with influenza might be associated with a 2-fold increase in the risk for ICU admission and for mechanical ventilation among COVID-19 patients whereas evidence is limited on the role of RSV co-infection. Co-infection with influenza does not increase the risk of death in COVID-19 patients.\nRegistration: PROSEPRO CRD42021283045.},\n\tlanguage = {eng},\n\tjournal = {Journal of Global Health},\n\tauthor = {Cong, Bingbing and Deng, Shuyu and Wang, Xin and Li, You},\n\tmonth = sep,\n\tyear = {2022},\n\tpmid = {36112521},\n\tpmcid = {PMC9480863},\n\tkeywords = {COVID-19, Coinfection, Humans, Influenza, Human, Oxygen, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, SARS-CoV-2},\n\tpages = {05040},\n}\n\n
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\n Background: With the easing of COVID-19 non-pharmaceutical interventions, the resurgence of both influenza and respiratory syncytial virus (RSV) was observed in several countries globally after remaining low in activity for over a year. However, whether co-infection with influenza or RSV influences disease severity in COVID-19 patients has not yet been determined clearly. We aimed to understand the impact of influenza/RSV co-infection on clinical disease severity among COVID-19 patients. Methods: We conducted a systematic literature review of publications comparing the clinical severity between the co-infection group (ie, influenza/RSV with SARS-CoV-2) and mono-infection group (ie, SARS-CoV-2), using the following four outcomes: need or use of supplemental oxygen, intensive care unit (ICU) admission, mechanical ventilation, and deaths. We summarized the results by clinical outcome and conducted random-effect meta-analyses where applicable. Results: Twelve studies reporting a total of 7862 COVID-19 patients were included in the review. Influenza and SARS-CoV-2 co-infection were found to be associated with a higher risk of ICU admission (five studies, odds ratio (OR) = 2.09, 95% confidence interval (CI) = 1.64-2.68) and mechanical ventilation (five studies, OR = 2.31, 95% CI = 1.10-4.85). No significant association was found between influenza co-infection and need/use of supplemental oxygen or deaths among COVID-19 patients (four studies, OR = 1.04, 95% CI = 0.37-2.95; 11 studies, OR = 1.41, 95% CI = 0.65-3.08, respectively). For RSV co-infection, data were only sufficient to allow for analyses for the outcome of deaths, and no significant association was found between RSV co-infection and deaths among COVID-19 patients (three studies, OR = 5.27, 95% CI = 0.58-47.87). Conclusions: Existing evidence suggests that co-infection with influenza might be associated with a 2-fold increase in the risk for ICU admission and for mechanical ventilation among COVID-19 patients whereas evidence is limited on the role of RSV co-infection. Co-infection with influenza does not increase the risk of death in COVID-19 patients. Registration: PROSEPRO CRD42021283045.\n
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\n \n\n \n \n \n \n \n The role of birth month in the burden of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in Croatia.\n \n \n \n\n\n \n Li, Y.; Batinović, E.; Milić, P.; and Markić, J.\n\n\n \n\n\n\n PloS One, 17(9): e0273962. 2022.\n \n\n\n\n
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@article{li_role_2022,\n\ttitle = {The role of birth month in the burden of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in {Croatia}},\n\tvolume = {17},\n\tissn = {1932-6203},\n\tdoi = {10.1371/journal.pone.0273962},\n\tabstract = {BACKGROUND: Birth month was an important risk factor for respiratory syncytial virus (RSV) hospitalisation in infants. However, little is known about the role of birth month in RSV hospitalisation in finer age bands during infancy, which is relevant to strategies for RSV passive immunisations for infants. We aimed to understand the role of birth month in the burden of RSV-associated acute lower respiratory infection (ALRI) hospitalisation in finer age bands of the first year of life.\nMETHODS: In this retrospective study, we analysed the hospitalisation records during 2014-19 at the University Hospital of Split, Split-Dalmatia County, Croatia. We estimated all-cause and RSV associated ALRI hospitalisation rates among children under five years, with a focus on infants by finer age band and birth month.\nRESULTS: We included 1897 ALRI hospitalisations during the study period. Overall in children under five years, annual hospitalisation rate was 14.66/1000 (95\\% CI: 14.01-15.34) for all-cause ALRI, and was 7.56/1000 (95\\% CI: 6.83-8.34) for RSV-ALRI. RSV-ALRI hospitalisation rate was highest in infants aged 28 days-{\\textless}3 months (61.15/1000, 95\\% CI: 52.91-70.31). Infants born in November, December and January (2-3 months before RSV peak) had the highest hospitalisation rates during infancy. Depending on the birth month of infants, the risk of RSV-ALRI hospitalisation peaked at different months of age; infants who were born in September had the highest RSV-ALRI hospitalisation rate at the age of 3-{\\textless}6 months.\nCONCLUSIONS: Our study underlines the importance of birth month in planning RSV immunisation strategies for infants, and provides useful baseline data for effectiveness analysis of novel RSV prophylactic products.},\n\tlanguage = {eng},\n\tnumber = {9},\n\tjournal = {PloS One},\n\tauthor = {Li, You and Batinović, Ena and Milić, Petra and Markić, Joško},\n\tyear = {2022},\n\tpmid = {36054117},\n\tpmcid = {PMC9439187},\n\tkeywords = {Child, Child, Preschool, Croatia, Hospitalization, Humans, Infant, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, Retrospective Studies},\n\tpages = {e0273962},\n}\n\n
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\n BACKGROUND: Birth month was an important risk factor for respiratory syncytial virus (RSV) hospitalisation in infants. However, little is known about the role of birth month in RSV hospitalisation in finer age bands during infancy, which is relevant to strategies for RSV passive immunisations for infants. We aimed to understand the role of birth month in the burden of RSV-associated acute lower respiratory infection (ALRI) hospitalisation in finer age bands of the first year of life. METHODS: In this retrospective study, we analysed the hospitalisation records during 2014-19 at the University Hospital of Split, Split-Dalmatia County, Croatia. We estimated all-cause and RSV associated ALRI hospitalisation rates among children under five years, with a focus on infants by finer age band and birth month. RESULTS: We included 1897 ALRI hospitalisations during the study period. Overall in children under five years, annual hospitalisation rate was 14.66/1000 (95% CI: 14.01-15.34) for all-cause ALRI, and was 7.56/1000 (95% CI: 6.83-8.34) for RSV-ALRI. RSV-ALRI hospitalisation rate was highest in infants aged 28 days-\\textless3 months (61.15/1000, 95% CI: 52.91-70.31). Infants born in November, December and January (2-3 months before RSV peak) had the highest hospitalisation rates during infancy. Depending on the birth month of infants, the risk of RSV-ALRI hospitalisation peaked at different months of age; infants who were born in September had the highest RSV-ALRI hospitalisation rate at the age of 3-\\textless6 months. CONCLUSIONS: Our study underlines the importance of birth month in planning RSV immunisation strategies for infants, and provides useful baseline data for effectiveness analysis of novel RSV prophylactic products.\n
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\n \n\n \n \n \n \n \n Trends in the global burden of lower respiratory infections: the knowns and the unknowns.\n \n \n \n\n\n \n Li, Y.; and Nair, H.\n\n\n \n\n\n\n The Lancet Infectious Diseases,S1473309922004455. August 2022.\n \n\n\n\n
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@article{li_trends_2022,\n\ttitle = {Trends in the global burden of lower respiratory infections: the knowns and the unknowns},\n\tissn = {14733099},\n\tshorttitle = {Trends in the global burden of lower respiratory infections},\n\tdoi = {10.1016/S1473-3099(22)00445-5},\n\tlanguage = {en},\n\tjournal = {The Lancet Infectious Diseases},\n\tauthor = {Li, You and Nair, Harish},\n\tmonth = aug,\n\tyear = {2022},\n\tpages = {S1473309922004455},\n}\n\n
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\n \n\n \n \n \n \n \n Age-Specific Estimates of Respiratory Syncytial Virus-Associated Hospitalizations in 6 European Countries: A Time Series Analysis.\n \n \n \n\n\n \n Johannesen, C. K.; van Wijhe, M.; Tong, S.; Fernández, L. V.; Heikkinen, T.; van Boven, M.; Wang, X.; Bøås, H.; Li, Y.; Campbell, H.; Paget, J.; Stona, L.; Teirlinck, A.; Lehtonen, T.; Nohynek, H.; Bangert, M.; Fischer, T. K.; and RESCEU Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases,jiac150. June 2022.\n \n\n\n\n
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@article{johannesen_age-specific_2022,\n\ttitle = {Age-{Specific} {Estimates} of {Respiratory} {Syncytial} {Virus}-{Associated} {Hospitalizations} in 6 {European} {Countries}: {A} {Time} {Series} {Analysis}},\n\tissn = {1537-6613},\n\tshorttitle = {Age-{Specific} {Estimates} of {Respiratory} {Syncytial} {Virus}-{Associated} {Hospitalizations} in 6 {European} {Countries}},\n\tdoi = {10.1093/infdis/jiac150},\n\tabstract = {BACKGROUND: Knowledge on age-specific hospitalizations associated with RSV infection is limited due to limited testing, especially in older children and adults in whom RSV infections are not expected to be severe. Burden estimates based on RSV coding of hospital admissions are known to underestimate the burden of RSV. We aimed to provide robust and reliable age-specific burden estimates of RSV-associated hospital admissions based on data on respiratory infections from national health registers and laboratory-confirmed cases of RSV.\nMETHODS: We conducted multiseason regression analysis of weekly hospitalizations with respiratory infection and weekly laboratory-confirmed cases of RSV and influenza as covariates, based on national health registers and laboratory databases across 6 European countries. The burden of RSV-associated hospitalizations was estimated by age group, clinical diagnosis, and presence of underlying medical conditions.\nRESULTS: Across the 6 European countries, hospitalizations of children with respiratory infections were clearly associated with RSV, with associated proportions ranging from 28\\% to 60\\% in children younger than 3 months and we found substantial proportions of admissions to hospital with respiratory infections associated with RSV in children younger than 3 years. Associated proportions were highest among hospitalizations with ICD-10 codes of "bronchitis and bronchiolitis." In all 6 countries, annual incidence of RSV-associated hospitalizations was {\\textgreater}40 per 1000 persons in the age group 0-2 months. In age group 1-2 years the incidence rate ranged from 1.3 to 10.5 hospitalizations per 1000. Adults older than 85 years had hospitalizations with respiratory infection associated to RSV in all 6 countries although incidence rates were low.\nCONCLUSIONS: Our findings highlight the substantial proportion of RSV infections among hospital admissions across different ages and may help public health professionals and policy makers when planning prevention and control strategies. In addition, our findings provide valuable insights for health care professionals attending to both children and adults presenting with symptoms of viral respiratory infections.},\n\tlanguage = {eng},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Johannesen, Caroline K. and van Wijhe, Maarten and Tong, Sabine and Fernández, Liliana V. and Heikkinen, Terho and van Boven, Michiel and Wang, Xin and Bøås, Håkon and Li, You and Campbell, Harry and Paget, John and Stona, Luca and Teirlinck, Anne and Lehtonen, Toni and Nohynek, Hanna and Bangert, Mathieu and Fischer, Thea K. and {RESCEU Investigators}},\n\tmonth = jun,\n\tyear = {2022},\n\tpmid = {35748871},\n\tkeywords = {RSV, burden of disease, public health, respiratory syncytial virus, time series analysis, viral hospitalizations},\n\tpages = {jiac150},\n}\n\n
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\n BACKGROUND: Knowledge on age-specific hospitalizations associated with RSV infection is limited due to limited testing, especially in older children and adults in whom RSV infections are not expected to be severe. Burden estimates based on RSV coding of hospital admissions are known to underestimate the burden of RSV. We aimed to provide robust and reliable age-specific burden estimates of RSV-associated hospital admissions based on data on respiratory infections from national health registers and laboratory-confirmed cases of RSV. METHODS: We conducted multiseason regression analysis of weekly hospitalizations with respiratory infection and weekly laboratory-confirmed cases of RSV and influenza as covariates, based on national health registers and laboratory databases across 6 European countries. The burden of RSV-associated hospitalizations was estimated by age group, clinical diagnosis, and presence of underlying medical conditions. RESULTS: Across the 6 European countries, hospitalizations of children with respiratory infections were clearly associated with RSV, with associated proportions ranging from 28% to 60% in children younger than 3 months and we found substantial proportions of admissions to hospital with respiratory infections associated with RSV in children younger than 3 years. Associated proportions were highest among hospitalizations with ICD-10 codes of \"bronchitis and bronchiolitis.\" In all 6 countries, annual incidence of RSV-associated hospitalizations was \\textgreater40 per 1000 persons in the age group 0-2 months. In age group 1-2 years the incidence rate ranged from 1.3 to 10.5 hospitalizations per 1000. Adults older than 85 years had hospitalizations with respiratory infection associated to RSV in all 6 countries although incidence rates were low. CONCLUSIONS: Our findings highlight the substantial proportion of RSV infections among hospital admissions across different ages and may help public health professionals and policy makers when planning prevention and control strategies. In addition, our findings provide valuable insights for health care professionals attending to both children and adults presenting with symptoms of viral respiratory infections.\n
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\n \n\n \n \n \n \n \n Global Disease Burden of Respiratory Syncytial Virus in Preterm Children in 2019: A Systematic Review and Individual Participant Data Meta-Analysis Protocol.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Shi, T.; Ma, Y.; Wahi-Singh, B.; Riley, R. D.; and Nair, H.\n\n\n \n\n\n\n The Journal of Infectious Diseases,jiac078. April 2022.\n \n\n\n\n
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@article{wang_global_2022,\n\ttitle = {Global {Disease} {Burden} of {Respiratory} {Syncytial} {Virus} in {Preterm} {Children} in 2019: {A} {Systematic} {Review} and {Individual} {Participant} {Data} {Meta}-{Analysis} {Protocol}},\n\tissn = {1537-6613},\n\tshorttitle = {Global {Disease} {Burden} of {Respiratory} {Syncytial} {Virus} in {Preterm} {Children} in 2019},\n\tdoi = {10.1093/infdis/jiac078},\n\tabstract = {Existing guidelines on respiratory syncytial virus (RSV) prophylaxis differ greatly by gestational age (GA) and other underlying risk factors, highlighting the data gaps in RSV disease burden among preterm infants. We will conduct a systematic review and individual participant data (IPD) meta-analysis of RSV global disease burden among preterm-born children. Three databases, Medline, Embase, and Global Health, will be searched for relevant studies on RSV disease burden for 2019 or before in preterm-born children published between 1 January 1995 and 31 December 2021. IPD will be sought by contacting the investigators identified from published literature and from existing collaboration networks. One-stage and 2-stage random-effects meta-analyses will be used to combine information from IPD and non-IPD studies to produce summary RSV burden estimates of incidence rate, hospital admission rate, and in-hospital case fatality ratio. The framework will be extended to examine subgroup(s) with the most substantial RSV disease burden.},\n\tlanguage = {eng},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Wang, Xin and Li, You and Shi, Ting and Ma, Yiming and Wahi-Singh, Bhanu and Riley, Richard D. and Nair, Harish},\n\tmonth = apr,\n\tyear = {2022},\n\tpmid = {35478251},\n\tkeywords = {RSV, global disease burden, preterm},\n\tpages = {jiac078},\n}\n\n
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\n Existing guidelines on respiratory syncytial virus (RSV) prophylaxis differ greatly by gestational age (GA) and other underlying risk factors, highlighting the data gaps in RSV disease burden among preterm infants. We will conduct a systematic review and individual participant data (IPD) meta-analysis of RSV global disease burden among preterm-born children. Three databases, Medline, Embase, and Global Health, will be searched for relevant studies on RSV disease burden for 2019 or before in preterm-born children published between 1 January 1995 and 31 December 2021. IPD will be sought by contacting the investigators identified from published literature and from existing collaboration networks. One-stage and 2-stage random-effects meta-analyses will be used to combine information from IPD and non-IPD studies to produce summary RSV burden estimates of incidence rate, hospital admission rate, and in-hospital case fatality ratio. The framework will be extended to examine subgroup(s) with the most substantial RSV disease burden.\n
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\n \n\n \n \n \n \n \n Research priorities to reduce the impact of COVID-19 in low- and middle-income countries.\n \n \n \n\n\n \n Polašek, O.; Wazny, K.; Adeloye, D.; Song, P.; Chan, K. Y.; Bojude, D. A.; Ali, S.; Bastien, S.; Becerra-Posada, F.; Borrescio-Higa, F.; Cheema, S.; Cipta, D. A.; Cvjetković, S.; Castro, L. D.; Ebenso, B.; Femi-Ajao, O.; Ganesan, B.; Glasnović, A.; He, L.; Heraud, J. M.; Igwesi-Chidobe, C.; Iversen, P. O.; Jadoon, B.; Karim, A. J.; Khan, J.; Biswas, R. K.; Lanza, G.; Lee, S. W.; Li, Y.; Liang, L.; Lowe, M.; Islam, M. M.; Marušić, A.; Mshelia, S.; Manyara, A. M.; Htay, M. N.; Parisi, M.; Peprah, P.; Sacks, E.; Akinyemi, K. O.; Shahraki-Sanavi, F.; Sharov, K.; Rotarou, E. S.; Stankov, S.; Supriyatiningsih, W.; Chan, B. T.; Tremblay, M.; Tsimpida, D.; Vento, S.; Glasnović, J. V.; Wang, L.; Wang, X.; Ng, Z. X.; Zhang, J.; Zhang, Y.; Campbell, H.; Chopra, M.; Cousens, S.; Krstić, G.; Macdonald, C.; Mansoori, P.; Patel, S.; Sheikh, A.; Tomlinson, M.; Tsai, A. C.; Yoshida, S.; and Rudan, I.\n\n\n \n\n\n\n Journal of Global Health, 12: 09003. 2022.\n \n\n\n\n
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@article{polasek_research_2022,\n\ttitle = {Research priorities to reduce the impact of {COVID}-19 in low- and middle-income countries},\n\tvolume = {12},\n\tissn = {2047-2986},\n\tdoi = {10.7189/jogh.12.09003},\n\tabstract = {Background: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.\nMethods: The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.\nResults: Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.\nInterpretation: Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.},\n\tlanguage = {eng},\n\tjournal = {Journal of Global Health},\n\tauthor = {Polašek, Ozren and Wazny, Kerri and Adeloye, Davies and Song, Peige and Chan, Kit Y. and Bojude, Danladi A. and Ali, Sajjad and Bastien, Sheri and Becerra-Posada, Francisco and Borrescio-Higa, Florencia and Cheema, Sohaila and Cipta, Darien A. and Cvjetković, Smiljana and Castro, Lina D. and Ebenso, Bassey and Femi-Ajao, Omolade and Ganesan, Balasankar and Glasnović, Anton and He, Longtao and Heraud, Jean M. and Igwesi-Chidobe, Chinonso and Iversen, Per O. and Jadoon, Bismeen and Karim, Abdulkarim J. and Khan, Johra and Biswas, Raaj K. and Lanza, Giuseppe and Lee, Shaun Wh and Li, You and Liang, Li-Lin and Lowe, Mat and Islam, Mohammad M. and Marušić, Ana and Mshelia, Suleiman and Manyara, Anthony M. and Htay, Mila Nn and Parisi, Michelle and Peprah, Prince and Sacks, Emma and Akinyemi, Kabiru O. and Shahraki-Sanavi, Fariba and Sharov, Konstantin and Rotarou, Elena S. and Stankov, Srdjan and Supriyatiningsih, Wenang and Chan, Benjamin Ty and Tremblay, Mark and Tsimpida, Dialechti and Vento, Sandro and Glasnović, Josipa V. and Wang, Liang and Wang, Xin and Ng, Zhi X. and Zhang, Jianrong and Zhang, Yanfeng and Campbell, Harry and Chopra, Mickey and Cousens, Simon and Krstić, Goran and Macdonald, Calum and Mansoori, Parisa and Patel, Smruti and Sheikh, Aziz and Tomlinson, Mark and Tsai, Alexander C. and Yoshida, Sachiyo and Rudan, Igor},\n\tyear = {2022},\n\tpmid = {35475006},\n\tpmcid = {PMC9010705},\n\tkeywords = {COVID-19, COVID-19 Vaccines, Child, Developing Countries, Humans, Pandemics, Research Design},\n\tpages = {09003},\n}\n\n
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\n Background: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods: The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. Results: Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation: Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.\n
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\n \n\n \n \n \n \n \n Seasonality of respiratory syncytial virus and its association with meteorological factors in 13 European countries, week 40 2010 to week 39 2019.\n \n \n \n\n\n \n Li, Y.; Wang, X.; Broberg, E. K.; Campbell, H.; Nair, H.; and European RSV Surveillance Network\n\n\n \n\n\n\n Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 27(16). April 2022.\n \n\n\n\n
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@article{li_seasonality_2022,\n\ttitle = {Seasonality of respiratory syncytial virus and its association with meteorological factors in 13 {European} countries, week 40 2010 to week 39 2019},\n\tvolume = {27},\n\tissn = {1560-7917},\n\tdoi = {10.2807/1560-7917.ES.2022.27.16.2100619},\n\tabstract = {BackgroundRespiratory syncytial virus (RSV) is the predominant cause of clinical pneumonia among infants and young children, often peaking during the winter months in temperate regions.AimTo describe RSV seasonality in 13 European countries and examine its association with meteorological factors.MethodsWe included weekly RSV seasonality data from 13 European countries between week 40 2010 and week 39 2019. Using local weighted regression method, we modelled weekly RSV activity with meteorological factors using data from the 2010/11 to the 2017/18 season. We predicted the weekly RSV activity of the 2018/19 season across 41 European countries and validated our prediction using empirical data.ResultsAll countries had annual wintertime RSV seasons with a longitudinal gradient in RSV onset (Pearson's correlation coefficient, r = 0.71, 95\\% CI: 0.60 to 0.80). The RSV season started 3.8 weeks later (95\\% CI: -0.5 to 8.0) in countries in the eastern vs western parts of Europe, and the duration ranged from 8-18 weeks across seasons and countries. Lower temperature and higher relative humidity were associated with higher RSV activity, with a 14-day lag time. Through external validation, the prediction error in RSV season onset was -2.4 ± 3.2 weeks. Similar longitudinal gradients in RSV onset were predicted by our model for the 2018/19 season (r = 0.45, 95\\% CI: 0.16 to 0.66).ConclusionMeteorological factors, such as temperature and relative humidity, could be used for early warning of RSV season onset. Our findings may inform healthcare services planning and optimisation of RSV immunisation strategies in Europe.},\n\tlanguage = {eng},\n\tnumber = {16},\n\tjournal = {Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin},\n\tauthor = {Li, You and Wang, Xin and Broberg, Eeva K. and Campbell, Harry and Nair, Harish and {European RSV Surveillance Network}},\n\tmonth = apr,\n\tyear = {2022},\n\tpmid = {35451364},\n\tpmcid = {PMC9027150},\n\tkeywords = {Child, Child, Preschool, Europe, Humans, Infant, Meteorological Concepts, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Seasons, Europe, Respiratory syncytial virus, humidity, seasonality, temperature},\n}\n\n
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\n BackgroundRespiratory syncytial virus (RSV) is the predominant cause of clinical pneumonia among infants and young children, often peaking during the winter months in temperate regions.AimTo describe RSV seasonality in 13 European countries and examine its association with meteorological factors.MethodsWe included weekly RSV seasonality data from 13 European countries between week 40 2010 and week 39 2019. Using local weighted regression method, we modelled weekly RSV activity with meteorological factors using data from the 2010/11 to the 2017/18 season. We predicted the weekly RSV activity of the 2018/19 season across 41 European countries and validated our prediction using empirical data.ResultsAll countries had annual wintertime RSV seasons with a longitudinal gradient in RSV onset (Pearson's correlation coefficient, r = 0.71, 95% CI: 0.60 to 0.80). The RSV season started 3.8 weeks later (95% CI: -0.5 to 8.0) in countries in the eastern vs western parts of Europe, and the duration ranged from 8-18 weeks across seasons and countries. Lower temperature and higher relative humidity were associated with higher RSV activity, with a 14-day lag time. Through external validation, the prediction error in RSV season onset was -2.4 ± 3.2 weeks. Similar longitudinal gradients in RSV onset were predicted by our model for the 2018/19 season (r = 0.45, 95% CI: 0.16 to 0.66).ConclusionMeteorological factors, such as temperature and relative humidity, could be used for early warning of RSV season onset. Our findings may inform healthcare services planning and optimisation of RSV immunisation strategies in Europe.\n
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\n \n\n \n \n \n \n \n Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis.\n \n \n \n\n\n \n Li, Y.; Wang, X.; Blau, D. M.; Caballero, M. T.; Feikin, D. R.; Gill, C. J.; Madhi, S. A.; Omer, S. B.; Simões, E. A. F.; Campbell, H.; Pariente, A. B.; Bardach, D.; Bassat, Q.; Casalegno, J.; Chakhunashvili, G.; Crawford, N.; Danilenko, D.; Do, L. A. H.; Echavarria, M.; Gentile, A.; Gordon, A.; Heikkinen, T.; Huang, Q. S.; Jullien, S.; Krishnan, A.; Lopez, E. L.; Markić, J.; Mira-Iglesias, A.; Moore, H. C.; Moyes, J.; Mwananyanda, L.; Nokes, D. J.; Noordeen, F.; Obodai, E.; Palani, N.; Romero, C.; Salimi, V.; Satav, A.; Seo, E.; Shchomak, Z.; Singleton, R.; Stolyarov, K.; Stoszek, S. K.; von Gottberg, A.; Wurzel, D.; Yoshida, L.; Yung, C. F.; Zar, H. J.; Respiratory Virus Global Epidemiology Network; Nair, H.; and RESCEU investigators\n\n\n \n\n\n\n Lancet (London, England), 399(10340): 2047–2064. May 2022.\n \n\n\n\n
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@article{li_global_2022,\n\ttitle = {Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis},\n\tvolume = {399},\n\tissn = {1474-547X},\n\tshorttitle = {Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019},\n\tdoi = {10.1016/S0140-6736(22)00478-0},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0-60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development.\nMETHODS: In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0-60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400).\nFINDINGS: In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33·0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25·4-44·6 million), 3·6 million RSV-associated acute lower respiratory infection hospital admissions (2·9-4·6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15 100-49 100), and 101 400 RSV-attributable overall deaths (84 500-125 200) in children aged 0-60 months. In infants aged 0-6 months, we estimated that there were 6·6 million RSV-associated acute lower respiratory infection episodes (4·6-9·7 million), 1·4 million RSV-associated acute lower respiratory infection hospital admissions (1·0-2·0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800-28 100), and 45 700 RSV-attributable overall deaths (38 400-55 900). 2·0\\% of deaths in children aged 0-60 months (UR 1·6-2·4) and 3·6\\% of deaths in children aged 28 days to 6 months (3·0-4·4) were attributable to RSV. More than 95\\% of RSV-associated acute lower respiratory infection episodes and more than 97\\% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs).\nINTERPRETATION: RSV contributes substantially to morbidity and mortality burden globally in children aged 0-60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented.\nFUNDING: EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).},\n\tlanguage = {eng},\n\tnumber = {10340},\n\tjournal = {Lancet (London, England)},\n\tauthor = {Li, You and Wang, Xin and Blau, Dianna M. and Caballero, Mauricio T. and Feikin, Daniel R. and Gill, Christopher J. and Madhi, Shabir A. and Omer, Saad B. and Simões, Eric A. F. and Campbell, Harry and Pariente, Ana Bermejo and Bardach, Darmaa and Bassat, Quique and Casalegno, Jean-Sebastien and Chakhunashvili, Giorgi and Crawford, Nigel and Danilenko, Daria and Do, Lien Anh Ha and Echavarria, Marcela and Gentile, Angela and Gordon, Aubree and Heikkinen, Terho and Huang, Q. Sue and Jullien, Sophie and Krishnan, Anand and Lopez, Eduardo Luis and Markić, Joško and Mira-Iglesias, Ainara and Moore, Hannah C. and Moyes, Jocelyn and Mwananyanda, Lawrence and Nokes, D. James and Noordeen, Faseeha and Obodai, Evangeline and Palani, Nandhini and Romero, Candice and Salimi, Vahid and Satav, Ashish and Seo, Euri and Shchomak, Zakhar and Singleton, Rosalyn and Stolyarov, Kirill and Stoszek, Sonia K. and von Gottberg, Anne and Wurzel, Danielle and Yoshida, Lay-Myint and Yung, Chee Fu and Zar, Heather J. and {Respiratory Virus Global Epidemiology Network} and Nair, Harish and {RESCEU investigators}},\n\tmonth = may,\n\tyear = {2022},\n\tpmid = {35598608},\n\tkeywords = {Child, Child, Preschool, Cost of Illness, Global Health, Hospital Mortality, Hospitalization, Humans, Infant, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Respiratory Tract Infections},\n\tpages = {2047--2064},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0-60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development. METHODS: In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0-60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400). FINDINGS: In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33·0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25·4-44·6 million), 3·6 million RSV-associated acute lower respiratory infection hospital admissions (2·9-4·6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15 100-49 100), and 101 400 RSV-attributable overall deaths (84 500-125 200) in children aged 0-60 months. In infants aged 0-6 months, we estimated that there were 6·6 million RSV-associated acute lower respiratory infection episodes (4·6-9·7 million), 1·4 million RSV-associated acute lower respiratory infection hospital admissions (1·0-2·0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800-28 100), and 45 700 RSV-attributable overall deaths (38 400-55 900). 2·0% of deaths in children aged 0-60 months (UR 1·6-2·4) and 3·6% of deaths in children aged 28 days to 6 months (3·0-4·4) were attributable to RSV. More than 95% of RSV-associated acute lower respiratory infection episodes and more than 97% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs). INTERPRETATION: RSV contributes substantially to morbidity and mortality burden globally in children aged 0-60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented. FUNDING: EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).\n
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\n \n\n \n \n \n \n \n A Systematic Review of European Clinical Practice Guidelines for Respiratory Syncytial Virus Prophylaxis.\n \n \n \n\n\n \n Reeves, R. M.; van Wijhe, M.; Lehtonen, T.; Stona, L.; Teirlinck, A. C.; Vazquez Fernandez, L.; Li, Y.; Osei-Yeboah, R.; Fischer, T. K.; Heikkinen, T.; van Boven, M.; Bøås, H.; Donà, D.; Barbieri, E.; Campbell, H.; and RESCEU Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases,jiac059. March 2022.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n  \n \n 1 download\n \n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n\n\n\n
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@article{reeves_systematic_2022,\n\ttitle = {A {Systematic} {Review} of {European} {Clinical} {Practice} {Guidelines} for {Respiratory} {Syncytial} {Virus} {Prophylaxis}},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiac059},\n\tabstract = {BACKGROUND: Since the widespread adoption of palivizumab prophylaxis in Europe, there have been a number of clinical practice guidelines (CPGs) published for the prevention of respiratory syncytial virus (RSV) infection in children. The aim of this systematic review was to identify CPGs for the prevention of RSV infection across Europe.\nMETHODS: We performed a systematic literature search and contacted European influenza and respiratory virus networks and public health institutions, to identify national CPGs for the prevention of RSV infection. The Reporting Items for practice Guidelines in Healthcare (RIGHT) Statement checklist was applied to extract data and review the quality of reporting.\nRESULTS: A total of 20 national CPGs were identified, all published between 2000 and 2018. The greatest discrepancy between guidelines was the recommendations for palivizumab prophylaxis for premature infants, with recommendations varying by gestational age. All guidelines recommended or considered the use of palivizumab in infants with bronchopulmonary dysplasia, 85\\% (n = 17) in children with congenital heart disease (CHD), and 60\\% (n = 12) in children with severe combined immunodeficiency.\nCONCLUSIONS: We recommend that agencies publishing RSV prevention guidelines adopt the RIGHT reporting requirements when updating these guidelines to improve the presentation of the evidence-base for decisions.},\n\tlanguage = {eng},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Reeves, Rachel M. and van Wijhe, Maarten and Lehtonen, Toni and Stona, Luca and Teirlinck, Anne C. and Vazquez Fernandez, Liliana and Li, You and Osei-Yeboah, Richard and Fischer, Thea K. and Heikkinen, Terho and van Boven, Michiel and Bøås, Håkon and Donà, Daniele and Barbieri, Elisa and Campbell, Harry and {RESCEU Investigators\n}},\n\tmonth = mar,\n\tyear = {2022},\n\tpmid = {35333332},\n\tkeywords = {RSV guidelines Europe, palivizumab, prophylaxis},\n\tpages = {jiac059},\n}\n\n
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\n BACKGROUND: Since the widespread adoption of palivizumab prophylaxis in Europe, there have been a number of clinical practice guidelines (CPGs) published for the prevention of respiratory syncytial virus (RSV) infection in children. The aim of this systematic review was to identify CPGs for the prevention of RSV infection across Europe. METHODS: We performed a systematic literature search and contacted European influenza and respiratory virus networks and public health institutions, to identify national CPGs for the prevention of RSV infection. The Reporting Items for practice Guidelines in Healthcare (RIGHT) Statement checklist was applied to extract data and review the quality of reporting. RESULTS: A total of 20 national CPGs were identified, all published between 2000 and 2018. The greatest discrepancy between guidelines was the recommendations for palivizumab prophylaxis for premature infants, with recommendations varying by gestational age. All guidelines recommended or considered the use of palivizumab in infants with bronchopulmonary dysplasia, 85% (n = 17) in children with congenital heart disease (CHD), and 60% (n = 12) in children with severe combined immunodeficiency. CONCLUSIONS: We recommend that agencies publishing RSV prevention guidelines adopt the RIGHT reporting requirements when updating these guidelines to improve the presentation of the evidence-base for decisions.\n
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\n \n\n \n \n \n \n \n Understanding the Potential Drivers for Respiratory Syncytial Virus Rebound During the Coronavirus Disease 2019 Pandemic.\n \n \n \n\n\n \n Li, Y.; Wang, X.; Cong, B.; Deng, S.; Feikin, D. R.; and Nair, H.\n\n\n \n\n\n\n The Journal of Infectious Diseases, 225(6): 957–964. March 2022.\n \n\n\n\n
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@article{li_understanding_2022,\n\ttitle = {Understanding the {Potential} {Drivers} for {Respiratory} {Syncytial} {Virus} {Rebound} {During} the {Coronavirus} {Disease} 2019 {Pandemic}},\n\tvolume = {225},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiab606},\n\tabstract = {Nonpharmaceutical interventions (NPIs) were widely introduced to combat the coronavirus disease 2019 (COVID-19) pandemic. These interventions also likely led to substantially reduced activity of respiratory syncytial virus (RSV). From late 2020, some countries observed out-of-season RSV epidemics. Here, we analyzed the role of NPIs, population mobility, climate, and severe acute respiratory syndrome coronavirus 2 circulation in RSV rebound through a time-to-event analysis across 18 countries. Full (re)opening of schools was associated with an increased risk for RSV rebound (hazard ratio [HR], 23.29 [95\\% confidence interval \\{CI\\}, 1.09-495.84]); every 5°C increase in temperature was associated with a decreased risk (HR, 0.63 [95\\% CI, .40-.99]). There was an increasing trend in the risk for RSV rebound over time, highlighting the role of increased population susceptibility. No other factors were found to be statistically significant. Further analysis suggests that increasing population susceptibility and full (re)opening of schools could both override the countereffect of high temperatures, which explains the out-of-season RSV epidemics during the COVID-19 pandemic.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Li, You and Wang, Xin and Cong, Bingbing and Deng, Shuyu and Feikin, Daniel R. and Nair, Harish},\n\tmonth = mar,\n\tyear = {2022},\n\tpmid = {35030633},\n\tpmcid = {PMC8807230},\n\tkeywords = {COVID-19, Climate, Humans, Pandemics, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Seasons, Temperature, COVID-19, humidity, nonpharmaceutical intervention, pandemic, respiratory syncytial virus, school, seasonality, susceptibility, temperature, wind speed},\n\tpages = {957--964},\n}\n\n
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\n Nonpharmaceutical interventions (NPIs) were widely introduced to combat the coronavirus disease 2019 (COVID-19) pandemic. These interventions also likely led to substantially reduced activity of respiratory syncytial virus (RSV). From late 2020, some countries observed out-of-season RSV epidemics. Here, we analyzed the role of NPIs, population mobility, climate, and severe acute respiratory syndrome coronavirus 2 circulation in RSV rebound through a time-to-event analysis across 18 countries. Full (re)opening of schools was associated with an increased risk for RSV rebound (hazard ratio [HR], 23.29 [95% confidence interval \\CI\\, 1.09-495.84]); every 5°C increase in temperature was associated with a decreased risk (HR, 0.63 [95% CI, .40-.99]). There was an increasing trend in the risk for RSV rebound over time, highlighting the role of increased population susceptibility. No other factors were found to be statistically significant. Further analysis suggests that increasing population susceptibility and full (re)opening of schools could both override the countereffect of high temperatures, which explains the out-of-season RSV epidemics during the COVID-19 pandemic.\n
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\n \n\n \n \n \n \n \n Respiratory Syncytial Virus-Associated Hospital Admissions and Bed Days in Children \\textless5 Years of Age in 7 European Countries.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Vazquez Fernandez, L.; Teirlinck, A. C.; Lehtonen, T.; van Wijhe, M.; Stona, L.; Bangert, M.; Reeves, R. M.; Bøås, H.; van Boven, M.; Heikkinen, T.; Klint Johannesen, C.; Baraldi, E.; Donà, D.; Tong, S.; Campbell, H.; and Respiratory Syncytial Virus Consortium in Europe (RESCEU) Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases,jiab560. January 2022.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{wang_respiratory_2022,\n\ttitle = {Respiratory {Syncytial} {Virus}-{Associated} {Hospital} {Admissions} and {Bed} {Days} in {Children} {\\textless}5 {Years} of {Age} in 7 {European} {Countries}},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiab560},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infections (RTIs) in young children. High-quality country-specific estimates of bed days and length of stay (LOS) show the population burden of RSV-RTI on secondary care services and the burden among patients, and can be used to inform RSV immunization implementation decisions.\nMETHODS: We estimated the hospital burden of RSV-associated RTI (RSV-RTI) in children under 5 years in 7 European countries (Finland, Denmark, Norway, Scotland, England, the Netherlands, and Italy) using routinely collected hospital databases during 2001-2018. We described RSV-RTI admission rates during the first year of life by birth month and assessed their correlation with RSV seasonality in 5 of the countries (except for England and Italy). We estimated average annual numbers and rates of bed days for RSV-RTI and other-pathogen RTI, as well as the hospital LOS.\nRESULTS: We found that infants born 2 months before the peak month of RSV epidemics more frequently had the highest RSV-RTI hospital admission rate. RSV-RTI hospital episodes accounted for 9.9-21.2 bed days per 1000 children aged {\\textless}5 years annually, with the median (interquartile range) LOS ranging from 2 days (0.5-4 days) to 4 days (2-6 days) between countries. Between 70\\% and 89\\% of these bed days were in infants aged {\\textless}1 year, representing 40.3 (95\\% confidence interval [CI], 40.1-40.4) to 91.2 (95\\% CI, 90.6-91.8) bed days per 1000 infants annually. The number of bed days for RSV-RTI was higher than that for RTIs associated with other pathogens in infants aged {\\textless}1 year, especially in those {\\textless}6 months.\nCONCLUSIONS: RSV disease prevention therapies (monoclonal antibodies and maternal vaccines) for infants could help prevent a substantial number of bed days due to RSV-RTI. "High-risk" birth months should be considered when developing RSV immunization schedules. Variation in LOS between countries might reflect differences in hospital care practices.},\n\tlanguage = {eng},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Wang, Xin and Li, You and Vazquez Fernandez, Liliana and Teirlinck, Anne C. and Lehtonen, Toni and van Wijhe, Maarten and Stona, Luca and Bangert, Mathieu and Reeves, Rachel M. and Bøås, Håkon and van Boven, Michiel and Heikkinen, Terho and Klint Johannesen, Caroline and Baraldi, Eugenio and Donà, Daniele and Tong, Sabine and Campbell, Harry and {Respiratory Syncytial Virus Consortium in Europe (RESCEU) Investigators\n}},\n\tmonth = jan,\n\tyear = {2022},\n\tpmid = {35023567},\n\tkeywords = {Europe, bed days, birth month, hospital admission, respiratory syncytial virus},\n\tpages = {jiab560},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infections (RTIs) in young children. High-quality country-specific estimates of bed days and length of stay (LOS) show the population burden of RSV-RTI on secondary care services and the burden among patients, and can be used to inform RSV immunization implementation decisions. METHODS: We estimated the hospital burden of RSV-associated RTI (RSV-RTI) in children under 5 years in 7 European countries (Finland, Denmark, Norway, Scotland, England, the Netherlands, and Italy) using routinely collected hospital databases during 2001-2018. We described RSV-RTI admission rates during the first year of life by birth month and assessed their correlation with RSV seasonality in 5 of the countries (except for England and Italy). We estimated average annual numbers and rates of bed days for RSV-RTI and other-pathogen RTI, as well as the hospital LOS. RESULTS: We found that infants born 2 months before the peak month of RSV epidemics more frequently had the highest RSV-RTI hospital admission rate. RSV-RTI hospital episodes accounted for 9.9-21.2 bed days per 1000 children aged \\textless5 years annually, with the median (interquartile range) LOS ranging from 2 days (0.5-4 days) to 4 days (2-6 days) between countries. Between 70% and 89% of these bed days were in infants aged \\textless1 year, representing 40.3 (95% confidence interval [CI], 40.1-40.4) to 91.2 (95% CI, 90.6-91.8) bed days per 1000 infants annually. The number of bed days for RSV-RTI was higher than that for RTIs associated with other pathogens in infants aged \\textless1 year, especially in those \\textless6 months. CONCLUSIONS: RSV disease prevention therapies (monoclonal antibodies and maternal vaccines) for infants could help prevent a substantial number of bed days due to RSV-RTI. \"High-risk\" birth months should be considered when developing RSV immunization schedules. Variation in LOS between countries might reflect differences in hospital care practices.\n
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\n \n\n \n \n \n \n \n Nasopharyngeal pneumococcal carriage in South Asian infants: Results of observational cohort studies in vaccinated and unvaccinated populations.\n \n \n \n\n\n \n Apte, A.; Dayma, G.; Naziat, H.; Williams, L.; Sanghavi, S.; Uddin, J.; Kawade, A.; Islam, M.; Kar, S.; Li, Y.; Kyaw, M. H.; Juvekar, S.; Campbell, H.; Nair, H.; Saha, S. K.; and Bavdekar, A.\n\n\n \n\n\n\n Journal of Global Health, 11: 04054. 2021.\n \n\n\n\n
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@article{apte_nasopharyngeal_2021,\n\ttitle = {Nasopharyngeal pneumococcal carriage in {South} {Asian} infants: {Results} of observational cohort studies in vaccinated and unvaccinated populations},\n\tvolume = {11},\n\tissn = {2047-2986},\n\tshorttitle = {Nasopharyngeal pneumococcal carriage in {South} {Asian} infants},\n\tdoi = {10.7189/jogh.11.04054},\n\tabstract = {Background: Nasopharyngeal pneumococcal carriage (NPC) is a prerequisite for invasive pneumococcal disease and reduced carriage of vaccine serotypes is a marker for the protection offered by the pneumococcal conjugate vaccine (PCV). The present study reports NPC during the first year of life in a vaccinated (with PCV10) cohort in Bangladesh and an unvaccinated cohort in India.\nMethods: A total of 450 and 459 infants were recruited from India and Bangladesh respectively within 0-7 days after birth. Nasopharyngeal swabs were collected at baseline, 18 and 36 weeks after birth. The swabs were processed for pneumococcal culture and identification of serotypes by the Quellung test and polymerase chain reaction (PCR). An identical protocol was applied at both sites.\nResults: Prevalence of NPC was 48\\% in the Indian and 54.8\\% in the Bangladeshi cohort at 18 weeks. It increased to 53\\% and 64.8\\% respectively at 36 weeks. The average prevalence of vaccine serotypes was higher in the Indian cohort (17.8\\% vs 9.8\\% for PCV-10 and 26.1\\% vs17.6\\% for PCV-13) with 6A, 6B, 19F, 23F, and 19A as the common serotypes. On the other hand, the prevalence of non-vaccine serotypes was higher (43.6\\% vs 27.1\\% for non-PCV13) in the Bangladeshi cohort with 34, 15B, 17F, and 35B as the common serotypes. Overcrowding was associated with increased risk of pneumococcal carriage. The present PCV-13 vaccine would cover 28\\%-30\\% and 47\\%-48\\% serotypes in the Bangladeshi and Indian cohorts respectively.\nConclusions: South Asian infants get colonised with pneumococci early in infancy; predominantly vaccine serotypes in PCV naïve population (India) and non-vaccine serotypes in the vaccinated population (Bangladesh). These local findings are important to inform the public health policy and the development of higher valent pneumococcal vaccines.},\n\tlanguage = {eng},\n\tjournal = {Journal of Global Health},\n\tauthor = {Apte, Aditi and Dayma, Girish and Naziat, Hakka and Williams, Linda and Sanghavi, Sonali and Uddin, Jamal and Kawade, Anand and Islam, Maksuda and Kar, Sanchita and Li, You and Kyaw, Moe H. and Juvekar, Sanjay and Campbell, Harry and Nair, Harish and Saha, Samir K. and Bavdekar, Ashish},\n\tyear = {2021},\n\tpmid = {34552723},\n\tpmcid = {PMC8442578},\n\tkeywords = {Carrier State, Cohort Studies, Humans, Infant, Nasopharynx, Pneumococcal Vaccines, Serogroup, Streptococcus pneumoniae},\n\tpages = {04054},\n}\n\n
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\n Background: Nasopharyngeal pneumococcal carriage (NPC) is a prerequisite for invasive pneumococcal disease and reduced carriage of vaccine serotypes is a marker for the protection offered by the pneumococcal conjugate vaccine (PCV). The present study reports NPC during the first year of life in a vaccinated (with PCV10) cohort in Bangladesh and an unvaccinated cohort in India. Methods: A total of 450 and 459 infants were recruited from India and Bangladesh respectively within 0-7 days after birth. Nasopharyngeal swabs were collected at baseline, 18 and 36 weeks after birth. The swabs were processed for pneumococcal culture and identification of serotypes by the Quellung test and polymerase chain reaction (PCR). An identical protocol was applied at both sites. Results: Prevalence of NPC was 48% in the Indian and 54.8% in the Bangladeshi cohort at 18 weeks. It increased to 53% and 64.8% respectively at 36 weeks. The average prevalence of vaccine serotypes was higher in the Indian cohort (17.8% vs 9.8% for PCV-10 and 26.1% vs17.6% for PCV-13) with 6A, 6B, 19F, 23F, and 19A as the common serotypes. On the other hand, the prevalence of non-vaccine serotypes was higher (43.6% vs 27.1% for non-PCV13) in the Bangladeshi cohort with 34, 15B, 17F, and 35B as the common serotypes. Overcrowding was associated with increased risk of pneumococcal carriage. The present PCV-13 vaccine would cover 28%-30% and 47%-48% serotypes in the Bangladeshi and Indian cohorts respectively. Conclusions: South Asian infants get colonised with pneumococci early in infancy; predominantly vaccine serotypes in PCV naïve population (India) and non-vaccine serotypes in the vaccinated population (Bangladesh). These local findings are important to inform the public health policy and the development of higher valent pneumococcal vaccines.\n
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\n \n\n \n \n \n \n \n Time-Varying Association Between Severe Respiratory Syncytial Virus Infections and Subsequent Severe Asthma and Wheeze and Influences of Age at the Infection.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Nair, H.; Campbell, H.; and RESCEU Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases,jiab308. September 2021.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n  \n \n 2 downloads\n \n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{wang_time-varying_2021,\n\ttitle = {Time-{Varying} {Association} {Between} {Severe} {Respiratory} {Syncytial} {Virus} {Infections} and {Subsequent} {Severe} {Asthma} and {Wheeze} and {Influences} of {Age} at the {Infection}},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiab308},\n\tabstract = {BACKGROUND: Early-life severe respiratory syncytial virus (RSV) infection has been associated with subsequent risk of asthma and recurrent wheeze. However, changes in the association over time and the interaction effect of the age at first RSV infection are less well understood. We aimed to assess the time-varying association between RSV and subsequent asthma and wheeze admission and explore how the association was affected by the age at RSV infection.\nMETHODS: We retrospectively followed up a cohort of 23 365 children for a median of 6.9 years using Scottish health databases. Children who were born between 2001 and 2013 and had RSV-associated respiratory tract infection (RTI) admissions under 2 years were in the exposed group; those with unintentional accident admissions under 2 years comprised the control group. The Cox proportional-hazards model was used to report adjusted hazard ratios (HRs) of RSV admissions on subsequent asthma and wheeze admissions. We did subgroup analyses by follow-up years. We also explored how this association was affected by the age at first RSV admission.\nRESULTS: The association was strongest in the first 2 years of follow-up and decreased over time. The association persisted for 6 years in children whose first RSV-RTI admission occurred at 6-23 months of age, with an adjusted HR of 3.9 (95\\% confidence interval [CI], 3.1-4.9) for the first 2 years, 2.3 (95\\% CI, 1.6-3.2) for 2 to {\\textless}4 years, and 1.9 (95\\% CI, 1.2-2.9) for 4 to {\\textless}6 years of follow-up. In contrast, the association was only significant for the first 2 years after first RSV-RTI admissions occurring at 0-5 months.\nCONCLUSIONS: We found a more persistent association for subsequent asthma and wheeze in children whose first severe RSV infection occurred at 6-23 months compared to those whose first severe RSV infection occurred at 0-6 months. This provides new evidence for further assessment of the association and RSV intervention programs.},\n\tlanguage = {eng},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Wang, Xin and Li, You and Nair, Harish and Campbell, Harry and {RESCEU Investigators\n}},\n\tmonth = sep,\n\tyear = {2021},\n\tpmid = {34522963},\n\tkeywords = {age at first RSV infection, asthma, severe RSV infections, time since RSV infection, wheeze},\n\tpages = {jiab308},\n}\n\n
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\n BACKGROUND: Early-life severe respiratory syncytial virus (RSV) infection has been associated with subsequent risk of asthma and recurrent wheeze. However, changes in the association over time and the interaction effect of the age at first RSV infection are less well understood. We aimed to assess the time-varying association between RSV and subsequent asthma and wheeze admission and explore how the association was affected by the age at RSV infection. METHODS: We retrospectively followed up a cohort of 23 365 children for a median of 6.9 years using Scottish health databases. Children who were born between 2001 and 2013 and had RSV-associated respiratory tract infection (RTI) admissions under 2 years were in the exposed group; those with unintentional accident admissions under 2 years comprised the control group. The Cox proportional-hazards model was used to report adjusted hazard ratios (HRs) of RSV admissions on subsequent asthma and wheeze admissions. We did subgroup analyses by follow-up years. We also explored how this association was affected by the age at first RSV admission. RESULTS: The association was strongest in the first 2 years of follow-up and decreased over time. The association persisted for 6 years in children whose first RSV-RTI admission occurred at 6-23 months of age, with an adjusted HR of 3.9 (95% confidence interval [CI], 3.1-4.9) for the first 2 years, 2.3 (95% CI, 1.6-3.2) for 2 to \\textless4 years, and 1.9 (95% CI, 1.2-2.9) for 4 to \\textless6 years of follow-up. In contrast, the association was only significant for the first 2 years after first RSV-RTI admissions occurring at 0-5 months. CONCLUSIONS: We found a more persistent association for subsequent asthma and wheeze in children whose first severe RSV infection occurred at 6-23 months compared to those whose first severe RSV infection occurred at 0-6 months. This provides new evidence for further assessment of the association and RSV intervention programs.\n
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\n \n\n \n \n \n \n \n The association of community mobility with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 330 local UK authorities.\n \n \n \n\n\n \n Li, Y.; Wang, X.; Campbell, H.; Nair, H.; and Usher Network for COVID-19 Evidence Reviews (UNCOVER) group\n\n\n \n\n\n\n The Lancet. Digital Health, 3(10): e676–e683. October 2021.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{li_association_2021,\n\ttitle = {The association of community mobility with the time-varying reproduction number ({R}) of {SARS}-{CoV}-2: a modelling study across 330 local {UK} authorities},\n\tvolume = {3},\n\tissn = {2589-7500},\n\tshorttitle = {The association of community mobility with the time-varying reproduction number ({R}) of {SARS}-{CoV}-2},\n\tdoi = {10.1016/S2589-7500(21)00144-8},\n\tabstract = {BACKGROUND: Community mobility data have been used to assess adherence to non-pharmaceutical interventions and its impact on SARS-CoV-2 transmission. We assessed the association between location-specific community mobility and the reproduction number (R) of SARS-CoV-2 across UK local authorities.\nMETHODS: In this modelling study, we linked data on community mobility from Google with data on R from 330 UK local authorities, for the period June 1, 2020, to Feb 13, 2021. Six mobility metrics are available in the Google community mobility dataset: visits to retail and recreation places, visits to grocery and pharmacy stores, visits to transit stations, visits to parks, visits to workplaces, and length of stay in residential places. For each local authority, we modelled the weekly change in R (the R ratio) per a rescaled weekly percentage change in each location-specific mobility metric relative to a pre-pandemic baseline period (Jan 3-Feb 6, 2020), with results synthesised across local authorities using a random-effects meta-analysis.\nFINDINGS: On a weekly basis, increased visits to retail and recreation places were associated with a substantial increase in R (R ratio 1·053 [99·2\\% CI 1·041-1·065] per 15\\% weekly increase compared with baseline visits) as were increased visits to workplaces (R ratio 1·060 [1·046-1·074] per 10\\% increase compared with baseline visits). By comparison, increased visits to grocery and pharmacy stores were associated with a small but still statistically significant increase in R (R ratio 1·011 [1·005-1·017] per 5\\% weekly increase compared with baseline visits). Increased visits to parks were associated with a decreased R (R ratio 0·972 [0·965-0·980]), as were longer stays at residential areas (R ratio 0·952 [0·928-0·976]). Increased visits to transit stations were not associated with R nationally, but were associated with a substantial increase in R in cities. An increasing trend was observed for the first 6 weeks of 2021 in the effect of visits to retail and recreation places and workplaces on R.\nINTERPRETATION: Increased visits to retail and recreation places, workplaces, and transit stations in cities are important drivers of increased SARS-CoV-2 transmission; the increasing trend in the effects of these drivers in the first 6 weeks of 2021 was possibly associated with the emerging alpha (B.1.1.7) variant. These findings provide important evidence for the management of current and future mobility restrictions.\nFUNDING: Wellcome Trust and Data-Driven Innovation initiative.},\n\tlanguage = {eng},\n\tnumber = {10},\n\tjournal = {The Lancet. Digital Health},\n\tauthor = {Li, You and Wang, Xin and Campbell, Harry and Nair, Harish and {Usher Network for COVID-19 Evidence Reviews (UNCOVER) group}},\n\tmonth = oct,\n\tyear = {2021},\n\tpmid = {34479825},\n\tpmcid = {PMC8452268},\n\tkeywords = {Behavior, COVID-19, Commerce, Humans, Incidence, Models, Biological, Pandemics, Parks, Recreational, Recreation, SARS-CoV-2, Transportation, Travel, United Kingdom, Workplace},\n\tpages = {e676--e683},\n}\n\n
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\n BACKGROUND: Community mobility data have been used to assess adherence to non-pharmaceutical interventions and its impact on SARS-CoV-2 transmission. We assessed the association between location-specific community mobility and the reproduction number (R) of SARS-CoV-2 across UK local authorities. METHODS: In this modelling study, we linked data on community mobility from Google with data on R from 330 UK local authorities, for the period June 1, 2020, to Feb 13, 2021. Six mobility metrics are available in the Google community mobility dataset: visits to retail and recreation places, visits to grocery and pharmacy stores, visits to transit stations, visits to parks, visits to workplaces, and length of stay in residential places. For each local authority, we modelled the weekly change in R (the R ratio) per a rescaled weekly percentage change in each location-specific mobility metric relative to a pre-pandemic baseline period (Jan 3-Feb 6, 2020), with results synthesised across local authorities using a random-effects meta-analysis. FINDINGS: On a weekly basis, increased visits to retail and recreation places were associated with a substantial increase in R (R ratio 1·053 [99·2% CI 1·041-1·065] per 15% weekly increase compared with baseline visits) as were increased visits to workplaces (R ratio 1·060 [1·046-1·074] per 10% increase compared with baseline visits). By comparison, increased visits to grocery and pharmacy stores were associated with a small but still statistically significant increase in R (R ratio 1·011 [1·005-1·017] per 5% weekly increase compared with baseline visits). Increased visits to parks were associated with a decreased R (R ratio 0·972 [0·965-0·980]), as were longer stays at residential areas (R ratio 0·952 [0·928-0·976]). Increased visits to transit stations were not associated with R nationally, but were associated with a substantial increase in R in cities. An increasing trend was observed for the first 6 weeks of 2021 in the effect of visits to retail and recreation places and workplaces on R. INTERPRETATION: Increased visits to retail and recreation places, workplaces, and transit stations in cities are important drivers of increased SARS-CoV-2 transmission; the increasing trend in the effects of these drivers in the first 6 weeks of 2021 was possibly associated with the emerging alpha (B.1.1.7) variant. These findings provide important evidence for the management of current and future mobility restrictions. FUNDING: Wellcome Trust and Data-Driven Innovation initiative.\n
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\n \n\n \n \n \n \n \n How reliable are COVID-19 burden estimates for India?.\n \n \n \n\n\n \n Li, Y.; and Nair, H.\n\n\n \n\n\n\n The Lancet. Infectious Diseases, 21(12): 1615–1617. December 2021.\n \n\n\n\n
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@article{li_how_2021,\n\ttitle = {How reliable are {COVID}-19 burden estimates for {India}?},\n\tvolume = {21},\n\tissn = {1474-4457},\n\tdoi = {10.1016/S1473-3099(21)00422-9},\n\tlanguage = {eng},\n\tnumber = {12},\n\tjournal = {The Lancet. Infectious Diseases},\n\tauthor = {Li, You and Nair, Harish},\n\tmonth = dec,\n\tyear = {2021},\n\tpmid = {34399092},\n\tpmcid = {PMC8363223},\n\tkeywords = {COVID-19, Humans, India, SARS-CoV-2},\n\tpages = {1615--1617},\n}\n\n
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\n \n\n \n \n \n \n \n Global hospital admissions and in-hospital mortality associated with all-cause and virus-specific acute lower respiratory infections in children and adolescents aged 5-19 years between 1995 and 2019: a systematic review and modelling study.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Mei, X.; Bushe, E.; Campbell, H.; and Nair, H.\n\n\n \n\n\n\n BMJ global health, 6(7): e006014. July 2021.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{wang_global_2021,\n\ttitle = {Global hospital admissions and in-hospital mortality associated with all-cause and virus-specific acute lower respiratory infections in children and adolescents aged 5-19 years between 1995 and 2019: a systematic review and modelling study},\n\tvolume = {6},\n\tissn = {2059-7908},\n\tshorttitle = {Global hospital admissions and in-hospital mortality associated with all-cause and virus-specific acute lower respiratory infections in children and adolescents aged 5-19 years between 1995 and 2019},\n\tdoi = {10.1136/bmjgh-2021-006014},\n\tabstract = {INTRODUCTION: The burden of acute lower respiratory infections (ALRI), and common viral ALRI aetiologies among 5-19 years are less well understood. We conducted a systematic review to estimate global burden of all-cause and virus-specific ALRI in 5-19 years.\nMETHODS: We searched eight databases and Google for studies published between 1995 and 2019 and reporting data on burden of all-cause ALRI or ALRI associated with influenza virus, respiratory syncytial virus, human metapneumovirus and human parainfluenza virus. We assessed risk of bias using a modified Newcastle-Ottawa Scale. We developed an analytical framework to report burden by age, country and region when there were sufficient data (all-cause and influenza-associated ALRI hospital admissions). We estimated all-cause ALRI in-hospital deaths and hospital admissions for ALRI associated with respiratory syncytial virus, human metapneumovirus and human parainfluenza virus by region.\nRESULTS: Globally, an estimated 5.5 million (UR 4.0-7.8) all-cause ALRI hospital admissions occurred annually between 1995 and 2019 in 5-19 year olds, causing 87 900 (UR 40 300-180 600) in-hospital deaths annually. Influenza virus and respiratory syncytial virus were associated with 1 078 600 (UR 4 56 500-2 650 200) and 231 800 (UR 142 700-3 73 200) ALRI hospital admissions in 5-19 years. Human metapneumovirus and human parainfluenza virus were associated with 105 500 (UR 57 200-181 700) and 124 800 (UR 67 300-228 500) ALRI hospital admissions in 5-14 years. About 55\\% of all-cause ALRI hospital admissions and 63\\% of influenza-associated ALRI hospital admissions occurred in those 5-9 years globally. All-cause and influenza-associated ALRI hospital admission rates were highest in upper-middle income countries, Asia-Pacific region and the Latin America and Caribbean region.\nCONCLUSION: Incidence and mortality data for all-cause and virus-specific ALRI in 5-19 year olds are scarce. The lack of data in low-income countries and Eastern Europe and Central Asia, South Asia, and West and Central Africa warrants efforts to improve the development and access to healthcare services, diagnostic capacity, and data reporting.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {BMJ global health},\n\tauthor = {Wang, Xin and Li, You and Mei, Xin and Bushe, Erin and Campbell, Harry and Nair, Harish},\n\tmonth = jul,\n\tyear = {2021},\n\tpmid = {34261758},\n\tpmcid = {PMC8281096},\n\tkeywords = {Adolescent, Child, Global Health, Hospital Mortality, Hospitalization, Hospitals, Humans, Respiratory Tract Infections, epidemiology, paediatrics, pneumonia, respiratory infections, systematic review},\n\tpages = {e006014},\n}\n\n
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\n INTRODUCTION: The burden of acute lower respiratory infections (ALRI), and common viral ALRI aetiologies among 5-19 years are less well understood. We conducted a systematic review to estimate global burden of all-cause and virus-specific ALRI in 5-19 years. METHODS: We searched eight databases and Google for studies published between 1995 and 2019 and reporting data on burden of all-cause ALRI or ALRI associated with influenza virus, respiratory syncytial virus, human metapneumovirus and human parainfluenza virus. We assessed risk of bias using a modified Newcastle-Ottawa Scale. We developed an analytical framework to report burden by age, country and region when there were sufficient data (all-cause and influenza-associated ALRI hospital admissions). We estimated all-cause ALRI in-hospital deaths and hospital admissions for ALRI associated with respiratory syncytial virus, human metapneumovirus and human parainfluenza virus by region. RESULTS: Globally, an estimated 5.5 million (UR 4.0-7.8) all-cause ALRI hospital admissions occurred annually between 1995 and 2019 in 5-19 year olds, causing 87 900 (UR 40 300-180 600) in-hospital deaths annually. Influenza virus and respiratory syncytial virus were associated with 1 078 600 (UR 4 56 500-2 650 200) and 231 800 (UR 142 700-3 73 200) ALRI hospital admissions in 5-19 years. Human metapneumovirus and human parainfluenza virus were associated with 105 500 (UR 57 200-181 700) and 124 800 (UR 67 300-228 500) ALRI hospital admissions in 5-14 years. About 55% of all-cause ALRI hospital admissions and 63% of influenza-associated ALRI hospital admissions occurred in those 5-9 years globally. All-cause and influenza-associated ALRI hospital admission rates were highest in upper-middle income countries, Asia-Pacific region and the Latin America and Caribbean region. CONCLUSION: Incidence and mortality data for all-cause and virus-specific ALRI in 5-19 year olds are scarce. The lack of data in low-income countries and Eastern Europe and Central Asia, South Asia, and West and Central Africa warrants efforts to improve the development and access to healthcare services, diagnostic capacity, and data reporting.\n
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\n \n\n \n \n \n \n \n The impact of the 2009 influenza pandemic on the seasonality of human respiratory syncytial virus: A systematic analysis.\n \n \n \n\n\n \n Li, Y.; Wang, X.; Msosa, T.; de Wit, F.; Murdock, J.; and Nair, H.\n\n\n \n\n\n\n Influenza and Other Respiratory Viruses, 15(6): 804–812. November 2021.\n \n\n\n\n
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@article{li_impact_2021,\n\ttitle = {The impact of the 2009 influenza pandemic on the seasonality of human respiratory syncytial virus: {A} systematic analysis},\n\tvolume = {15},\n\tissn = {1750-2659},\n\tshorttitle = {The impact of the 2009 influenza pandemic on the seasonality of human respiratory syncytial virus},\n\tdoi = {10.1111/irv.12884},\n\tabstract = {BACKGROUND: Several local studies showed that the 2009 influenza pandemic delayed the RSV season. However, no global-level analyses are available on the possible impact of the 2009 influenza pandemic on the RSV season.\nOBJECTIVES: We aim to understand the impact of the 2009 influenza pandemic on the RSV season.\nMETHODS: We compiled data from published literature (through a systematic review), online reports/datasets and previously published data on global RSV seasonality and conducted a global-level systematic analysis on the impact of the 2009 influenza pandemic on RSV seasonality.\nRESULTS: We included 354 seasons of 45 unique sites, from 26 countries. Globally, the influenza pandemic delayed the onset of the first RSV season by 0.58 months on average (95\\% CI: 0.42, 0.73; maximum delay: 2.5 months) and the onset of the second RSV season by a lesser extent (0.25 months; 95\\% CI: 0.12, 0.39; maximum delay: 3.4 months); no delayed onset was observed for the third RSV season. The delayed onset was most pronounced in the northern temperate, followed by the southern temperate, and was least pronounced in the tropics.\nCONCLUSIONS: The 2009 influenza pandemic delayed the RSV onset on average by 0.58 months and up to 2.5 months. This suggests evidence of viral interference as well as the impact of public health measures and has important implications for preparedness for RSV season during the ongoing COVID-19 pandemic and future pandemics.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {Influenza and Other Respiratory Viruses},\n\tauthor = {Li, You and Wang, Xin and Msosa, Takondwa and de Wit, Femke and Murdock, Jayne and Nair, Harish},\n\tmonth = nov,\n\tyear = {2021},\n\tpmid = {34219389},\n\tpmcid = {PMC8542946},\n\tkeywords = {COVID-19, Humans, Infant, Influenza, Human, Pandemics, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, SARS-CoV-2, Seasons, COVID-19, influenza virus, pandemic, respiratory syncytial virus, seasonality},\n\tpages = {804--812},\n}\n\n
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\n BACKGROUND: Several local studies showed that the 2009 influenza pandemic delayed the RSV season. However, no global-level analyses are available on the possible impact of the 2009 influenza pandemic on the RSV season. OBJECTIVES: We aim to understand the impact of the 2009 influenza pandemic on the RSV season. METHODS: We compiled data from published literature (through a systematic review), online reports/datasets and previously published data on global RSV seasonality and conducted a global-level systematic analysis on the impact of the 2009 influenza pandemic on RSV seasonality. RESULTS: We included 354 seasons of 45 unique sites, from 26 countries. Globally, the influenza pandemic delayed the onset of the first RSV season by 0.58 months on average (95% CI: 0.42, 0.73; maximum delay: 2.5 months) and the onset of the second RSV season by a lesser extent (0.25 months; 95% CI: 0.12, 0.39; maximum delay: 3.4 months); no delayed onset was observed for the third RSV season. The delayed onset was most pronounced in the northern temperate, followed by the southern temperate, and was least pronounced in the tropics. CONCLUSIONS: The 2009 influenza pandemic delayed the RSV onset on average by 0.58 months and up to 2.5 months. This suggests evidence of viral interference as well as the impact of public health measures and has important implications for preparedness for RSV season during the ongoing COVID-19 pandemic and future pandemics.\n
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\n \n\n \n \n \n \n \n Global burden of acute lower respiratory infection associated with human parainfluenza virus in children younger than 5 years for 2018: a systematic review and meta-analysis.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Deloria-Knoll, M.; Madhi, S. A.; Cohen, C.; Arguelles, V. L.; Basnet, S.; Bassat, Q.; Brooks, W. A.; Echavarria, M.; Fasce, R. A.; Gentile, A.; Goswami, D.; Homaira, N.; Howie, S. R. C.; Kotloff, K. L.; Khuri-Bulos, N.; Krishnan, A.; Lucero, M. G.; Lupisan, S.; Mathisen, M.; McLean, K. A.; Mira-Iglesias, A.; Moraleda, C.; Okamoto, M.; Oshitani, H.; O'Brien, K. L.; Owor, B. E.; Rasmussen, Z. A.; Rath, B. A.; Salimi, V.; Sawatwong, P.; Scott, J. A. G.; Simões, E. A. F.; Sotomayor, V.; Thea, D. M.; Treurnicht, F. K.; Yoshida, L.; Zar, H. J.; Campbell, H.; Nair, H.; and Respiratory Virus Global Epidemiology Network\n\n\n \n\n\n\n The Lancet. Global Health, 9(8): e1077–e1087. August 2021.\n \n\n\n\n
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@article{wang_global_2021-1,\n\ttitle = {Global burden of acute lower respiratory infection associated with human parainfluenza virus in children younger than 5 years for 2018: a systematic review and meta-analysis},\n\tvolume = {9},\n\tissn = {2214-109X},\n\tshorttitle = {Global burden of acute lower respiratory infection associated with human parainfluenza virus in children younger than 5 years for 2018},\n\tdoi = {10.1016/S2214-109X(21)00218-7},\n\tabstract = {BACKGROUND: Human parainfluenza virus (hPIV) is a common virus in childhood acute lower respiratory infections (ALRI). However, no estimates have been made to quantify the global burden of hPIV in childhood ALRI. We aimed to estimate the global and regional hPIV-associated and hPIV-attributable ALRI incidence, hospital admissions, and mortality for children younger than 5 years and stratified by 0-5 months, 6-11 months, and 12-59 months of age.\nMETHODS: We did a systematic review of hPIV-associated ALRI burden studies published between Jan 1, 1995, and Dec 31, 2020, found in MEDLINE, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Global Health Library, three Chinese databases, and Google search, and also identified a further 41 high-quality unpublished studies through an international research network. We included studies reporting community incidence of ALRI with laboratory-confirmed hPIV; hospital admission rates of ALRI or ALRI with hypoxaemia in children with laboratory-confirmed hPIV; proportions of patients with ALRI admitted to hospital with laboratory-confirmed hPIV; or in-hospital case-fatality ratios (hCFRs) of ALRI with laboratory-confirmed hPIV. We used a modified Newcastle-Ottawa Scale to assess risk of bias. We analysed incidence, hospital admission rates, and hCFRs of hPIV-associated ALRI using a generalised linear mixed model. Adjustment was made to account for the non-detection of hPIV-4. We estimated hPIV-associated ALRI cases, hospital admissions, and in-hospital deaths using adjusted incidence, hospital admission rates, and hCFRs. We estimated the overall hPIV-associated ALRI mortality (both in-hospital and out-hospital mortality) on the basis of the number of in-hospital deaths and care-seeking for child pneumonia. We estimated hPIV-attributable ALRI burden by accounting for attributable fractions for hPIV in laboratory-confirmed hPIV cases and deaths. Sensitivity analyses were done to validate the estimates of overall hPIV-associated ALRI mortality and hPIV-attributable ALRI mortality. The systematic review protocol was registered on PROSPERO (CRD42019148570).\nFINDINGS: 203 studies were identified, including 162 hPIV-associated ALRI burden studies and a further 41 high-quality unpublished studies. Globally in 2018, an estimated 18·8 million (uncertainty range 12·8-28·9) ALRI cases, 725 000 (433 000-1 260 000) ALRI hospital admissions, and 34 400 (16 400-73 800) ALRI deaths were attributable to hPIVs among children younger than 5 years. The age-stratified and region-stratified analyses suggested that about 61\\% (35\\% for infants aged 0-5 months and 26\\% for 6-11 months) of the hospital admissions and 66\\% (42\\% for infants aged 0-5 months and 24\\% for 6-11 months) of the in-hospital deaths were in infants, and 70\\% of the in-hospital deaths were in low-income and lower-middle-income countries. Between 73\\% and 100\\% (varying by outcome) of the data had a low risk in study design; the proportion was 46-65\\% for the adjustment for health-care use, 59-77\\% for patient groups excluded, 54-93\\% for case definition, 42-93\\% for sampling strategy, and 67-77\\% for test methods. Heterogeneity in estimates was found between studies for each outcome.\nINTERPRETATION: We report the first global burden estimates of hPIV-associated and hPIV-attributable ALRI in young children. Globally, approximately 13\\% of ALRI cases, 4-14\\% of ALRI hospital admissions, and 4\\% of childhood ALRI mortality were attributable to hPIV. These numbers indicate a potentially notable burden of hPIV in ALRI morbidity and mortality in young children. These estimates should encourage and inform investment to accelerate the development of targeted interventions.\nFUNDING: Bill \\& Melinda Gates Foundation.},\n\tlanguage = {eng},\n\tnumber = {8},\n\tjournal = {The Lancet. Global Health},\n\tauthor = {Wang, Xin and Li, You and Deloria-Knoll, Maria and Madhi, Shabir A. and Cohen, Cheryl and Arguelles, Vina Lea and Basnet, Sudha and Bassat, Quique and Brooks, W. Abdullah and Echavarria, Marcela and Fasce, Rodrigo A. and Gentile, Angela and Goswami, Doli and Homaira, Nusrat and Howie, Stephen R. C. and Kotloff, Karen L. and Khuri-Bulos, Najwa and Krishnan, Anand and Lucero, Marilla G. and Lupisan, Socorro and Mathisen, Maria and McLean, Kenneth A. and Mira-Iglesias, Ainara and Moraleda, Cinta and Okamoto, Michiko and Oshitani, Histoshi and O'Brien, Katherine L. and Owor, Betty E. and Rasmussen, Zeba A. and Rath, Barbara A. and Salimi, Vahid and Sawatwong, Pongpun and Scott, J. Anthony G. and Simões, Eric A. F. and Sotomayor, Viviana and Thea, Donald M. and Treurnicht, Florette K. and Yoshida, Lay-Myint and Zar, Heather J. and Campbell, Harry and Nair, Harish and {Respiratory Virus Global Epidemiology Network}},\n\tmonth = aug,\n\tyear = {2021},\n\tpmid = {34166626},\n\tpmcid = {PMC8298256},\n\tkeywords = {Child, Preschool, Global Health, Humans, Infant, Infant, Newborn, Paramyxoviridae Infections, Paramyxovirinae, Respiratory Tract Infections},\n\tpages = {e1077--e1087},\n}\n\n
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\n BACKGROUND: Human parainfluenza virus (hPIV) is a common virus in childhood acute lower respiratory infections (ALRI). However, no estimates have been made to quantify the global burden of hPIV in childhood ALRI. We aimed to estimate the global and regional hPIV-associated and hPIV-attributable ALRI incidence, hospital admissions, and mortality for children younger than 5 years and stratified by 0-5 months, 6-11 months, and 12-59 months of age. METHODS: We did a systematic review of hPIV-associated ALRI burden studies published between Jan 1, 1995, and Dec 31, 2020, found in MEDLINE, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Global Health Library, three Chinese databases, and Google search, and also identified a further 41 high-quality unpublished studies through an international research network. We included studies reporting community incidence of ALRI with laboratory-confirmed hPIV; hospital admission rates of ALRI or ALRI with hypoxaemia in children with laboratory-confirmed hPIV; proportions of patients with ALRI admitted to hospital with laboratory-confirmed hPIV; or in-hospital case-fatality ratios (hCFRs) of ALRI with laboratory-confirmed hPIV. We used a modified Newcastle-Ottawa Scale to assess risk of bias. We analysed incidence, hospital admission rates, and hCFRs of hPIV-associated ALRI using a generalised linear mixed model. Adjustment was made to account for the non-detection of hPIV-4. We estimated hPIV-associated ALRI cases, hospital admissions, and in-hospital deaths using adjusted incidence, hospital admission rates, and hCFRs. We estimated the overall hPIV-associated ALRI mortality (both in-hospital and out-hospital mortality) on the basis of the number of in-hospital deaths and care-seeking for child pneumonia. We estimated hPIV-attributable ALRI burden by accounting for attributable fractions for hPIV in laboratory-confirmed hPIV cases and deaths. Sensitivity analyses were done to validate the estimates of overall hPIV-associated ALRI mortality and hPIV-attributable ALRI mortality. The systematic review protocol was registered on PROSPERO (CRD42019148570). FINDINGS: 203 studies were identified, including 162 hPIV-associated ALRI burden studies and a further 41 high-quality unpublished studies. Globally in 2018, an estimated 18·8 million (uncertainty range 12·8-28·9) ALRI cases, 725 000 (433 000-1 260 000) ALRI hospital admissions, and 34 400 (16 400-73 800) ALRI deaths were attributable to hPIVs among children younger than 5 years. The age-stratified and region-stratified analyses suggested that about 61% (35% for infants aged 0-5 months and 26% for 6-11 months) of the hospital admissions and 66% (42% for infants aged 0-5 months and 24% for 6-11 months) of the in-hospital deaths were in infants, and 70% of the in-hospital deaths were in low-income and lower-middle-income countries. Between 73% and 100% (varying by outcome) of the data had a low risk in study design; the proportion was 46-65% for the adjustment for health-care use, 59-77% for patient groups excluded, 54-93% for case definition, 42-93% for sampling strategy, and 67-77% for test methods. Heterogeneity in estimates was found between studies for each outcome. INTERPRETATION: We report the first global burden estimates of hPIV-associated and hPIV-attributable ALRI in young children. Globally, approximately 13% of ALRI cases, 4-14% of ALRI hospital admissions, and 4% of childhood ALRI mortality were attributable to hPIV. These numbers indicate a potentially notable burden of hPIV in ALRI morbidity and mortality in young children. These estimates should encourage and inform investment to accelerate the development of targeted interventions. FUNDING: Bill & Melinda Gates Foundation.\n
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\n \n\n \n \n \n \n \n Hospital utilization rates for influenza and RSV: a novel approach and critical assessment.\n \n \n \n\n\n \n Johnson, E. K.; Sylte, D.; Chaves, S. S.; Li, Y.; Mahe, C.; Nair, H.; Paget, J.; van Pomeren, T.; Shi, T.; Viboud, C.; and James, S. L.\n\n\n \n\n\n\n Population Health Metrics, 19(1): 31. June 2021.\n \n\n\n\n
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@article{johnson_hospital_2021,\n\ttitle = {Hospital utilization rates for influenza and {RSV}: a novel approach and critical assessment},\n\tvolume = {19},\n\tissn = {1478-7954},\n\tshorttitle = {Hospital utilization rates for influenza and {RSV}},\n\tdoi = {10.1186/s12963-021-00252-5},\n\tabstract = {BACKGROUND: Influenza and respiratory syncytial virus (RSV) contribute significantly to the burden of acute lower respiratory infection (ALRI) inpatient care, but heterogeneous coding practices and availability of inpatient data make it difficult to estimate global hospital utilization for either disease based on coded diagnoses alone.\nMETHODS: This study estimates rates of influenza and RSV hospitalization by calculating the proportion of ALRI due to influenza and RSV and applying this proportion to inpatient admissions with ALRI coded as primary diagnosis. Proportions of ALRI attributed to influenza and RSV were extracted from a meta-analysis of 360 total sources describing inpatient hospital admissions which were input to a Bayesian mixed effects model over age with random effects over location. Results of this model were applied to inpatient admission datasets for 44 countries to produce rates of hospital utilization for influenza and RSV respectively, and rates were compared to raw coded admissions for each disease.\nRESULTS: For most age groups, these methods estimated a higher national admission rate than the rate of directly coded influenza or RSV admissions in the same inpatient sources. In many inpatient sources, International Classification of Disease (ICD) coding detail was insufficient to estimate RSV burden directly. The influenza inpatient burden estimates in older adults appear to be substantially underestimated using this method on primary diagnoses alone. Application of the mixed effects model reduced heterogeneity between countries in influenza and RSV which was biased by coding practices and between-country variation.\nCONCLUSIONS: This new method presents the opportunity of estimating hospital utilization rates for influenza and RSV using a wide range of clinical databases. Estimates generally seem promising for influenza and RSV associated hospitalization, but influenza estimates from primary diagnosis seem highly underestimated among older adults. Considerable heterogeneity remains between countries in ALRI coding (i.e., primary vs non-primary cause), and in the age profile of proportion positive for influenza and RSV across studies. While this analysis is interesting because of its wide data utilization and applicability in locations without laboratory-confirmed admission data, understanding the sources of variability and data quality will be essential in future applications of these methods.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Population Health Metrics},\n\tauthor = {Johnson, Emily K. and Sylte, Dillon and Chaves, Sandra S. and Li, You and Mahe, Cedric and Nair, Harish and Paget, John and van Pomeren, Tayma and Shi, Ting and Viboud, Cecile and James, Spencer L.},\n\tmonth = jun,\n\tyear = {2021},\n\tpmid = {34126993},\n\tpmcid = {PMC8204427},\n\tkeywords = {Aged, Bayes Theorem, Global Health, Hospitalization, Hospitals, Humans, Influenza, Human, Respiratory Syncytial Viruses, Acute lower respiratory infections, Influenza, Inpatient admissions, Respiratory syncytial virus},\n\tpages = {31},\n}\n\n
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\n BACKGROUND: Influenza and respiratory syncytial virus (RSV) contribute significantly to the burden of acute lower respiratory infection (ALRI) inpatient care, but heterogeneous coding practices and availability of inpatient data make it difficult to estimate global hospital utilization for either disease based on coded diagnoses alone. METHODS: This study estimates rates of influenza and RSV hospitalization by calculating the proportion of ALRI due to influenza and RSV and applying this proportion to inpatient admissions with ALRI coded as primary diagnosis. Proportions of ALRI attributed to influenza and RSV were extracted from a meta-analysis of 360 total sources describing inpatient hospital admissions which were input to a Bayesian mixed effects model over age with random effects over location. Results of this model were applied to inpatient admission datasets for 44 countries to produce rates of hospital utilization for influenza and RSV respectively, and rates were compared to raw coded admissions for each disease. RESULTS: For most age groups, these methods estimated a higher national admission rate than the rate of directly coded influenza or RSV admissions in the same inpatient sources. In many inpatient sources, International Classification of Disease (ICD) coding detail was insufficient to estimate RSV burden directly. The influenza inpatient burden estimates in older adults appear to be substantially underestimated using this method on primary diagnoses alone. Application of the mixed effects model reduced heterogeneity between countries in influenza and RSV which was biased by coding practices and between-country variation. CONCLUSIONS: This new method presents the opportunity of estimating hospital utilization rates for influenza and RSV using a wide range of clinical databases. Estimates generally seem promising for influenza and RSV associated hospitalization, but influenza estimates from primary diagnosis seem highly underestimated among older adults. Considerable heterogeneity remains between countries in ALRI coding (i.e., primary vs non-primary cause), and in the age profile of proportion positive for influenza and RSV across studies. While this analysis is interesting because of its wide data utilization and applicability in locations without laboratory-confirmed admission data, understanding the sources of variability and data quality will be essential in future applications of these methods.\n
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\n \n\n \n \n \n \n \n Respiratory syncytial virus seasonality and prevention strategy planning for passive immunisation of infants in low-income and middle-income countries: a modelling study.\n \n \n \n\n\n \n Li, Y.; Hodgson, D.; Wang, X.; Atkins, K. E.; Feikin, D. R.; and Nair, H.\n\n\n \n\n\n\n The Lancet. Infectious Diseases, 21(9): 1303–1312. September 2021.\n \n\n\n\n
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@article{li_respiratory_2021,\n\ttitle = {Respiratory syncytial virus seasonality and prevention strategy planning for passive immunisation of infants in low-income and middle-income countries: a modelling study},\n\tvolume = {21},\n\tissn = {1474-4457},\n\tshorttitle = {Respiratory syncytial virus seasonality and prevention strategy planning for passive immunisation of infants in low-income and middle-income countries},\n\tdoi = {10.1016/S1473-3099(20)30703-9},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) represents a substantial burden of disease in young infants in low-income and middle-income countries (LMICs). Because RSV passive immunisations, including maternal vaccination and monoclonal antibodies, can only grant a temporary period of protection, their effectiveness and efficiency will be determined by the timing of the immunisation relative to the underlying RSV seasonality. We aimed to assess the potential effect of different approaches for passive RSV immunisation of infants in LMICs.\nMETHODS: We included 52 LMICs in this study on the basis of the availability of RSV seasonality data and developed a mathematical model to compare the effect of different RSV passive immunisation approaches (seasonal approaches vs a year-round approach). For each candidate approach, we calculated the expected annual proportion of RSV incidence among infants younger than 6 months averted (effectiveness) and the ratio of per-dose cases averted between that approach and the year-round approach (relative efficiency).\nFINDINGS: 39 (75\\%) of 52 LMICs included in the study had clear RSV seasonality, defined as having more than 75\\% of annual RSV cases occurring in 5 or fewer months. In these countries with clear RSV seasonality, the seasonal approach in which monoclonal antibody administration began 3 months before RSV season onset was only a median of 16\\% (IQR 13-18) less effective in averting RSV-associated acute lower respiratory infection (ALRI) hospital admissions than a year-round approach, but was a median of 70\\% (50-97) more efficient in reducing RSV-associated hospital admissions per dose. The seasonal approach that delivered maternal vaccination 1 month before the season onset was a median of 27\\% (25-33) less effective in averting hospital admissions associated with RSV-ALRI than a year-round approach, but was a median of 126\\% (87-177) more efficient at averting these hospital admissions per dose.\nINTERPRETATION: In LMICs with clear RSV seasonality, seasonal approaches to monoclonal antibody and maternal vaccine administration might optimise disease prevention by dose given compared with year-round administration. More data are needed to clarify if seasonal administration of RSV monoclonal antibodies or maternal immunisation is programmatically suitable and cost effective in LMICs.\nFUNDING: The Bill \\& Melinda Gates Foundation, World Health Organization.},\n\tlanguage = {eng},\n\tnumber = {9},\n\tjournal = {The Lancet. Infectious Diseases},\n\tauthor = {Li, You and Hodgson, David and Wang, Xin and Atkins, Katherine E. and Feikin, Daniel R. and Nair, Harish},\n\tmonth = sep,\n\tyear = {2021},\n\tpmid = {33965062},\n\tpmcid = {PMC8386346},\n\tkeywords = {Cost-Benefit Analysis, Developing Countries, Female, Hospitalization, Humans, Immunization, Passive, Incidence, Infant, Infant, Newborn, Male, Models, Theoretical, Poverty, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Seasons, Vaccination},\n\tpages = {1303--1312},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) represents a substantial burden of disease in young infants in low-income and middle-income countries (LMICs). Because RSV passive immunisations, including maternal vaccination and monoclonal antibodies, can only grant a temporary period of protection, their effectiveness and efficiency will be determined by the timing of the immunisation relative to the underlying RSV seasonality. We aimed to assess the potential effect of different approaches for passive RSV immunisation of infants in LMICs. METHODS: We included 52 LMICs in this study on the basis of the availability of RSV seasonality data and developed a mathematical model to compare the effect of different RSV passive immunisation approaches (seasonal approaches vs a year-round approach). For each candidate approach, we calculated the expected annual proportion of RSV incidence among infants younger than 6 months averted (effectiveness) and the ratio of per-dose cases averted between that approach and the year-round approach (relative efficiency). FINDINGS: 39 (75%) of 52 LMICs included in the study had clear RSV seasonality, defined as having more than 75% of annual RSV cases occurring in 5 or fewer months. In these countries with clear RSV seasonality, the seasonal approach in which monoclonal antibody administration began 3 months before RSV season onset was only a median of 16% (IQR 13-18) less effective in averting RSV-associated acute lower respiratory infection (ALRI) hospital admissions than a year-round approach, but was a median of 70% (50-97) more efficient in reducing RSV-associated hospital admissions per dose. The seasonal approach that delivered maternal vaccination 1 month before the season onset was a median of 27% (25-33) less effective in averting hospital admissions associated with RSV-ALRI than a year-round approach, but was a median of 126% (87-177) more efficient at averting these hospital admissions per dose. INTERPRETATION: In LMICs with clear RSV seasonality, seasonal approaches to monoclonal antibody and maternal vaccine administration might optimise disease prevention by dose given compared with year-round administration. More data are needed to clarify if seasonal administration of RSV monoclonal antibodies or maternal immunisation is programmatically suitable and cost effective in LMICs. FUNDING: The Bill & Melinda Gates Foundation, World Health Organization.\n
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\n \n\n \n \n \n \n \n Risk factors for poor outcomes in hospitalised COVID-19 patients: A systematic review and meta-analysis.\n \n \n \n\n\n \n Li, Y.; Ashcroft, T.; Chung, A.; Dighero, I.; Dozier, M.; Horne, M.; McSwiggan, E.; Shamsuddin, A.; and Nair, H.\n\n\n \n\n\n\n Journal of Global Health, 11: 10001. March 2021.\n \n\n\n\n
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@article{li_risk_2021,\n\ttitle = {Risk factors for poor outcomes in hospitalised {COVID}-19 patients: {A} systematic review and meta-analysis},\n\tvolume = {11},\n\tissn = {2047-2986},\n\tshorttitle = {Risk factors for poor outcomes in hospitalised {COVID}-19 patients},\n\tdoi = {10.7189/jogh.11.10001},\n\tabstract = {Background: Understanding the risk factors for poor outcomes among COVID-19 patients could help identify vulnerable populations who would need prioritisation in prevention and treatment for COVID-19. We aimed to critically appraise and synthesise published evidence on the risk factors for poor outcomes in hospitalised COVID-19 patients.\nMethods: We searched PubMed, medRxiv and the WHO COVID-19 literature database for studies that reported characteristics of COVID-19 patients who required hospitalisation. We included studies published between January and May 2020 that reported adjusted effect size of any demographic and/or clinical factors for any of the three poor outcomes: mortality, intensive care unit (ICU) admission, and invasive mechanical ventilation. We appraised the quality of the included studies using Joanna Briggs Institute appraisal tools and quantitatively synthesised the evidence through a series of random-effect meta-analyses. To aid data interpretation, we further developed an interpretation framework that indicated strength of the evidence, informed by both quantity and quality of the evidence.\nResults: We included a total of 40 studies in our review. Most of the included studies (29/40, 73\\%) were assessed as "good quality", with assessment scores of 80 or more. We found that male sex (pooled odds ratio (OR) = 1.32 (95\\% confidence interval (CI) = 1.18-1.48; 20 studies), older age (OR = 1.05, 95\\% CI = 1.04-1.07, per one year of age increase; 10 studies), obesity (OR = 1.59, 95\\% CI = 1.02-2.48; 4 studies), diabetes (OR = 1.25, 95\\% CI = 1.11-1.40; 11 studies) and chronic kidney diseases (6 studies; OR = 1.57, 95\\% CI = 1.27-1.93) were associated with increased risks for mortality with the greatest strength of evidence based on our interpretation framework. We did not find increased risk of mortality for several factors including chronic obstructive pulmonary diseases (5 studies), cancer (4 studies), or current smoker (5 studies); however, this does not indicate absence of risk due to limited data on each of these factors.\nConclusion: Male sex, older age, obesity, diabetes and chronic kidney diseases are important risk factors of COVID-19 poor outcomes. Our review provides not only an appraisal and synthesis of evidence on the risk factors of COVID-19 poor outcomes, but also a data interpretation framework that could be adopted by relevant future research.},\n\tlanguage = {eng},\n\tjournal = {Journal of Global Health},\n\tauthor = {Li, You and Ashcroft, Thulani and Chung, Alexandria and Dighero, Izzie and Dozier, Marshall and Horne, Margaret and McSwiggan, Emilie and Shamsuddin, Azwa and Nair, Harish},\n\tmonth = mar,\n\tyear = {2021},\n\tpmid = {33767855},\n\tpmcid = {PMC7980087},\n\tkeywords = {Aged, COVID-19, Comorbidity, Female, Hospitalization, Humans, Intensive Care Units, Male, Respiration, Artificial, Risk Factors, SARS-CoV-2, Severity of Illness Index},\n\tpages = {10001},\n}\n\n
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\n Background: Understanding the risk factors for poor outcomes among COVID-19 patients could help identify vulnerable populations who would need prioritisation in prevention and treatment for COVID-19. We aimed to critically appraise and synthesise published evidence on the risk factors for poor outcomes in hospitalised COVID-19 patients. Methods: We searched PubMed, medRxiv and the WHO COVID-19 literature database for studies that reported characteristics of COVID-19 patients who required hospitalisation. We included studies published between January and May 2020 that reported adjusted effect size of any demographic and/or clinical factors for any of the three poor outcomes: mortality, intensive care unit (ICU) admission, and invasive mechanical ventilation. We appraised the quality of the included studies using Joanna Briggs Institute appraisal tools and quantitatively synthesised the evidence through a series of random-effect meta-analyses. To aid data interpretation, we further developed an interpretation framework that indicated strength of the evidence, informed by both quantity and quality of the evidence. Results: We included a total of 40 studies in our review. Most of the included studies (29/40, 73%) were assessed as \"good quality\", with assessment scores of 80 or more. We found that male sex (pooled odds ratio (OR) = 1.32 (95% confidence interval (CI) = 1.18-1.48; 20 studies), older age (OR = 1.05, 95% CI = 1.04-1.07, per one year of age increase; 10 studies), obesity (OR = 1.59, 95% CI = 1.02-2.48; 4 studies), diabetes (OR = 1.25, 95% CI = 1.11-1.40; 11 studies) and chronic kidney diseases (6 studies; OR = 1.57, 95% CI = 1.27-1.93) were associated with increased risks for mortality with the greatest strength of evidence based on our interpretation framework. We did not find increased risk of mortality for several factors including chronic obstructive pulmonary diseases (5 studies), cancer (4 studies), or current smoker (5 studies); however, this does not indicate absence of risk due to limited data on each of these factors. Conclusion: Male sex, older age, obesity, diabetes and chronic kidney diseases are important risk factors of COVID-19 poor outcomes. Our review provides not only an appraisal and synthesis of evidence on the risk factors of COVID-19 poor outcomes, but also a data interpretation framework that could be adopted by relevant future research.\n
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\n \n\n \n \n \n \n \n The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries.\n \n \n \n\n\n \n Li, Y.; Campbell, H.; Kulkarni, D.; Harpur, A.; Nundy, M.; Wang, X.; Nair, H.; and Usher Network for COVID-19 Evidence Reviews (UNCOVER) group\n\n\n \n\n\n\n The Lancet. Infectious Diseases, 21(2): 193–202. February 2021.\n \n\n\n\n
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@article{li_temporal_2021,\n\ttitle = {The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number ({R}) of {SARS}-{CoV}-2: a modelling study across 131 countries},\n\tvolume = {21},\n\tissn = {1474-4457},\n\tshorttitle = {The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number ({R}) of {SARS}-{CoV}-2},\n\tdoi = {10.1016/S1473-3099(20)30785-4},\n\tabstract = {BACKGROUND: Non-pharmaceutical interventions (NPIs) were implemented by many countries to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of COVID-19. A resurgence in COVID-19 cases has been reported in some countries that lifted some of these NPIs. We aimed to understand the association of introducing and lifting NPIs with the level of transmission of SARS-CoV-2, as measured by the time-varying reproduction number (R), from a broad perspective across 131 countries.\nMETHODS: In this modelling study, we linked data on daily country-level estimates of R from the London School of Hygiene \\& Tropical Medicine (London, UK) with data on country-specific policies on NPIs from the Oxford COVID-19 Government Response Tracker, available between Jan 1 and July 20, 2020. We defined a phase as a time period when all NPIs remained the same, and we divided the timeline of each country into individual phases based on the status of NPIs. We calculated the R ratio as the ratio between the daily R of each phase and the R from the last day of the previous phase (ie, before the NPI status changed) as a measure of the association between NPI status and transmission of SARS-CoV-2. We then modelled the R ratio using a log-linear regression with introduction and relaxation of each NPI as independent variables for each day of the first 28 days after the change in the corresponding NPI. In an ad-hoc analysis, we estimated the effect of reintroducing multiple NPIs with the greatest effects, and in the observed sequence, to tackle the possible resurgence of SARS-CoV-2.\nFINDINGS: 790 phases from 131 countries were included in the analysis. A decreasing trend over time in the R ratio was found following the introduction of school closure, workplace closure, public events ban, requirements to stay at home, and internal movement limits; the reduction in R ranged from 3\\% to 24\\% on day 28 following the introduction compared with the last day before introduction, although the reduction was significant only for public events ban (R ratio 0·76, 95\\% CI 0·58-1·00); for all other NPIs, the upper bound of the 95\\% CI was above 1. An increasing trend over time in the R ratio was found following the relaxation of school closure, bans on public events, bans on public gatherings of more than ten people, requirements to stay at home, and internal movement limits; the increase in R ranged from 11\\% to 25\\% on day 28 following the relaxation compared with the last day before relaxation, although the increase was significant only for school reopening (R ratio 1·24, 95\\% CI 1·00-1·52) and lifting bans on public gatherings of more than ten people (1·25, 1·03-1·51); for all other NPIs, the lower bound of the 95\\% CI was below 1. It took a median of 8 days (IQR 6-9) following the introduction of an NPI to observe 60\\% of the maximum reduction in R and even longer (17 days [14-20]) following relaxation to observe 60\\% of the maximum increase in R. In response to a possible resurgence of COVID-19, a control strategy of banning public events and public gatherings of more than ten people was estimated to reduce R, with an R ratio of 0·71 (95\\% CI 0·55-0·93) on day 28, decreasing to 0·62 (0·47-0·82) on day 28 if measures to close workplaces were added, 0·58 (0·41-0·81) if measures to close workplaces and internal movement restrictions were added, and 0·48 (0·32-0·71) if measures to close workplaces, internal movement restrictions, and requirements to stay at home were added.\nINTERPRETATION: Individual NPIs, including school closure, workplace closure, public events ban, ban on gatherings of more than ten people, requirements to stay at home, and internal movement limits, are associated with reduced transmission of SARS-CoV-2, but the effect of introducing and lifting these NPIs is delayed by 1-3 weeks, with this delay being longer when lifting NPIs. These findings provide additional evidence that can inform policy-maker decisions on the timing of introducing and lifting different NPIs, although R should be interpreted in the context of its known limitations.\nFUNDING: Wellcome Trust Institutional Strategic Support Fund and Data-Driven Innovation initiative.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {The Lancet. Infectious Diseases},\n\tauthor = {Li, You and Campbell, Harry and Kulkarni, Durga and Harpur, Alice and Nundy, Madhurima and Wang, Xin and Nair, Harish and {Usher Network for COVID-19 Evidence Reviews (UNCOVER) group}},\n\tmonth = feb,\n\tyear = {2021},\n\tpmid = {33729915},\n\tpmcid = {PMC7581351},\n\tkeywords = {Basic Reproduction Number, COVID-19, Communicable Diseases, Emerging, Global Health, Humans, Models, Theoretical, Quarantine, SARS-CoV-2, Time Factors},\n\tpages = {193--202},\n}\n\n
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\n BACKGROUND: Non-pharmaceutical interventions (NPIs) were implemented by many countries to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of COVID-19. A resurgence in COVID-19 cases has been reported in some countries that lifted some of these NPIs. We aimed to understand the association of introducing and lifting NPIs with the level of transmission of SARS-CoV-2, as measured by the time-varying reproduction number (R), from a broad perspective across 131 countries. METHODS: In this modelling study, we linked data on daily country-level estimates of R from the London School of Hygiene & Tropical Medicine (London, UK) with data on country-specific policies on NPIs from the Oxford COVID-19 Government Response Tracker, available between Jan 1 and July 20, 2020. We defined a phase as a time period when all NPIs remained the same, and we divided the timeline of each country into individual phases based on the status of NPIs. We calculated the R ratio as the ratio between the daily R of each phase and the R from the last day of the previous phase (ie, before the NPI status changed) as a measure of the association between NPI status and transmission of SARS-CoV-2. We then modelled the R ratio using a log-linear regression with introduction and relaxation of each NPI as independent variables for each day of the first 28 days after the change in the corresponding NPI. In an ad-hoc analysis, we estimated the effect of reintroducing multiple NPIs with the greatest effects, and in the observed sequence, to tackle the possible resurgence of SARS-CoV-2. FINDINGS: 790 phases from 131 countries were included in the analysis. A decreasing trend over time in the R ratio was found following the introduction of school closure, workplace closure, public events ban, requirements to stay at home, and internal movement limits; the reduction in R ranged from 3% to 24% on day 28 following the introduction compared with the last day before introduction, although the reduction was significant only for public events ban (R ratio 0·76, 95% CI 0·58-1·00); for all other NPIs, the upper bound of the 95% CI was above 1. An increasing trend over time in the R ratio was found following the relaxation of school closure, bans on public events, bans on public gatherings of more than ten people, requirements to stay at home, and internal movement limits; the increase in R ranged from 11% to 25% on day 28 following the relaxation compared with the last day before relaxation, although the increase was significant only for school reopening (R ratio 1·24, 95% CI 1·00-1·52) and lifting bans on public gatherings of more than ten people (1·25, 1·03-1·51); for all other NPIs, the lower bound of the 95% CI was below 1. It took a median of 8 days (IQR 6-9) following the introduction of an NPI to observe 60% of the maximum reduction in R and even longer (17 days [14-20]) following relaxation to observe 60% of the maximum increase in R. In response to a possible resurgence of COVID-19, a control strategy of banning public events and public gatherings of more than ten people was estimated to reduce R, with an R ratio of 0·71 (95% CI 0·55-0·93) on day 28, decreasing to 0·62 (0·47-0·82) on day 28 if measures to close workplaces were added, 0·58 (0·41-0·81) if measures to close workplaces and internal movement restrictions were added, and 0·48 (0·32-0·71) if measures to close workplaces, internal movement restrictions, and requirements to stay at home were added. INTERPRETATION: Individual NPIs, including school closure, workplace closure, public events ban, ban on gatherings of more than ten people, requirements to stay at home, and internal movement limits, are associated with reduced transmission of SARS-CoV-2, but the effect of introducing and lifting these NPIs is delayed by 1-3 weeks, with this delay being longer when lifting NPIs. These findings provide additional evidence that can inform policy-maker decisions on the timing of introducing and lifting different NPIs, although R should be interpreted in the context of its known limitations. FUNDING: Wellcome Trust Institutional Strategic Support Fund and Data-Driven Innovation initiative.\n
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\n \n\n \n \n \n \n \n Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018: a systematic review and modelling study.\n \n \n \n\n\n \n Wang, X.; Li, Y.; Deloria-Knoll, M.; Madhi, S. A.; Cohen, C.; Ali, A.; Basnet, S.; Bassat, Q.; Brooks, W. A.; Chittaganpitch, M.; Echavarria, M.; Fasce, R. A.; Goswami, D.; Hirve, S.; Homaira, N.; Howie, S. R. C.; Kotloff, K. L.; Khuri-Bulos, N.; Krishnan, A.; Lucero, M. G.; Lupisan, S.; Mira-Iglesias, A.; Moore, D. P.; Moraleda, C.; Nunes, M.; Oshitani, H.; Owor, B. E.; Polack, F. P.; O'Brien, K. L.; Rasmussen, Z. A.; Rath, B. A.; Salimi, V.; Scott, J. A. G.; Simões, E. A. F.; Strand, T. A.; Thea, D. M.; Treurnicht, F. K.; Vaccari, L. C.; Yoshida, L.; Zar, H. J.; Campbell, H.; Nair, H.; and Respiratory Virus Global Epidemiology Network\n\n\n \n\n\n\n The Lancet. Global Health, 9(1): e33–e43. January 2021.\n \n\n\n\n
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@article{wang_global_2021-2,\n\ttitle = {Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018: a systematic review and modelling study},\n\tvolume = {9},\n\tissn = {2214-109X},\n\tshorttitle = {Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018},\n\tdoi = {10.1016/S2214-109X(20)30393-4},\n\tabstract = {BACKGROUND: Human metapneumovirus is a common virus associated with acute lower respiratory infections (ALRIs) in children. No global burden estimates are available for ALRIs associated with human metapneumovirus in children, and no licensed vaccines or drugs exist for human metapneumovirus infections. We aimed to estimate the age-stratified human metapneumovirus-associated ALRI global incidence, hospital admissions, and mortality burden in children younger than 5 years.\nMETHODS: We estimated the global burden of human metapneumovirus-associated ALRIs in children younger than 5 years from a systematic review of 119 studies published between Jan 1, 2001, and Dec 31, 2019, and a further 40 high quality unpublished studies. We assessed risk of bias using a modified Newcastle-Ottawa Scale. We estimated incidence, hospital admission rates, and in-hospital case-fatality ratios (hCFRs) of human metapneumovirus-associated ALRI using a generalised linear mixed model. We applied incidence and hospital admission rates of human metapneumovirus-associated ALRI to population estimates to yield the morbidity burden estimates by age bands and World Bank income levels. We also estimated human metapneumovirus-associated ALRI in-hospital deaths and overall human metapneumovirus-associated ALRI deaths (both in-hospital and non-hospital deaths). Additionally, we estimated human metapneumovirus-attributable ALRI cases, hospital admissions, and deaths by combining human metapneumovirus-associated burden estimates and attributable fractions of human metapneumovirus in laboratory-confirmed human metapneumovirus cases and deaths.\nFINDINGS: In 2018, among children younger than 5 years globally, there were an estimated 14·2 million human metapneumovirus-associated ALRI cases (uncertainty range [UR] 10·2 million to 20·1 million), 643 000 human metapneumovirus-associated hospital admissions (UR 425 000 to 977 000), 7700 human metapneumovirus-associated in-hospital deaths (2600 to 48 800), and 16 100 overall (hospital and community) human metapneumovirus-associated ALRI deaths (5700 to 88 000). An estimated 11·1 million ALRI cases (UR 8·0 million to 15·7 million), 502 000 ALRI hospital admissions (UR 332 000 to 762 000), and 11 300 ALRI deaths (4000 to 61 600) could be causally attributed to human metapneumovirus in 2018. Around 58\\% of the hospital admissions were in infants under 12 months, and 64\\% of in-hospital deaths occurred in infants younger than 6 months, of which 79\\% occurred in low-income and lower-middle-income countries.\nINTERPRETATION: Infants younger than 1 year have disproportionately high risks of severe human metapneumovirus infections across all World Bank income regions and all child mortality settings, similar to respiratory syncytial virus and influenza virus. Infants younger than 6 months in low-income and lower-middle-income countries are at greater risk of death from human metapneumovirus-associated ALRI than older children and those in upper-middle-income and high-income countries. Our mortality estimates demonstrate the importance of intervention strategies for infants across all settings, and warrant continued efforts to improve the outcome of human metapneumovirus-associated ALRI among young infants in low-income and lower-middle-income countries.\nFUNDING: Bill \\& Melinda Gates Foundation.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {The Lancet. Global Health},\n\tauthor = {Wang, Xin and Li, You and Deloria-Knoll, Maria and Madhi, Shabir A. and Cohen, Cheryl and Ali, Asad and Basnet, Sudha and Bassat, Quique and Brooks, W. Abdullah and Chittaganpitch, Malinee and Echavarria, Marcela and Fasce, Rodrigo A. and Goswami, Doli and Hirve, Siddhivinayak and Homaira, Nusrat and Howie, Stephen R. C. and Kotloff, Karen L. and Khuri-Bulos, Najwa and Krishnan, Anand and Lucero, Marilla G. and Lupisan, Socorro and Mira-Iglesias, Ainara and Moore, David P. and Moraleda, Cinta and Nunes, Marta and Oshitani, Histoshi and Owor, Betty E. and Polack, Fernando P. and O'Brien, Katherine L. and Rasmussen, Zeba A. and Rath, Barbara A. and Salimi, Vahid and Scott, J. Anthony G. and Simões, Eric A. F. and Strand, Tor A. and Thea, Donald M. and Treurnicht, Florette K. and Vaccari, Linda C. and Yoshida, Lay-Myint and Zar, Heather J. and Campbell, Harry and Nair, Harish and {Respiratory Virus Global Epidemiology Network}},\n\tmonth = jan,\n\tyear = {2021},\n\tpmid = {33248481},\n\tpmcid = {PMC7783516},\n\tkeywords = {Acute Disease, Child, Preschool, Cost of Illness, Female, Global Health, Humans, Infant, Infant, Newborn, Linear Models, Male, Metapneumovirus, Paramyxoviridae Infections, Respiratory Tract Infections},\n\tpages = {e33--e43},\n}\n\n
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\n BACKGROUND: Human metapneumovirus is a common virus associated with acute lower respiratory infections (ALRIs) in children. No global burden estimates are available for ALRIs associated with human metapneumovirus in children, and no licensed vaccines or drugs exist for human metapneumovirus infections. We aimed to estimate the age-stratified human metapneumovirus-associated ALRI global incidence, hospital admissions, and mortality burden in children younger than 5 years. METHODS: We estimated the global burden of human metapneumovirus-associated ALRIs in children younger than 5 years from a systematic review of 119 studies published between Jan 1, 2001, and Dec 31, 2019, and a further 40 high quality unpublished studies. We assessed risk of bias using a modified Newcastle-Ottawa Scale. We estimated incidence, hospital admission rates, and in-hospital case-fatality ratios (hCFRs) of human metapneumovirus-associated ALRI using a generalised linear mixed model. We applied incidence and hospital admission rates of human metapneumovirus-associated ALRI to population estimates to yield the morbidity burden estimates by age bands and World Bank income levels. We also estimated human metapneumovirus-associated ALRI in-hospital deaths and overall human metapneumovirus-associated ALRI deaths (both in-hospital and non-hospital deaths). Additionally, we estimated human metapneumovirus-attributable ALRI cases, hospital admissions, and deaths by combining human metapneumovirus-associated burden estimates and attributable fractions of human metapneumovirus in laboratory-confirmed human metapneumovirus cases and deaths. FINDINGS: In 2018, among children younger than 5 years globally, there were an estimated 14·2 million human metapneumovirus-associated ALRI cases (uncertainty range [UR] 10·2 million to 20·1 million), 643 000 human metapneumovirus-associated hospital admissions (UR 425 000 to 977 000), 7700 human metapneumovirus-associated in-hospital deaths (2600 to 48 800), and 16 100 overall (hospital and community) human metapneumovirus-associated ALRI deaths (5700 to 88 000). An estimated 11·1 million ALRI cases (UR 8·0 million to 15·7 million), 502 000 ALRI hospital admissions (UR 332 000 to 762 000), and 11 300 ALRI deaths (4000 to 61 600) could be causally attributed to human metapneumovirus in 2018. Around 58% of the hospital admissions were in infants under 12 months, and 64% of in-hospital deaths occurred in infants younger than 6 months, of which 79% occurred in low-income and lower-middle-income countries. INTERPRETATION: Infants younger than 1 year have disproportionately high risks of severe human metapneumovirus infections across all World Bank income regions and all child mortality settings, similar to respiratory syncytial virus and influenza virus. Infants younger than 6 months in low-income and lower-middle-income countries are at greater risk of death from human metapneumovirus-associated ALRI than older children and those in upper-middle-income and high-income countries. Our mortality estimates demonstrate the importance of intervention strategies for infants across all settings, and warrant continued efforts to improve the outcome of human metapneumovirus-associated ALRI among young infants in low-income and lower-middle-income countries. FUNDING: Bill & Melinda Gates Foundation.\n
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\n \n\n \n \n \n \n \n National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in 2019 among 58 countries: a modelling study.\n \n \n \n\n\n \n Li, Y.; Johnson, E. K.; Shi, T.; Campbell, H.; Chaves, S. S.; Commaille-Chapus, C.; Dighero, I.; James, S. L.; Mahé, C.; Ooi, Y.; Paget, J.; van Pomeren, T.; Viboud, C.; and Nair, H.\n\n\n \n\n\n\n The Lancet. Respiratory Medicine, 9(2): 175–185. February 2021.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{li_national_2021,\n\ttitle = {National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in 2019 among 58 countries: a modelling study},\n\tvolume = {9},\n\tissn = {2213-2619},\n\tshorttitle = {National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in 2019 among 58 countries},\n\tdoi = {10.1016/S2213-2600(20)30322-2},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) is the predominant viral pathogen associated with acute lower respiratory infection (ALRI) in children who are younger than 5 years. Little is reported on the national estimates of RSV-associated ALRI hospitalisations in these children on the basis of robust epidemiological data. We aimed to generate national level estimates for RSV-associated ALRI hospitalisations in children aged younger than 5 years.\nMETHODS: We included data for RSV and ALRI hospitalisation in children who were younger than 5 years from systematic literature reviews (including unpublished data) and from inpatient databases, representing 58 countries. We used two different methods, the rate-based method and the proportion-based method, to estimate national RSV-associated ALRI hospitalisations in children younger than 5 years in 2019. The rate-based method synthesised data for laboratory-confirmed RSV-associated ALRI hospitalisation rates using a spatiotemporal Gaussian process meta-regression (ST-GPR). The proportion-based method applied data for RSV positive proportions among ALRI to all-cause ALRI hospitalisation envelopes (ie, total disease burden of ALRI hospitalisations of any cause) using a Bayesian regularised trimmed meta-regression (MR-BRT). Where applicable, we reported estimates by both methods to provide a plausible range for each country.\nFINDINGS: A total of 334 studies and 1985 data points (defined as an individual estimate for one age group and 1 year for each study) were included in our analysis, accounting for 398 million (59\\%) of the 677 million children aged younger than 5 years worldwide representing 58 countries. We reported the number of annual national RSV-associated ALRI hospitalisations for 29 countries using the rate-based method, and for 42 countries using the proportion-based method. The median number of RSV-associated ALRI hospitalisations in children younger than 5 years was 8·25 thousand (IQR 1·97-48·01), and the median rate of RSV-associated ALRI hospitalisations was 514 (339-866) hospitalisations per thousand children younger than 5 years. Despite large variation among countries, a high proportion of the RSV-associated ALRI hospitalisations were in infants aged younger than 1 year in all countries (median proportion 45\\%, IQR 32-56). In 272 (76\\%) of the 358 years included in the analysis, the RSV-associated ALRI hospitalisation rate fluctuated between 0·8 and 1·2 times the country's median yearly rate. General agreement was observed between estimates by the rate-based method and proportion-based method, with the exceptions of India, Kenya, Norway, and Philippines.\nINTERPRETATION: By incorporating data from various sources, our study provides robust estimates on national level burden of RSV-associated ALRI hospitalisation in children aged younger than 5 years. These estimates are important for informing policy for the introduction of RSV immunisations and also serve as baseline data for the RSV disease burden in young children.\nFUNDING: The Foundation for Influenza Epidemiology.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {The Lancet. Respiratory Medicine},\n\tauthor = {Li, You and Johnson, Emily K. and Shi, Ting and Campbell, Harry and Chaves, Sandra S. and Commaille-Chapus, Catherine and Dighero, Izzie and James, Spencer L. and Mahé, Cédric and Ooi, Yujing and Paget, John and van Pomeren, Tayma and Viboud, Cécile and Nair, Harish},\n\tmonth = feb,\n\tyear = {2021},\n\tpmid = {32971018},\n\tkeywords = {Acute Disease, Bayes Theorem, Child, Preschool, Cost of Illness, Female, Global Health, Hospitalization, Humans, Incidence, Infant, Internationality, Male, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human},\n\tpages = {175--185},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) is the predominant viral pathogen associated with acute lower respiratory infection (ALRI) in children who are younger than 5 years. Little is reported on the national estimates of RSV-associated ALRI hospitalisations in these children on the basis of robust epidemiological data. We aimed to generate national level estimates for RSV-associated ALRI hospitalisations in children aged younger than 5 years. METHODS: We included data for RSV and ALRI hospitalisation in children who were younger than 5 years from systematic literature reviews (including unpublished data) and from inpatient databases, representing 58 countries. We used two different methods, the rate-based method and the proportion-based method, to estimate national RSV-associated ALRI hospitalisations in children younger than 5 years in 2019. The rate-based method synthesised data for laboratory-confirmed RSV-associated ALRI hospitalisation rates using a spatiotemporal Gaussian process meta-regression (ST-GPR). The proportion-based method applied data for RSV positive proportions among ALRI to all-cause ALRI hospitalisation envelopes (ie, total disease burden of ALRI hospitalisations of any cause) using a Bayesian regularised trimmed meta-regression (MR-BRT). Where applicable, we reported estimates by both methods to provide a plausible range for each country. FINDINGS: A total of 334 studies and 1985 data points (defined as an individual estimate for one age group and 1 year for each study) were included in our analysis, accounting for 398 million (59%) of the 677 million children aged younger than 5 years worldwide representing 58 countries. We reported the number of annual national RSV-associated ALRI hospitalisations for 29 countries using the rate-based method, and for 42 countries using the proportion-based method. The median number of RSV-associated ALRI hospitalisations in children younger than 5 years was 8·25 thousand (IQR 1·97-48·01), and the median rate of RSV-associated ALRI hospitalisations was 514 (339-866) hospitalisations per thousand children younger than 5 years. Despite large variation among countries, a high proportion of the RSV-associated ALRI hospitalisations were in infants aged younger than 1 year in all countries (median proportion 45%, IQR 32-56). In 272 (76%) of the 358 years included in the analysis, the RSV-associated ALRI hospitalisation rate fluctuated between 0·8 and 1·2 times the country's median yearly rate. General agreement was observed between estimates by the rate-based method and proportion-based method, with the exceptions of India, Kenya, Norway, and Philippines. INTERPRETATION: By incorporating data from various sources, our study provides robust estimates on national level burden of RSV-associated ALRI hospitalisation in children aged younger than 5 years. These estimates are important for informing policy for the introduction of RSV immunisations and also serve as baseline data for the RSV disease burden in young children. FUNDING: The Foundation for Influenza Epidemiology.\n
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\n \n\n \n \n \n \n \n Respiratory Syncytial Virus-Associated Hospital Admissions in Children Younger Than 5 Years in 7 European Countries Using Routinely Collected Datasets.\n \n \n \n\n\n \n Reeves, R. M.; van Wijhe, M.; Tong, S.; Lehtonen, T.; Stona, L.; Teirlinck, A. C.; Fernandez, L. V.; Li, Y.; Giaquinto, C.; Fischer, T. K.; Demont, C.; Heikkinen, T.; Speltra, I.; van Boven, M.; Bøås, H.; Campbell, H.; and RESCEU Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases, 222(Suppl 7): S599–S605. October 2020.\n \n\n\n\n
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@article{reeves_respiratory_2020,\n\ttitle = {Respiratory {Syncytial} {Virus}-{Associated} {Hospital} {Admissions} in {Children} {Younger} {Than} 5 {Years} in 7 {European} {Countries} {Using} {Routinely} {Collected} {Datasets}},\n\tvolume = {222},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiaa360},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infection (RTI) in young children. Registries provide opportunities to explore RSV epidemiology and burden.\nMETHODS: We explored routinely collected hospital data on RSV in children aged {\\textless} 5 years in 7 European countries. We compare RSV-associated admission rates, age, seasonality, and time trends between countries.\nRESULTS: We found similar age distributions of RSV-associated hospital admissions in each country, with the highest burden in children {\\textless} 1 years old and peak at age 1 month. Average annual rates of RTI admission were 41.3-112.0 per 1000 children aged {\\textless} 1 year and 8.6-22.3 per 1000 children aged {\\textless} 1 year. In children aged {\\textless} 5 years, 57\\%-72\\% of RTI admissions with specified causal pathogen were coded as RSV, with 62\\%-87\\% of pathogen-coded admissions in children {\\textless} 1 year coded as RSV.\nCONCLUSIONS: Our results demonstrate the benefits and limitations of using linked routinely collected data to explore epidemiology and burden of RSV. Our future work will use these data to generate estimates of RSV burden using time-series modelling methodology, to inform policymaking and regulatory decisions regarding RSV immunization strategy and monitor the impact of future vaccines.},\n\tlanguage = {eng},\n\tnumber = {Suppl 7},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Reeves, Rachel M. and van Wijhe, Maarten and Tong, Sabine and Lehtonen, Toni and Stona, Luca and Teirlinck, Anne C. and Fernandez, Liliana Vazquez and Li, You and Giaquinto, Carlo and Fischer, Thea Kølsen and Demont, Clarisse and Heikkinen, Terho and Speltra, Irene and van Boven, Michiel and Bøås, Håkon and Campbell, Harry and {RESCEU Investigators}},\n\tmonth = oct,\n\tyear = {2020},\n\tpmid = {32815542},\n\tkeywords = {Child, Preschool, Europe, Female, Hospitalization, Hospitals, Humans, Infant, Infant, Newborn, Male, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, Vaccination, Europe, RSV, hospital admissions, national registry data, respiratory syncytial virus},\n\tpages = {S599--S605},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infection (RTI) in young children. Registries provide opportunities to explore RSV epidemiology and burden. METHODS: We explored routinely collected hospital data on RSV in children aged \\textless 5 years in 7 European countries. We compare RSV-associated admission rates, age, seasonality, and time trends between countries. RESULTS: We found similar age distributions of RSV-associated hospital admissions in each country, with the highest burden in children \\textless 1 years old and peak at age 1 month. Average annual rates of RTI admission were 41.3-112.0 per 1000 children aged \\textless 1 year and 8.6-22.3 per 1000 children aged \\textless 1 year. In children aged \\textless 5 years, 57%-72% of RTI admissions with specified causal pathogen were coded as RSV, with 62%-87% of pathogen-coded admissions in children \\textless 1 year coded as RSV. CONCLUSIONS: Our results demonstrate the benefits and limitations of using linked routinely collected data to explore epidemiology and burden of RSV. Our future work will use these data to generate estimates of RSV burden using time-series modelling methodology, to inform policymaking and regulatory decisions regarding RSV immunization strategy and monitor the impact of future vaccines.\n
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\n \n\n \n \n \n \n \n Unveiling the Risk Period for Death After Respiratory Syncytial Virus Illness in Young Children Using a Self-Controlled Case Series Design.\n \n \n \n\n\n \n Li, Y.; Campbell, H.; Nair, H.; and RESCEU Investigators\n\n\n \n\n\n\n The Journal of Infectious Diseases, 222(Suppl 7): S634–S639. October 2020.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{li_unveiling_2020,\n\ttitle = {Unveiling the {Risk} {Period} for {Death} {After} {Respiratory} {Syncytial} {Virus} {Illness} in {Young} {Children} {Using} a {Self}-{Controlled} {Case} {Series} {Design}},\n\tvolume = {222},\n\tissn = {1537-6613},\n\tdoi = {10.1093/infdis/jiaa309},\n\tabstract = {BACKGROUND: Respiratory syncytial virus (RSV)-related acute lower respiratory infection is an important cause of death in infants and young children. However, little is known about the risk period for RSV-related deaths after presentation to health services with an RSV illness.\nMETHODS: Using the Scottish national mortality database, we identified deaths from respiratory/circulatory causes (hereafter "respiratory/circulatory deaths") in young children aged {\\textless}5 years during 2009-2016, whose medical history and records of laboratory-confirmed RSV infections were obtained by linking the mortality database to the national surveillance data set and the Scottish Morbidity Record. We used a self-controlled case series (SCCS) design to evaluate the relative incidence of deaths with respiratory/circulatory deaths in the first year after an RSV episode. We defined the risk interval as the first year after the RSV episode, and the control interval as the period before and after the risk interval until 5 years after birth. Age-adjusted incidence ratio and attributable fraction were generated using the R software package SCCS.\nRESULTS: We included 162 respiratory/circulatory deaths, of which 36 occurred in children with a history of laboratory-confirmed RSV infection. We found that the mortality risk decreased with time after the RSV episode and that the risk was statistically significant for the month after RSV illness. More than 90\\% of respiratory/circulatory deaths occurring within 1 week after the RSV episode were attributable to RSV (attributable fraction, 93.9\\%; 95\\% confidence interval, 77.6\\%-98.4\\%), compared with about 80\\% of those occurring 1 week to 1 month after RSV illness (80.3\\%; 28.5\\%-94.6\\%).\nCONCLUSIONS: We found an increased risk of death in the first month after an RSV illness episode leading to healthcare attendance. This provides a practical cutoff time window for community-based surveillance studies estimating RSV-related mortality risk. Further studies are warranted to assess the mortality risk beyond the first month after RSV illness episode.},\n\tlanguage = {eng},\n\tnumber = {Suppl 7},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Li, You and Campbell, Harry and Nair, Harish and {RESCEU Investigators}},\n\tmonth = oct,\n\tyear = {2020},\n\tpmid = {32794576},\n\tkeywords = {Child, Preschool, Female, Humans, Incidence, Infant, Male, Morbidity, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, Risk Factors, children, data linkage, fatality, incidence ratio, infants, mortality, respiratory syncytial virus, risk period, self-controlled case series},\n\tpages = {S634--S639},\n}\n\n
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\n BACKGROUND: Respiratory syncytial virus (RSV)-related acute lower respiratory infection is an important cause of death in infants and young children. However, little is known about the risk period for RSV-related deaths after presentation to health services with an RSV illness. METHODS: Using the Scottish national mortality database, we identified deaths from respiratory/circulatory causes (hereafter \"respiratory/circulatory deaths\") in young children aged \\textless5 years during 2009-2016, whose medical history and records of laboratory-confirmed RSV infections were obtained by linking the mortality database to the national surveillance data set and the Scottish Morbidity Record. We used a self-controlled case series (SCCS) design to evaluate the relative incidence of deaths with respiratory/circulatory deaths in the first year after an RSV episode. We defined the risk interval as the first year after the RSV episode, and the control interval as the period before and after the risk interval until 5 years after birth. Age-adjusted incidence ratio and attributable fraction were generated using the R software package SCCS. RESULTS: We included 162 respiratory/circulatory deaths, of which 36 occurred in children with a history of laboratory-confirmed RSV infection. We found that the mortality risk decreased with time after the RSV episode and that the risk was statistically significant for the month after RSV illness. More than 90% of respiratory/circulatory deaths occurring within 1 week after the RSV episode were attributable to RSV (attributable fraction, 93.9%; 95% confidence interval, 77.6%-98.4%), compared with about 80% of those occurring 1 week to 1 month after RSV illness (80.3%; 28.5%-94.6%). CONCLUSIONS: We found an increased risk of death in the first month after an RSV illness episode leading to healthcare attendance. This provides a practical cutoff time window for community-based surveillance studies estimating RSV-related mortality risk. Further studies are warranted to assess the mortality risk beyond the first month after RSV illness episode.\n
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\n \n\n \n \n \n \n \n Global Seasonality of Human Seasonal Coronaviruses: A Clue for Postpandemic Circulating Season of Severe Acute Respiratory Syndrome Coronavirus 2?.\n \n \n \n\n\n \n Li, Y.; Wang, X.; and Nair, H.\n\n\n \n\n\n\n The Journal of Infectious Diseases, 222(7): 1090–1097. September 2020.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{li_global_2020,\n\ttitle = {Global {Seasonality} of {Human} {Seasonal} {Coronaviruses}: {A} {Clue} for {Postpandemic} {Circulating} {Season} of {Severe} {Acute} {Respiratory} {Syndrome} {Coronavirus} 2?},\n\tvolume = {222},\n\tissn = {1537-6613},\n\tshorttitle = {Global {Seasonality} of {Human} {Seasonal} {Coronaviruses}},\n\tdoi = {10.1093/infdis/jiaa436},\n\tabstract = {BACKGROUND: The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could recur as seasonal outbreaks, a circulating pattern observed among other preexisting human seasonal coronaviruses (sCoVs). However, little is known about seasonality of sCoVs on a global scale.\nMETHODS: We conducted a systematic review of data on seasonality of sCoVs. We compared seasonality of sCoVs with influenza virus and respiratory syncytial virus. We modeled monthly activity of sCoVs using site-specific weather data.\nRESULTS: We included sCoV seasonality data in 40 sites from 21 countries. sCoVs were prevalent in winter months in most temperate sites except for China, whereas sCoVs tended to be less seasonal in China and in tropical sites. In temperate sites excluding China, 53.1\\% of annual sCoV cases (interquartile range [IQR], 34.6\\%-61.9\\%) occurred during influenza season and 49.6\\% (IQR, 30.2\\%-60.2\\%) of sCoV cases occurred during respiratory syncytial virus season. Low temperature combined with high relative humidity was associated with higher sCoV activity.\nCONCLUSIONS: This is the first study that provides an overview of the global seasonality of sCoVs. Our findings offer clues to the possible postpandemic circulating season of SARS-CoV-2 and add to the knowledge pool necessary for postpandemic preparedness for SARS-CoV-2.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Li, You and Wang, Xin and Nair, Harish},\n\tmonth = sep,\n\tyear = {2020},\n\tpmid = {32691843},\n\tpmcid = {PMC7454715},\n\tkeywords = {Betacoronavirus, COVID-19, China, Coronavirus Infections, Humans, Pandemics, Pneumonia, Viral, SARS-CoV-2, Seasons, COVID-19, SARS-CoV-2, human coronavirus, relative humidity, seasonality, temperature},\n\tpages = {1090--1097},\n}\n\n
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\n BACKGROUND: The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could recur as seasonal outbreaks, a circulating pattern observed among other preexisting human seasonal coronaviruses (sCoVs). However, little is known about seasonality of sCoVs on a global scale. METHODS: We conducted a systematic review of data on seasonality of sCoVs. We compared seasonality of sCoVs with influenza virus and respiratory syncytial virus. We modeled monthly activity of sCoVs using site-specific weather data. RESULTS: We included sCoV seasonality data in 40 sites from 21 countries. sCoVs were prevalent in winter months in most temperate sites except for China, whereas sCoVs tended to be less seasonal in China and in tropical sites. In temperate sites excluding China, 53.1% of annual sCoV cases (interquartile range [IQR], 34.6%-61.9%) occurred during influenza season and 49.6% (IQR, 30.2%-60.2%) of sCoV cases occurred during respiratory syncytial virus season. Low temperature combined with high relative humidity was associated with higher sCoV activity. CONCLUSIONS: This is the first study that provides an overview of the global seasonality of sCoVs. Our findings offer clues to the possible postpandemic circulating season of SARS-CoV-2 and add to the knowledge pool necessary for postpandemic preparedness for SARS-CoV-2.\n
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\n \n\n \n \n \n \n \n The role of viral co-infections in the severity of acute respiratory infections among children infected with respiratory syncytial virus (RSV): A systematic review and meta-analysis.\n \n \n \n\n\n \n Li, Y.; Pillai, P.; Miyake, F.; and Nair, H.\n\n\n \n\n\n\n Journal of Global Health, 10(1): 010426. June 2020.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{li_role_2020,\n\ttitle = {The role of viral co-infections in the severity of acute respiratory infections among children infected with respiratory syncytial virus ({RSV}): {A} systematic review and meta-analysis},\n\tvolume = {10},\n\tissn = {2047-2986},\n\tshorttitle = {The role of viral co-infections in the severity of acute respiratory infections among children infected with respiratory syncytial virus ({RSV})},\n\tdoi = {10.7189/jogh.10.010426},\n\tabstract = {Background: Respiratory syncytial virus (RSV) is the predominant viral cause of childhood pneumonia. Little is known about the role of viral-coinfections in the clinical severity in children infected with RSV.\nMethods: We conducted a systematic literature review of publications comparing the clinical severity between RSV mono-infection and RSV co-infection with other viruses in children under five years ({\\textless}5y). Clinical severity was measured using the following six clinical outcomes: hospitalisation, length of hospital stay, use of supplemental oxygen, intensive care unit (ICU) admission, mechanical ventilation and deaths. We summarised the findings by clinical outcome and conducted random-effect meta-analyses, where applicable, to quantitatively synthesize the association between RSV mono-infection/RSV co-infection and the clinical severity.\nResults: Overall, no differences in the clinical severity were found between RSV mono-infection and RSV co-infection with any viruses, except for the RSV-human metapneumovirus (hMPV) co-infection. RSV-hMPV coinfection was found to be associated with a higher risk of ICU admission (odds ratio (OR) = 7.2, 95\\% confidence interval (CI) = 2.1-25.1; OR after removal of the most influential study was 3.7, 95\\% CI = 1.1-12.3). We also observed a trend from three studies that RSV-hMPV coinfections were likely to be associated with longer hospital stay.\nConclusion: Our findings suggest that RSV-hMPV coinfections might be associated with increased risk for ICU admission in children {\\textless}5y compared with RSV mono-infection but such association does not imply causation. Our findings do not support the association between RSV coinfections with other viruses and clinical severity but further large-scale investigations are needed to confirm the findings.\nProtocol registration: PROSPERO CRD42019154761.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Journal of Global Health},\n\tauthor = {Li, You and Pillai, Pallavi and Miyake, Fuyu and Nair, Harish},\n\tmonth = jun,\n\tyear = {2020},\n\tpmid = {32566164},\n\tpmcid = {PMC7295447},\n\tkeywords = {Child, Preschool, Coinfection, Hospitalization, Humans, Infant, Intensive Care Units, Length of Stay, Respiratory Syncytial Virus Infections, Severity of Illness Index},\n\tpages = {010426},\n}\n\n
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\n Background: Respiratory syncytial virus (RSV) is the predominant viral cause of childhood pneumonia. Little is known about the role of viral-coinfections in the clinical severity in children infected with RSV. Methods: We conducted a systematic literature review of publications comparing the clinical severity between RSV mono-infection and RSV co-infection with other viruses in children under five years (\\textless5y). Clinical severity was measured using the following six clinical outcomes: hospitalisation, length of hospital stay, use of supplemental oxygen, intensive care unit (ICU) admission, mechanical ventilation and deaths. We summarised the findings by clinical outcome and conducted random-effect meta-analyses, where applicable, to quantitatively synthesize the association between RSV mono-infection/RSV co-infection and the clinical severity. Results: Overall, no differences in the clinical severity were found between RSV mono-infection and RSV co-infection with any viruses, except for the RSV-human metapneumovirus (hMPV) co-infection. RSV-hMPV coinfection was found to be associated with a higher risk of ICU admission (odds ratio (OR) = 7.2, 95% confidence interval (CI) = 2.1-25.1; OR after removal of the most influential study was 3.7, 95% CI = 1.1-12.3). We also observed a trend from three studies that RSV-hMPV coinfections were likely to be associated with longer hospital stay. Conclusion: Our findings suggest that RSV-hMPV coinfections might be associated with increased risk for ICU admission in children \\textless5y compared with RSV mono-infection but such association does not imply causation. Our findings do not support the association between RSV coinfections with other viruses and clinical severity but further large-scale investigations are needed to confirm the findings. Protocol registration: PROSPERO CRD42019154761.\n
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\n \n\n \n \n \n \n \n A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and HIV/AIDS infection.\n \n \n \n\n\n \n Zirimenya, L.; Mahmud-Ajeigbe, F.; McQuillan, R.; and Li, Y.\n\n\n \n\n\n\n PLoS neglected tropical diseases, 14(6): e0008383. June 2020.\n \n\n\n\n
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@article{zirimenya_systematic_2020,\n\ttitle = {A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and {HIV}/{AIDS} infection},\n\tvolume = {14},\n\tissn = {1935-2735},\n\tdoi = {10.1371/journal.pntd.0008383},\n\tabstract = {BACKGROUND: Urogenital schistosomiasis and HIV/AIDS infections are widespread in sub-Saharan Africa (SSA) leading to substantial morbidity and mortality. The co-occurrence of both diseases has led to the possible hypothesis that urogenital schistosomiasis leads to increased risk of acquiring HIV infection. However, the available evidence concerning this association is inconsistent. The aim of this study was to systematically review and quantitatively synthesize studies that investigated the association between urogenital schistosomiasis and HIV/AIDS infection.\nMETHODS: A systematic review basing on PRISMA guidelines was conducted. It is registered with PROSPERO, number CRD42018116648. We searched four databases, MEDLINE, EMBASE, Global Health and Global Index Medicus for studies investigating the association between urogenital schistosomiasis and HIV infection. Only studies published in English were considered. Results of the association were summarised by gender. A meta-analysis was performed for studies on females using random-effects model and a pooled OR with 95\\% confidence interval was reported.\nRESULTS: Of the 993 studies screened, only eight observational studies met the inclusion criteria. Across all studies, the reported unadjusted OR ranged from 0.78 to 3.76. The pooled estimate of unadjusted OR among females was 1.31 (95\\% CI: 0.87-1.99). Only four of the eight studies reported an adjusted OR. A separate meta-analysis done in the three studies among females that reported an adjusted OR showed that the pooled estimate was 1.85 (95\\% CI: 1.17-2.92). There were insufficient data to pool results for association between urogenital schistosomiasis and HIV infection in the males.\nCONCLUSION: Our investigation supports the hypothesis of an association between urogenital schistosomiasis with HIV/AIDS infection in females. Due to insufficient evidence, no conclusion could be drawn in males with urogenital schistosomiasis. Large-scale prospective studies are needed in future.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {PLoS neglected tropical diseases},\n\tauthor = {Zirimenya, Ludoviko and Mahmud-Ajeigbe, Fatima and McQuillan, Ruth and Li, You},\n\tmonth = jun,\n\tyear = {2020},\n\tpmid = {32542045},\n\tpmcid = {PMC7316344},\n\tkeywords = {Acquired Immunodeficiency Syndrome, Africa South of the Sahara, Databases, Factual, Female, Global Health, Humans, Male, Schistosomiasis haematobia},\n\tpages = {e0008383},\n}\n\n
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\n BACKGROUND: Urogenital schistosomiasis and HIV/AIDS infections are widespread in sub-Saharan Africa (SSA) leading to substantial morbidity and mortality. The co-occurrence of both diseases has led to the possible hypothesis that urogenital schistosomiasis leads to increased risk of acquiring HIV infection. However, the available evidence concerning this association is inconsistent. The aim of this study was to systematically review and quantitatively synthesize studies that investigated the association between urogenital schistosomiasis and HIV/AIDS infection. METHODS: A systematic review basing on PRISMA guidelines was conducted. It is registered with PROSPERO, number CRD42018116648. We searched four databases, MEDLINE, EMBASE, Global Health and Global Index Medicus for studies investigating the association between urogenital schistosomiasis and HIV infection. Only studies published in English were considered. Results of the association were summarised by gender. A meta-analysis was performed for studies on females using random-effects model and a pooled OR with 95% confidence interval was reported. RESULTS: Of the 993 studies screened, only eight observational studies met the inclusion criteria. Across all studies, the reported unadjusted OR ranged from 0.78 to 3.76. The pooled estimate of unadjusted OR among females was 1.31 (95% CI: 0.87-1.99). Only four of the eight studies reported an adjusted OR. A separate meta-analysis done in the three studies among females that reported an adjusted OR showed that the pooled estimate was 1.85 (95% CI: 1.17-2.92). There were insufficient data to pool results for association between urogenital schistosomiasis and HIV infection in the males. CONCLUSION: Our investigation supports the hypothesis of an association between urogenital schistosomiasis with HIV/AIDS infection in females. Due to insufficient evidence, no conclusion could be drawn in males with urogenital schistosomiasis. Large-scale prospective studies are needed in future.\n
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\n \n\n \n \n \n \n \n Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study.\n \n \n \n\n\n \n Wang, X.; Li, Y.; O'Brien, K. L.; Madhi, S. A.; Widdowson, M.; Byass, P.; Omer, S. B.; Abbas, Q.; Ali, A.; Amu, A.; Azziz-Baumgartner, E.; Bassat, Q.; Abdullah Brooks, W.; Chaves, S. S.; Chung, A.; Cohen, C.; Echavarria, M.; Fasce, R. A.; Gentile, A.; Gordon, A.; Groome, M.; Heikkinen, T.; Hirve, S.; Jara, J. H.; Katz, M. A.; Khuri-Bulos, N.; Krishnan, A.; de Leon, O.; Lucero, M. G.; McCracken, J. P.; Mira-Iglesias, A.; Moïsi, J. C.; Munywoki, P. K.; Ourohiré, M.; Polack, F. P.; Rahi, M.; Rasmussen, Z. A.; Rath, B. A.; Saha, S. K.; Simões, E. A.; Sotomayor, V.; Thamthitiwat, S.; Treurnicht, F. K.; Wamukoya, M.; Yoshida, L.; Zar, H. J.; Campbell, H.; Nair, H.; and Respiratory Virus Global Epidemiology Network\n\n\n \n\n\n\n The Lancet. Global Health, 8(4): e497–e510. April 2020.\n \n\n\n\n
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@article{wang_global_2020,\n\ttitle = {Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study},\n\tvolume = {8},\n\tissn = {2214-109X},\n\tshorttitle = {Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018},\n\tdoi = {10.1016/S2214-109X(19)30545-5},\n\tabstract = {BACKGROUND: Seasonal influenza virus is a common cause of acute lower respiratory infection (ALRI) in young children. In 2008, we estimated that 20 million influenza-virus-associated ALRI and 1 million influenza-virus-associated severe ALRI occurred in children under 5 years globally. Despite this substantial burden, only a few low-income and middle-income countries have adopted routine influenza vaccination policies for children and, where present, these have achieved only low or unknown levels of vaccine uptake. Moreover, the influenza burden might have changed due to the emergence and circulation of influenza A/H1N1pdm09. We aimed to incorporate new data to update estimates of the global number of cases, hospital admissions, and mortality from influenza-virus-associated respiratory infections in children under 5 years in 2018.\nMETHODS: We estimated the regional and global burden of influenza-associated respiratory infections in children under 5 years from a systematic review of 100 studies published between Jan 1, 1995, and Dec 31, 2018, and a further 57 high-quality unpublished studies. We adapted the Newcastle-Ottawa Scale to assess the risk of bias. We estimated incidence and hospitalisation rates of influenza-virus-associated respiratory infections by severity, case ascertainment, region, and age. We estimated in-hospital deaths from influenza virus ALRI by combining hospital admissions and in-hospital case-fatality ratios of influenza virus ALRI. We estimated the upper bound of influenza virus-associated ALRI deaths based on the number of in-hospital deaths, US paediatric influenza-associated death data, and population-based childhood all-cause pneumonia mortality data in six sites in low-income and lower-middle-income countries.\nFINDINGS: In 2018, among children under 5 years globally, there were an estimated 109·5 million influenza virus episodes (uncertainty range [UR] 63·1-190·6), 10·1 million influenza-virus-associated ALRI cases (6·8-15·1); 870 000 influenza-virus-associated ALRI hospital admissions (543 000-1 415 000), 15 300 in-hospital deaths (5800-43 800), and up to 34 800 (13 200-97 200) overall influenza-virus-associated ALRI deaths. Influenza virus accounted for 7\\% of ALRI cases, 5\\% of ALRI hospital admissions, and 4\\% of ALRI deaths in children under 5 years. About 23\\% of the hospital admissions and 36\\% of the in-hospital deaths were in infants under 6 months. About 82\\% of the in-hospital deaths occurred in low-income and lower-middle-income countries.\nINTERPRETATION: A large proportion of the influenza-associated burden occurs among young infants and in low-income and lower middle-income countries. Our findings provide new and important evidence for maternal and paediatric influenza immunisation, and should inform future immunisation policy particularly in low-income and middle-income countries.\nFUNDING: WHO; Bill \\& Melinda Gates Foundation.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {The Lancet. Global Health},\n\tauthor = {Wang, Xin and Li, You and O'Brien, Katherine L. and Madhi, Shabir A. and Widdowson, Marc-Alain and Byass, Peter and Omer, Saad B. and Abbas, Qalab and Ali, Asad and Amu, Alberta and Azziz-Baumgartner, Eduardo and Bassat, Quique and Abdullah Brooks, W. and Chaves, Sandra S. and Chung, Alexandria and Cohen, Cheryl and Echavarria, Marcela and Fasce, Rodrigo A. and Gentile, Angela and Gordon, Aubree and Groome, Michelle and Heikkinen, Terho and Hirve, Siddhivinayak and Jara, Jorge H. and Katz, Mark A. and Khuri-Bulos, Najwa and Krishnan, Anand and de Leon, Oscar and Lucero, Marilla G. and McCracken, John P. and Mira-Iglesias, Ainara and Moïsi, Jennifer C. and Munywoki, Patrick K. and Ourohiré, Millogo and Polack, Fernando P. and Rahi, Manveer and Rasmussen, Zeba A. and Rath, Barbara A. and Saha, Samir K. and Simões, Eric Af and Sotomayor, Viviana and Thamthitiwat, Somsak and Treurnicht, Florette K. and Wamukoya, Marylene and Yoshida, Lay-Myint and Zar, Heather J. and Campbell, Harry and Nair, Harish and {Respiratory Virus Global Epidemiology Network}},\n\tmonth = apr,\n\tyear = {2020},\n\tpmid = {32087815},\n\tpmcid = {PMC7083228},\n\tkeywords = {Child, Preschool, Global Health, Humans, Infant, Infant, Newborn, Influenza, Human, Linear Models, Respiratory Tract Infections, Seasons},\n\tpages = {e497--e510},\n}\n\n
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\n BACKGROUND: Seasonal influenza virus is a common cause of acute lower respiratory infection (ALRI) in young children. In 2008, we estimated that 20 million influenza-virus-associated ALRI and 1 million influenza-virus-associated severe ALRI occurred in children under 5 years globally. Despite this substantial burden, only a few low-income and middle-income countries have adopted routine influenza vaccination policies for children and, where present, these have achieved only low or unknown levels of vaccine uptake. Moreover, the influenza burden might have changed due to the emergence and circulation of influenza A/H1N1pdm09. We aimed to incorporate new data to update estimates of the global number of cases, hospital admissions, and mortality from influenza-virus-associated respiratory infections in children under 5 years in 2018. METHODS: We estimated the regional and global burden of influenza-associated respiratory infections in children under 5 years from a systematic review of 100 studies published between Jan 1, 1995, and Dec 31, 2018, and a further 57 high-quality unpublished studies. We adapted the Newcastle-Ottawa Scale to assess the risk of bias. We estimated incidence and hospitalisation rates of influenza-virus-associated respiratory infections by severity, case ascertainment, region, and age. We estimated in-hospital deaths from influenza virus ALRI by combining hospital admissions and in-hospital case-fatality ratios of influenza virus ALRI. We estimated the upper bound of influenza virus-associated ALRI deaths based on the number of in-hospital deaths, US paediatric influenza-associated death data, and population-based childhood all-cause pneumonia mortality data in six sites in low-income and lower-middle-income countries. FINDINGS: In 2018, among children under 5 years globally, there were an estimated 109·5 million influenza virus episodes (uncertainty range [UR] 63·1-190·6), 10·1 million influenza-virus-associated ALRI cases (6·8-15·1); 870 000 influenza-virus-associated ALRI hospital admissions (543 000-1 415 000), 15 300 in-hospital deaths (5800-43 800), and up to 34 800 (13 200-97 200) overall influenza-virus-associated ALRI deaths. Influenza virus accounted for 7% of ALRI cases, 5% of ALRI hospital admissions, and 4% of ALRI deaths in children under 5 years. About 23% of the hospital admissions and 36% of the in-hospital deaths were in infants under 6 months. About 82% of the in-hospital deaths occurred in low-income and lower-middle-income countries. INTERPRETATION: A large proportion of the influenza-associated burden occurs among young infants and in low-income and lower middle-income countries. Our findings provide new and important evidence for maternal and paediatric influenza immunisation, and should inform future immunisation policy particularly in low-income and middle-income countries. FUNDING: WHO; Bill & Melinda Gates Foundation.\n
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\n \n\n \n \n \n \n \n Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis.\n \n \n \n\n\n \n Li, Y.; Reeves, R. M.; Wang, X.; Bassat, Q.; Brooks, W. A.; Cohen, C.; Moore, D. P.; Nunes, M.; Rath, B.; Campbell, H.; Nair, H.; RSV Global Epidemiology Network; and RESCEU investigators\n\n\n \n\n\n\n The Lancet. Global Health, 7(8): e1031–e1045. August 2019.\n \n\n\n\n
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@article{li_global_2019,\n\ttitle = {Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis},\n\tvolume = {7},\n\tissn = {2214-109X},\n\tshorttitle = {Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus},\n\tdoi = {10.1016/S2214-109X(19)30264-5},\n\tabstract = {BACKGROUND: Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children ({\\textless}5 years) and older people (≥65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control.\nMETHODS: In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75\\% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5° by 5° grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628.\nFINDINGS: We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0·3 months [95\\% CI -0·3 to 0·9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3·8 months [3·6 to 4·0]) in temperate sites and longer duration (5·2 months [4·9 to 5·5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4·6 months [4·3 to 4·8]), as it was for metapneumovirus (4·8 months [4·4 to 5·1]). By comparison, parainfluenza virus had longer duration of epidemics (6·3 months [6·0 to 6·7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0·2 months [-0·6 to 0·1]; respiratory syncytial virus 0·1 months [-0·2 to 0·4]).\nINTERPRETATION: This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination.\nFUNDING: European Union Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).},\n\tlanguage = {eng},\n\tnumber = {8},\n\tjournal = {The Lancet. Global Health},\n\tauthor = {Li, You and Reeves, Rachel M. and Wang, Xin and Bassat, Quique and Brooks, W. Abdullah and Cohen, Cheryl and Moore, David P. and Nunes, Marta and Rath, Barbara and Campbell, Harry and Nair, Harish and {RSV Global Epidemiology Network} and {RESCEU investigators}},\n\tmonth = aug,\n\tyear = {2019},\n\tpmid = {31303294},\n\tkeywords = {Female, Global Health, Humans, Influenza A virus, Influenza, Human, Male, Metapneumovirus, Paramyxoviridae Infections, Respiratory Syncytial Virus Infections, Respiratory Syncytial Virus, Human},\n\tpages = {e1031--e1045},\n}\n\n
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\n BACKGROUND: Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (\\textless5 years) and older people (≥65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control. METHODS: In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5° by 5° grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628. FINDINGS: We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0·3 months [95% CI -0·3 to 0·9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3·8 months [3·6 to 4·0]) in temperate sites and longer duration (5·2 months [4·9 to 5·5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4·6 months [4·3 to 4·8]), as it was for metapneumovirus (4·8 months [4·4 to 5·1]). By comparison, parainfluenza virus had longer duration of epidemics (6·3 months [6·0 to 6·7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0·2 months [-0·6 to 0·1]; respiratory syncytial virus 0·1 months [-0·2 to 0·4]). INTERPRETATION: This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. FUNDING: European Union Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).\n
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\n \n\n \n \n \n \n \n Serogroup-specific meningococcal carriage by age group: a systematic review and meta-analysis.\n \n \n \n\n\n \n Peterson, M. E.; Li, Y.; Shanks, H.; Mile, R.; Nair, H.; Kyaw, M. H.; and Meningococcal Carriage Group\n\n\n \n\n\n\n BMJ open, 9(4): e024343. April 2019.\n \n\n\n\n
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@article{peterson_serogroup-specific_2019,\n\ttitle = {Serogroup-specific meningococcal carriage by age group: a systematic review and meta-analysis},\n\tvolume = {9},\n\tissn = {2044-6055},\n\tshorttitle = {Serogroup-specific meningococcal carriage by age group},\n\tdoi = {10.1136/bmjopen-2018-024343},\n\tabstract = {OBJECTIVE: Neisseria meningitidis carriage prevalence has known variation across the lifespan, but it is unclear whether carriage varies among meningococcal capsular groups. Therefore, we aimed to characterise group-specific meningococcal carriage by age group and world region from 2007 to 2016.\nDESIGN: Systematic review and meta-analysis.\nDATA SOURCES: MEDLINE, Embase, Global Health Database, WHO Global Health Library, Web of Science, Current Contents Connects, China National Knowledge Infrastructure and Wanfang were systematically searched. Database searches were conducted through July 2018 and Google Scholar forward searches of included studies were conducted through August 2018. References of included studies and relevant conference abstracts were also searched to identify additional articles for inclusion.\nELIGIBILITY CRITERIA: Studies were eligible for inclusion if they reported capsular group-specific meningococcal carriage in a healthy population of a specified age group and geographical region. For this review, only studies conducted between 2007 and 2016 were included.\nDATA EXTRACTION AND SYNTHESIS: Data were independently extracted by two authors into Microsoft Access. Studies were assessed for risk of bias using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Studies eligible for inclusion in quantitative analyses by pre-specified age groups were pooled using random effects meta-analyses. Results are reported by capsular group, age group and WHO region. Where meta-analyses were not appropriate, study results were discussed narratively.\nRESULTS: 7511 articles were identified and 65 were eligible for inclusion. Adolescents and young adults were the focus of many studies (n=24), especially in the Americas and Europe. Studies from China and Africa, typically, included data from a wider age range. The overall carriage prevalence varied markedly by age group and region. Based on the available data, 21 studies were included in meta-analyses reporting serogroup carriage for: all ages in Africa, 18-24-year olds in the Americas, and 11-17 and 18-24-year olds in Europe. Capsular groups W, X, Y and 'other' (non-ABCWXY, including non-groupable) were the most prevalent in Africa, and 5-17-year olds had higher carriage prevalence than other age groups. 'Other' serogroups (11.5\\%, 95\\% CI 1.6\\% to 16.1\\%) were the most common among 18-24-year olds from the Americas. In Europe, 18-24-year old were carriers more frequently than 11-17-year olds, and groups B (5.0\\%, 95\\% CI 3.0\\% to 7.5\\%), Y (3.9\\%, 95\\% CI 1.3\\% to 7.8\\%) and 'other' (6.4\\%, 95\\% CI 3.1\\% to 10.8\\%) were the most commonly carried in the older age group.\nCONCLUSIONS: Of the age groups included in the analysis, carriage patterns by age were similar across capsular groups within a region but differed between regions. Data gaps remain for age- and capsular group-specific carriage in many regions, especially in the Eastern Mediterranean and South-East Asia. As such, clear and robust conclusions about the variation of capsular group-specific carriage by age group and WHO region were unable to be determined.\nPROSPERO REGISTRATION NUMBER: CRD42017074671.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {BMJ open},\n\tauthor = {Peterson, Meagan E. and Li, You and Shanks, Heather and Mile, Rebecca and Nair, Harish and Kyaw, Moe H. and {Meningococcal Carriage Group}},\n\tmonth = apr,\n\tyear = {2019},\n\tpmid = {31005910},\n\tpmcid = {PMC6500331},\n\tkeywords = {Africa, Age Distribution, Americas, Carrier State, Europe, Humans, Meningococcal Infections, Neisseria meningitidis, Prevalence, Serogroup, Neisseira meningitidis, carriage, serogroup},\n\tpages = {e024343},\n}\n\n
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\n OBJECTIVE: Neisseria meningitidis carriage prevalence has known variation across the lifespan, but it is unclear whether carriage varies among meningococcal capsular groups. Therefore, we aimed to characterise group-specific meningococcal carriage by age group and world region from 2007 to 2016. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, Global Health Database, WHO Global Health Library, Web of Science, Current Contents Connects, China National Knowledge Infrastructure and Wanfang were systematically searched. Database searches were conducted through July 2018 and Google Scholar forward searches of included studies were conducted through August 2018. References of included studies and relevant conference abstracts were also searched to identify additional articles for inclusion. ELIGIBILITY CRITERIA: Studies were eligible for inclusion if they reported capsular group-specific meningococcal carriage in a healthy population of a specified age group and geographical region. For this review, only studies conducted between 2007 and 2016 were included. DATA EXTRACTION AND SYNTHESIS: Data were independently extracted by two authors into Microsoft Access. Studies were assessed for risk of bias using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Studies eligible for inclusion in quantitative analyses by pre-specified age groups were pooled using random effects meta-analyses. Results are reported by capsular group, age group and WHO region. Where meta-analyses were not appropriate, study results were discussed narratively. RESULTS: 7511 articles were identified and 65 were eligible for inclusion. Adolescents and young adults were the focus of many studies (n=24), especially in the Americas and Europe. Studies from China and Africa, typically, included data from a wider age range. The overall carriage prevalence varied markedly by age group and region. Based on the available data, 21 studies were included in meta-analyses reporting serogroup carriage for: all ages in Africa, 18-24-year olds in the Americas, and 11-17 and 18-24-year olds in Europe. Capsular groups W, X, Y and 'other' (non-ABCWXY, including non-groupable) were the most prevalent in Africa, and 5-17-year olds had higher carriage prevalence than other age groups. 'Other' serogroups (11.5%, 95% CI 1.6% to 16.1%) were the most common among 18-24-year olds from the Americas. In Europe, 18-24-year old were carriers more frequently than 11-17-year olds, and groups B (5.0%, 95% CI 3.0% to 7.5%), Y (3.9%, 95% CI 1.3% to 7.8%) and 'other' (6.4%, 95% CI 3.1% to 10.8%) were the most commonly carried in the older age group. CONCLUSIONS: Of the age groups included in the analysis, carriage patterns by age were similar across capsular groups within a region but differed between regions. Data gaps remain for age- and capsular group-specific carriage in many regions, especially in the Eastern Mediterranean and South-East Asia. As such, clear and robust conclusions about the variation of capsular group-specific carriage by age group and WHO region were unable to be determined. PROSPERO REGISTRATION NUMBER: CRD42017074671.\n
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\n \n\n \n \n \n \n \n Meningococcal serogroups and surveillance: a systematic review and survey.\n \n \n \n\n\n \n Peterson, M. E.; Li, Y.; Bita, A.; Moureau, A.; Nair, H.; Kyaw, M. H.; Meningococcal Surveillance Group (in alphabetical order); Abad, R.; Bailey, F.; Garcia, I. d. l. F.; Decheva, A.; Krizova, P.; Melillo, T.; Skoczynska, A.; and Vladimirova, N.\n\n\n \n\n\n\n Journal of Global Health, 9(1): 010409. June 2019.\n \n\n\n\n
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@article{peterson_meningococcal_2019,\n\ttitle = {Meningococcal serogroups and surveillance: a systematic review and survey},\n\tvolume = {9},\n\tissn = {2047-2986},\n\tshorttitle = {Meningococcal serogroups and surveillance},\n\tdoi = {10.7189/jogh.09.010409},\n\tabstract = {BACKGROUND: Meningococcal disease continues to be a global public health concern due to its epidemic potential, severity, and sequelae. The global epidemiological data on circulating meningococcal serogroups have never been reviewed concurrently with the laboratory capacity for meningococcal surveillance at the national level. We, therefore, aimed to conduct a country-level review of meningococcal surveillance, serogroup distribution, and vaccine use.\nMETHODS: We conducted a systematic literature review across six databases to identify studies (published January 1, 2010 to October 16, 2017) and grey literature reporting meningococcal serogroup data for the years 2010-2016. We performed independent random effects meta-analyses for serogroups A, B, C, W, X, Y, and other. We developed and circulated a questionnaire-based survey to surveillance focal points in countries (N = 95) with known regional bacterial meningitis surveillance programs to assess their surveillance capacity and summarized using descriptive methods.\nRESULTS: We included 173 studies from 59 countries in the final analysis. The distribution of meningococcal serogroups differed markedly between countries and regions. Meningococcal serogroups C and W accounted for substantial proportions of meningococcal disease in most of Africa and Latin America. Serogroup B was the predominant cause of meningococcal disease in many locations in Europe, the Americas, and the Western Pacific. Serogroup Y also caused many cases of meningococcal disease in these regions, particularly in Nordic countries. Survey responses were received from 51 countries. All countries reported the ability to confirm the pathogen in-country, while approximately 30\\% either relied on reference laboratories for serogrouping (N = 10) or did not serogroup specimens (N = 5). Approximately half of countries did not utilize active laboratory-based surveillance system (N = 22). Nationwide use of a meningococcal vaccine varied, but most countries (N = 36) utilized a meningococcal vaccine at least for certain high-risk population groups, in private care, or during outbreaks.\nCONCLUSIONS: Due to the large geographical variations in circulating meningococcal serogroups, each country should continue to be monitored for changes in major disease-causing serogroups in order to inform vaccine and control policies. Similarly, laboratory capacity should be appropriately scaled up to more accurately understand local epidemiology and disease burden, as well as the impact of vaccination programs.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Journal of Global Health},\n\tauthor = {Peterson, Meagan E. and Li, You and Bita, André and Moureau, Annick and Nair, Harish and Kyaw, Moe H. and {Meningococcal Surveillance Group (in alphabetical order)} and Abad, Raquel and Bailey, Freddie and Garcia, Isabel de la Fuente and Decheva, Antoaneta and Krizova, Pavla and Melillo, Tanya and Skoczynska, Anna and Vladimirova, Nadezhda},\n\tmonth = jun,\n\tyear = {2019},\n\tpmid = {30603079},\n\tpmcid = {PMC6304171},\n\tkeywords = {Global Health, Humans, Meningococcal Infections, Meningococcal Vaccines, Neisseria meningitidis, Population Surveillance, Serogroup, Surveys and Questionnaires},\n\tpages = {010409},\n}\n\n
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\n BACKGROUND: Meningococcal disease continues to be a global public health concern due to its epidemic potential, severity, and sequelae. The global epidemiological data on circulating meningococcal serogroups have never been reviewed concurrently with the laboratory capacity for meningococcal surveillance at the national level. We, therefore, aimed to conduct a country-level review of meningococcal surveillance, serogroup distribution, and vaccine use. METHODS: We conducted a systematic literature review across six databases to identify studies (published January 1, 2010 to October 16, 2017) and grey literature reporting meningococcal serogroup data for the years 2010-2016. We performed independent random effects meta-analyses for serogroups A, B, C, W, X, Y, and other. We developed and circulated a questionnaire-based survey to surveillance focal points in countries (N = 95) with known regional bacterial meningitis surveillance programs to assess their surveillance capacity and summarized using descriptive methods. RESULTS: We included 173 studies from 59 countries in the final analysis. The distribution of meningococcal serogroups differed markedly between countries and regions. Meningococcal serogroups C and W accounted for substantial proportions of meningococcal disease in most of Africa and Latin America. Serogroup B was the predominant cause of meningococcal disease in many locations in Europe, the Americas, and the Western Pacific. Serogroup Y also caused many cases of meningococcal disease in these regions, particularly in Nordic countries. Survey responses were received from 51 countries. All countries reported the ability to confirm the pathogen in-country, while approximately 30% either relied on reference laboratories for serogrouping (N = 10) or did not serogroup specimens (N = 5). Approximately half of countries did not utilize active laboratory-based surveillance system (N = 22). Nationwide use of a meningococcal vaccine varied, but most countries (N = 36) utilized a meningococcal vaccine at least for certain high-risk population groups, in private care, or during outbreaks. CONCLUSIONS: Due to the large geographical variations in circulating meningococcal serogroups, each country should continue to be monitored for changes in major disease-causing serogroups in order to inform vaccine and control policies. Similarly, laboratory capacity should be appropriately scaled up to more accurately understand local epidemiology and disease burden, as well as the impact of vaccination programs.\n
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\n \n\n \n \n \n \n \n The Role of Attributable Fraction in the Exposed in Assessing the Association of Microorganisms With Pneumonia.\n \n \n \n\n\n \n Wang, X.; Li, Y.; and Nair, H.\n\n\n \n\n\n\n Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 68(6): 1067–1068. March 2019.\n \n\n\n\n
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@article{wang_role_2019,\n\ttitle = {The {Role} of {Attributable} {Fraction} in the {Exposed} in {Assessing} the {Association} of {Microorganisms} {With} {Pneumonia}},\n\tvolume = {68},\n\tissn = {1537-6591},\n\tdoi = {10.1093/cid/ciy815},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},\n\tauthor = {Wang, Xin and Li, You and Nair, Harish},\n\tmonth = mar,\n\tyear = {2019},\n\tpmid = {30252022},\n\tkeywords = {Case-Control Studies, Child, Child, Preschool, Humans, Pneumonia, Prospective Studies, association, attributable fraction in the exposed (AFE), children, microorganisms, pneumonia},\n\tpages = {1067--1068},\n}\n\n
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\n  \n 2018\n \n \n (2)\n \n \n
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\n \n\n \n \n \n \n \n Meningococcal carriage in high-risk settings: A systematic review.\n \n \n \n\n\n \n Peterson, M. E.; Mile, R.; Li, Y.; Nair, H.; and Kyaw, M. H.\n\n\n \n\n\n\n International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases, 73: 109–117. August 2018.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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@article{peterson_meningococcal_2018,\n\ttitle = {Meningococcal carriage in high-risk settings: {A} systematic review},\n\tvolume = {73},\n\tissn = {1878-3511},\n\tshorttitle = {Meningococcal carriage in high-risk settings},\n\tdoi = {10.1016/j.ijid.2018.05.022},\n\tabstract = {BACKGROUND: Historically, semi-closed populations have had high rates of meningococcal carriage and have experienced recurrent outbreaks. As such, these high-risk groups are recommended for targeted vaccination in many countries.\nMETHODS: A systematic review of eight databases and Google Scholar forward citations was conducted to characterize serogroup-specific meningococcal carriage in university students, military personnel, and Hajj pilgrims from 2007 to 2016.\nRESULTS: A total of 7014 records were identified and 22 studies were included. Overall carriage ranged from 0.0\\% to 27.4\\% in Hajj pilgrims, from 1.5\\% to 71.1\\% in university students, and from 4.2\\% to 15.2\\% in military personnel. Among serogroups A, B, C, W, X, and Y, serogroup B was most prevalent in Hajj pilgrims, B and Y in university students, and B, C, and Y in military personnel. 'Other' serogroups were more prevalent in university students than Hajj pilgrims or military personnel. Risk factors for carriage varied by setting. Among Hajj pilgrims, a high endemicity in the country of origin increased the risk of carriage, while smoking, male sex, and frequently attending parties increased the carriage risk for university students. Similarly, smoking increased the carriage risk for professional soldiers. Data gaps remain for many regions.\nCONCLUSIONS: Preventative vaccination policies for high-risk groups should be based on current disease data in individual countries, supplemented by carriage data. Meningococcal carriage studies and disease surveillance are critical for determining the local epidemiology, populations responsible for disease transmission, and the need for targeted vaccination.},\n\tlanguage = {eng},\n\tjournal = {International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases},\n\tauthor = {Peterson, Meagan E. and Mile, Rebecca and Li, You and Nair, Harish and Kyaw, Moe H.},\n\tmonth = aug,\n\tyear = {2018},\n\tpmid = {29997031},\n\tkeywords = {Carrier State, Female, Humans, Male, Meningococcal Infections, Military Personnel, Prevalence, Vaccination, Carriage, Hajj, Meningococcal, Military, Neisseria meningitidis, University},\n\tpages = {109--117},\n}\n\n
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\n BACKGROUND: Historically, semi-closed populations have had high rates of meningococcal carriage and have experienced recurrent outbreaks. As such, these high-risk groups are recommended for targeted vaccination in many countries. METHODS: A systematic review of eight databases and Google Scholar forward citations was conducted to characterize serogroup-specific meningococcal carriage in university students, military personnel, and Hajj pilgrims from 2007 to 2016. RESULTS: A total of 7014 records were identified and 22 studies were included. Overall carriage ranged from 0.0% to 27.4% in Hajj pilgrims, from 1.5% to 71.1% in university students, and from 4.2% to 15.2% in military personnel. Among serogroups A, B, C, W, X, and Y, serogroup B was most prevalent in Hajj pilgrims, B and Y in university students, and B, C, and Y in military personnel. 'Other' serogroups were more prevalent in university students than Hajj pilgrims or military personnel. Risk factors for carriage varied by setting. Among Hajj pilgrims, a high endemicity in the country of origin increased the risk of carriage, while smoking, male sex, and frequently attending parties increased the carriage risk for university students. Similarly, smoking increased the carriage risk for professional soldiers. Data gaps remain for many regions. CONCLUSIONS: Preventative vaccination policies for high-risk groups should be based on current disease data in individual countries, supplemented by carriage data. Meningococcal carriage studies and disease surveillance are critical for determining the local epidemiology, populations responsible for disease transmission, and the need for targeted vaccination.\n
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\n \n\n \n \n \n \n \n Association of seasonal viral acute respiratory infection with pneumococcal disease: a systematic review of population-based studies.\n \n \n \n\n\n \n Li, Y.; Peterson, M. E.; Campbell, H.; and Nair, H.\n\n\n \n\n\n\n BMJ open, 8(4): e019743. April 2018.\n \n\n\n\n
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@article{li_association_2018,\n\ttitle = {Association of seasonal viral acute respiratory infection with pneumococcal disease: a systematic review of population-based studies},\n\tvolume = {8},\n\tissn = {2044-6055},\n\tshorttitle = {Association of seasonal viral acute respiratory infection with pneumococcal disease},\n\tdoi = {10.1136/bmjopen-2017-019743},\n\tabstract = {OBJECTIVE: Animal and in vitro studies suggest that viral acute respiratory infection (VARI) can predispose to pneumococcal infection. These findings suggest that the prevention of VARI can yield additional benefits for the control of pneumococcal disease (PD). In population-based studies, however, the evidence is not in accordance, possibly due to a variety of methodological challenges and problems in these studies. We aimed to summarise and critically review the methods and results from these studies in order to inform future studies.\nMETHODS: We conducted a systematic review of population-based studies that analysed the association between preceding seasonal VARI and subsequent PD. We searched MEDLINE, Embase and Global Health databases using tailored search strategies.\nRESULTS: A total of 28 studies were included. After critically reviewing the methodologies and findings, 11 studies did not control for seasonal factors shared by VARI and PD. This, in turn, could lead to an overestimation of the association between the two illnesses. One case-control study was limited by its small sample size (n case=13). The remaining 16 studies that controlled for seasonal factors suggested that influenza and/or respiratory syncytial virus (RSV) infections were likely to be associated with the subsequent occurrence of PD (influenza: 12/14 studies; RSV: 4/5 studies). However, these 16 studies were unable to conduct individual patient data-based analyses. Nevertheless, these studies suggested the association between VARI and subsequent PD was related to additional factors such as virus type and subtype, age group, comorbidity status, presentation of PD and pneumococcal serotype.\nCONCLUSIONS: Population-based studies do not give consistent support for an association between preceding seasonal VARI and subsequent PD incidence. The main methodological challenges of existing studies include the failure to use individual patient data, control for seasonal factors of VARI and PD, or include other factors related to the association (eg, virus, age, comorbidity and pneumococcal serotype).},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {BMJ open},\n\tauthor = {Li, You and Peterson, Meagan E. and Campbell, Harry and Nair, Harish},\n\tmonth = apr,\n\tyear = {2018},\n\tpmid = {29680810},\n\tpmcid = {PMC5914779},\n\tkeywords = {Animals, Case-Control Studies, Humans, Pneumococcal Infections, Respiratory Syncytial Virus Infections, Respiratory Tract Infections, Seasons, pneumococcal disease, pneumococcal infection, respiratory tract Infection, viral acute respiratory infection},\n\tpages = {e019743},\n}\n\n
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\n OBJECTIVE: Animal and in vitro studies suggest that viral acute respiratory infection (VARI) can predispose to pneumococcal infection. These findings suggest that the prevention of VARI can yield additional benefits for the control of pneumococcal disease (PD). In population-based studies, however, the evidence is not in accordance, possibly due to a variety of methodological challenges and problems in these studies. We aimed to summarise and critically review the methods and results from these studies in order to inform future studies. METHODS: We conducted a systematic review of population-based studies that analysed the association between preceding seasonal VARI and subsequent PD. We searched MEDLINE, Embase and Global Health databases using tailored search strategies. RESULTS: A total of 28 studies were included. After critically reviewing the methodologies and findings, 11 studies did not control for seasonal factors shared by VARI and PD. This, in turn, could lead to an overestimation of the association between the two illnesses. One case-control study was limited by its small sample size (n case=13). The remaining 16 studies that controlled for seasonal factors suggested that influenza and/or respiratory syncytial virus (RSV) infections were likely to be associated with the subsequent occurrence of PD (influenza: 12/14 studies; RSV: 4/5 studies). However, these 16 studies were unable to conduct individual patient data-based analyses. Nevertheless, these studies suggested the association between VARI and subsequent PD was related to additional factors such as virus type and subtype, age group, comorbidity status, presentation of PD and pneumococcal serotype. CONCLUSIONS: Population-based studies do not give consistent support for an association between preceding seasonal VARI and subsequent PD incidence. The main methodological challenges of existing studies include the failure to use individual patient data, control for seasonal factors of VARI and PD, or include other factors related to the association (eg, virus, age, comorbidity and pneumococcal serotype).\n
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\n  \n 2016\n \n \n (1)\n \n \n
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\n \n\n \n \n \n \n \n A Correlation Study of DHA Dietary Intake and Plasma, Erythrocyte and Breast Milk DHA Concentrations in Lactating Women from Coastland, Lakeland, and Inland Areas of China.\n \n \n \n\n\n \n Liu, M.; Li, H.; Yu, L.; Xu, G.; Ge, H.; Wang, L.; Zhang, Y.; Zhou, Y.; Li, Y.; Bai, M.; and Liu, J.\n\n\n \n\n\n\n Nutrients, 8(5): E312. May 2016.\n \n\n\n\n
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@article{liu_correlation_2016,\n\ttitle = {A {Correlation} {Study} of {DHA} {Dietary} {Intake} and {Plasma}, {Erythrocyte} and {Breast} {Milk} {DHA} {Concentrations} in {Lactating} {Women} from {Coastland}, {Lakeland}, and {Inland} {Areas} of {China}},\n\tvolume = {8},\n\tissn = {2072-6643},\n\tdoi = {10.3390/nu8050312},\n\tabstract = {We aimed to assess the correlation between docosahexaenoic acid (DHA) dietary intake and the plasma, erythrocyte and breast milk DHA concentrations in lactating women residing in the coastland, lakeland and inland areas of China. A total of 408 healthy lactating women (42 ± 7 days postpartum) were recruited from four hospitals located in Weihai (coastland), Yueyang (lakeland) and Baotou (inland) city. The categories of food containing DHA, the average amount consumed per time and the frequency of consumption in the past month were assessed by a tailored DHA food frequency questionnaire, the DHA Intake Evaluation Tool (DIET). DHA dietary intake (mg/day) was calculated according to the Chinese Food Composition Table (Version 2009). In addition, fasting venous blood (5 mL) and breast milk (10 mL) were collected from lactating women. DHA concentrations in plasma, erythrocyte and breast milk were measured using capillary gas chromatography, and were reported as absolute concentration (μg/mL) and relative concentration (weight percent of total fatty acids, wt. \\%). Spearman correlation coefficients were used to assess the correlation between intakes of DHA and its concentrations in biological specimens. The study showed that the breast milk, plasma and erythrocyte DHA concentrations were positively correlated with DHA dietary intake; corresponding correlation coefficients were 0.36, 0.36 and 0.24 for relative concentration and 0.33, 0.32, and 0.18 for absolute concentration (p {\\textless} 0.05). The median DHA dietary intake varied significantly across areas (p {\\textless} 0.05), which was highest in the coastland (24.32 mg/day), followed by lakeland (13.69 mg/day), and lowest in the inland (8.84 mg/day). The overall relative and absolute DHA concentrations in breast milk were 0.36\\% ± 0.23\\% and 141.49 ± 107.41 μg/mL; the concentrations were significantly lower in inland women than those from coastland and lakeland. We conclude that DHA dietary intake is positively correlated with DHA concentrations in blood and breast milk in Chinese lactating women, suggesting that the tailored DHA food frequency questionnaire, DIET, is a valid tool for the assessment of DHA dietary intake.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {Nutrients},\n\tauthor = {Liu, Meng-Jiao and Li, Hong-Tian and Yu, Li-Xia and Xu, Gao-Sheng and Ge, Hua and Wang, Lin-Lin and Zhang, Ya-Li and Zhou, Yu-Bo and Li, You and Bai, Man-Xi and Liu, Jian-Meng},\n\tmonth = may,\n\tyear = {2016},\n\tpmid = {27213448},\n\tpmcid = {PMC4882724},\n\tkeywords = {Adolescent, Adult, China, Chromatography, Gas, Diet, Docosahexaenoic Acids, Erythrocytes, Female, Humans, Lactation, Maternal Health, Maternal Nutritional Physiological Phenomena, Milk, Human, Nutritional Status, Postpartum Period, Pregnancy, Reproducibility of Results, Surveys and Questionnaires, Time Factors, Young Adult, breast milk, correlation, docosahexaenoic acid, erythrocyte, food frequency questionnaire, lactating women, plasma},\n\tpages = {E312},\n}\n\n
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\n We aimed to assess the correlation between docosahexaenoic acid (DHA) dietary intake and the plasma, erythrocyte and breast milk DHA concentrations in lactating women residing in the coastland, lakeland and inland areas of China. A total of 408 healthy lactating women (42 ± 7 days postpartum) were recruited from four hospitals located in Weihai (coastland), Yueyang (lakeland) and Baotou (inland) city. The categories of food containing DHA, the average amount consumed per time and the frequency of consumption in the past month were assessed by a tailored DHA food frequency questionnaire, the DHA Intake Evaluation Tool (DIET). DHA dietary intake (mg/day) was calculated according to the Chinese Food Composition Table (Version 2009). In addition, fasting venous blood (5 mL) and breast milk (10 mL) were collected from lactating women. DHA concentrations in plasma, erythrocyte and breast milk were measured using capillary gas chromatography, and were reported as absolute concentration (μg/mL) and relative concentration (weight percent of total fatty acids, wt. %). Spearman correlation coefficients were used to assess the correlation between intakes of DHA and its concentrations in biological specimens. The study showed that the breast milk, plasma and erythrocyte DHA concentrations were positively correlated with DHA dietary intake; corresponding correlation coefficients were 0.36, 0.36 and 0.24 for relative concentration and 0.33, 0.32, and 0.18 for absolute concentration (p \\textless 0.05). The median DHA dietary intake varied significantly across areas (p \\textless 0.05), which was highest in the coastland (24.32 mg/day), followed by lakeland (13.69 mg/day), and lowest in the inland (8.84 mg/day). The overall relative and absolute DHA concentrations in breast milk were 0.36% ± 0.23% and 141.49 ± 107.41 μg/mL; the concentrations were significantly lower in inland women than those from coastland and lakeland. We conclude that DHA dietary intake is positively correlated with DHA concentrations in blood and breast milk in Chinese lactating women, suggesting that the tailored DHA food frequency questionnaire, DIET, is a valid tool for the assessment of DHA dietary intake.\n
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\n  \n 2015\n \n \n (1)\n \n \n
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\n \n\n \n \n \n \n \n DHA in Pregnant and Lactating Women from Coastland, Lakeland, and Inland Areas of China: Results of a DHA Evaluation in Women (DEW) Study.\n \n \n \n\n\n \n Li, Y.; Li, H.; Trasande, L.; Ge, H.; Yu, L.; Xu, G.; Bai, M.; and Liu, J.\n\n\n \n\n\n\n Nutrients, 7(10): 8723–8732. October 2015.\n \n\n\n\n
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@article{li_dha_2015,\n\ttitle = {{DHA} in {Pregnant} and {Lactating} {Women} from {Coastland}, {Lakeland}, and {Inland} {Areas} of {China}: {Results} of a {DHA} {Evaluation} in {Women} ({DEW}) {Study}},\n\tvolume = {7},\n\tissn = {2072-6643},\n\tshorttitle = {{DHA} in {Pregnant} and {Lactating} {Women} from {Coastland}, {Lakeland}, and {Inland} {Areas} of {China}},\n\tdoi = {10.3390/nu7105428},\n\tabstract = {Few studies have examined docosahexaenoic acid (DHA) in pregnant and lactating women in developing countries like China, where DHA-enriched supplements are increasingly popular. We aimed to assess the DHA status among Chinese pregnant and lactating women residing areas differing in the availability of aquatic products. In total, 1211 women in mid-pregnancy (17 ± 2 weeks), late pregnancy (39 ± 2 weeks), or lactation (42 ± 7 days) were enrolled from Weihai (coastland), Yueyang (lakeland), and Baotou (inland) city, with approximately 135 women in each participant group by region. DHA concentrations were measured using capillary gas chromatography, and are reported as weight percent of total fatty acids. Mean plasma DHA concentrations were higher in coastland (mid-pregnancy 3.19\\%, late pregnancy 2.54\\%, lactation 2.24\\%) and lakeland women (2.45\\%, 1.95\\%, 2.26\\%) than inland women (2.25\\%, 1.67\\%, 1.68\\%) (p values {\\textless} 0.001). Similar differences were observed for erythrocyte DHA. We conclude that DHA concentrations of Chinese pregnant and lactating women are higher in coastland and lakeland regions than in inland areas. DHA status in the study population appears to be stronger than populations from other countries studied to date.},\n\tlanguage = {eng},\n\tnumber = {10},\n\tjournal = {Nutrients},\n\tauthor = {Li, You and Li, Hong-Tian and Trasande, Leonardo and Ge, Hua and Yu, Li-Xia and Xu, Gao-Sheng and Bai, Man-Xi and Liu, Jian-Meng},\n\tmonth = oct,\n\tyear = {2015},\n\tpmid = {26506380},\n\tpmcid = {PMC4632448},\n\tkeywords = {Adult, Animals, Breast Feeding, China, Diet, Docosahexaenoic Acids, Feeding Behavior, Female, Fishes, Food Supply, Humans, Lactation, Lakes, Malnutrition, Nutritional Status, Oceans and Seas, Pregnancy, Pregnancy Complications, Residence Characteristics, Seafood, Young Adult, correlation, docosahexaenoic acid, erythrocyte, lactating women, plasma, pregnant women},\n\tpages = {8723--8732},\n}\n
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\n Few studies have examined docosahexaenoic acid (DHA) in pregnant and lactating women in developing countries like China, where DHA-enriched supplements are increasingly popular. We aimed to assess the DHA status among Chinese pregnant and lactating women residing areas differing in the availability of aquatic products. In total, 1211 women in mid-pregnancy (17 ± 2 weeks), late pregnancy (39 ± 2 weeks), or lactation (42 ± 7 days) were enrolled from Weihai (coastland), Yueyang (lakeland), and Baotou (inland) city, with approximately 135 women in each participant group by region. DHA concentrations were measured using capillary gas chromatography, and are reported as weight percent of total fatty acids. Mean plasma DHA concentrations were higher in coastland (mid-pregnancy 3.19%, late pregnancy 2.54%, lactation 2.24%) and lakeland women (2.45%, 1.95%, 2.26%) than inland women (2.25%, 1.67%, 1.68%) (p values \\textless 0.001). Similar differences were observed for erythrocyte DHA. We conclude that DHA concentrations of Chinese pregnant and lactating women are higher in coastland and lakeland regions than in inland areas. DHA status in the study population appears to be stronger than populations from other countries studied to date.\n
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