• Bmc Med · Apr 2023

    The burden of RSV-associated illness in children aged < 5 years, South Africa, 2011 to 2016.

    • Jocelyn Moyes, Stefano Tempia, Sibongile Walaza, Meredith L McMorrow, Florette Treurnicht, Nicole Wolter, Anne von Gottberg, Kathleen Kahn, Adam L Cohen, Halima Dawood, Ebrahim Variava, and Cheryl Cohen.
    • Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Private Bag X4, Sandringham, 2131, Johannesburg, Gauteng, South Africa. jossmoyes@gmail.com.
    • Bmc Med. 2023 Apr 11; 21 (1): 139139.

    BackgroundVaccines and monoclonal antibodies to protect the very young infant against the respiratory syncytial virus (RSV)-associated illness are effective for limited time periods. We aimed to estimate age-specific burden to guide implementation strategies and cost-effectiveness analyses.MethodsWe combined case-based surveillance and ecological data to generate a national estimate of the burden of RSV-associated acute respiratory illness (ARI) and severe acute respiratory illness (SARI) in South African children aged < 5 years (2011-2016), including adjustment for attributable fraction. We estimated the RSV burden by month of life in the < 1-year age group, by 3-month intervals until 2 years, and then 12 monthly intervals to < 5 years for medically and non-medically attended illness.ResultsWe estimated a mean annual total (medically and non-medically attended) of 264,112 (95% confidence interval (CI) 134,357-437,187) cases of RSV-associated ARI and 96,220 (95% CI 66,470-132,844) cases of RSV-associated SARI (4.7% and 1.7% of the population aged < 5 years, respectively). RSV-associated ARI incidence was highest in 2-month-old infants (18,361/100,000 population, 95% CI 9336-28,466). The highest incidence of RSV-associated SARI was in the < 1-month age group 14,674/100,000 (95% CI 11,175-19,645). RSV-associated deaths were highest in the first and second month of life (110.8 (95% CI 74.8-144.5) and 111.3 (86.0-135.8), respectively).ConclusionsDue to the high burden of RSV-associated illness, specifically SARI cases in young infants, maternal vaccination and monoclonal antibody products delivered at birth could prevent significant RSV-associated disease burden.© 2023. The Author(s).

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