Estimated impact of maternal vaccination on global paediatric influenza-related in-hospital mortality: A retrospective case series
Makaleler > Tam Makale · 2021
Yazarlar: Esen DEMİR
ECLINICALMEDICINE, SCI Expanded İndekslerine Giren Dergi, Uluslararası, 2021, cilt 37, ss 100945-100945
DOI: 10.1016/j.eclinm.2021.100945
Özet
<h2 class="title" style="box-sizing: inherit; clear: both; font-family: Merriweather, Georgia, Cambria, "Times New Roman", Times, serif; line-height: 2.4rem; margin-bottom: 1.2rem; margin-top: 3.6rem; font-size: 2rem; font-weight: 700; color: rgb(33, 33, 33); letter-spacing: normal;">Abstract</h2><div class="abstract-content selected" id="enc-abstract" style="box-sizing: inherit; clear: left; color: rgb(33, 33, 33); font-family: "system-ui", -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; font-size: 16px;"><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;">Background: </strong>Influenza virus infection is an important cause of under-five mortality. Maternal vaccination protects children younger than 3 months of age from influenza infection. However, it is unknown to what extent paediatric influenza-related mortality may be prevented by a maternal vaccine since global age-stratified mortality data are lacking.</p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;">Methods: </strong>We invited clinicians and researchers to share clinical and demographic characteristics from children younger than 5 years who died with laboratory-confirmed influenza infection between January 1, 1995 and March 31, 2020. We evaluated the potential impact of maternal vaccination by estimating the number of children younger than 3 months with in-hospital influenza-related death using published global mortality estimates.</p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;">Findings: </strong>We included 314 children from 31 countries. Comorbidities were present in 166 (53%) children and 41 (13%) children were born prematurely. Median age at death was 8·6 (IQR 4·5-16·6), 11·5 (IQR 4·3-24·0), and 15·5 (IQR 7·4-27·0) months for children from low- and lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs), respectively. The proportion of children younger than 3 months at time of death was 17% in LMICs, 12% in UMICs, and 7% in HICs. We estimated that 3339 annual influenza-related in-hospital deaths occur in the first 3 months of life globally.</p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;">Interpretation: </strong>In our study, less than 20% of children is younger than 3 months at time of influenza-related death. Although maternal influenza vaccination may impact maternal and infant influenza disease burden, additional immunisation strategies are needed to prevent global influenza-related childhood mortality. The missing data, global coverage, and data quality in this study should be taken into consideration for further interpretation of the results.</p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;">Funding: </strong>Bill & Melinda Gates Foundation.</p></div>