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Identifying residual hotspots and mapping lower respiratory infection morbidity and mortality in African children from 2000 to 2017.

ABSTRACT: Lower respiratory infections (LRIs) are the leading cause of death in children under the age of 5, despite the existence of vaccines against many of their aetiologies. Furthermore, more than half of these deaths occur in Africa. Geospatial models can provide highly detailed estimates of trends subnationally, at the level where implementation of health policies has the greatest impact. We used Bayesian geostatistical modelling to estimate LRI incidence, prevalence and mortality in children under 5 subnationally in Africa for 2000-2017, using surveys covering 1.46 million children and 9,215,000 cases of LRI. Our model reveals large within-country variation in both health burden and its change over time. While reductions in childhood morbidity and mortality due to LRI were estimated for almost every country, we expose a cluster of residual high risk across seven countries, which averages 5.5 LRI deaths per 1,000 children per year. The preventable nature of the vast majority of LRI deaths mandates focused health system efforts in specific locations with the highest burden.

SUBMITTER: Reiner RC 

PROVIDER: S-EPMC6877470 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Identifying residual hotspots and mapping lower respiratory infection morbidity and mortality in African children from 2000 to 2017.

Reiner Robert C RC   Welgan Catherine A CA   Casey Daniel C DC   Troeger Christopher E CE   Baumann Mathew M MM   Nguyen QuynhAnh P QP   Swartz Scott J SJ   Blacker Brigette F BF   Deshpande Aniruddha A   Mosser Jonathan F JF   Osgood-Zimmerman Aaron E AE   Earl Lucas L   Marczak Laurie B LB   Munro Sandra B SB   Miller-Petrie Molly K MK   Rodgers Kemp Grant G   Frostad Joseph J   Wiens Kirsten E KE   Lindstedt Paulina A PA   Pigott David M DM   Dwyer-Lindgren Laura L   Ross Jennifer M JM   Burstein Roy R   Graetz Nicholas N   Rao Puja C PC   Khalil Ibrahim A IA   Davis Weaver Nicole N   Ray Sarah E SE   Davis Ian I   Farag Tamer T   Brady Oliver J OJ   Kraemer Moritz U G MUG   Smith David L DL   Bhatt Samir S   Weiss Daniel J DJ   Gething Peter W PW   Kassebaum Nicholas J NJ   Mokdad Ali H AH   Murray Christopher J L CJL   Hay Simon I SI  

Nature microbiology 20190930 12

Lower respiratory infections (LRIs) are the leading cause of death in children under the age of 5, despite the existence of vaccines against many of their aetiologies. Furthermore, more than half of these deaths occur in Africa. Geospatial models can provide highly detailed estimates of trends subnationally, at the level where implementation of health policies has the greatest impact. We used Bayesian geostatistical modelling to estimate LRI incidence, prevalence and mortality in children under  ...[more]