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5. A multinational Delphi consensus to end the COVID-19 public health threat

Author

Lazarus, J. V., Romero, D., Kopka, C. J., Karim, S. A., Abu-Raddad, L. J., Almeida, G., Baptista-Leite, R., Barocas, J. A., Barreto, M. L., Bar-Yam, Y., Bassat, Q., Batista, C., Bazilian, M., Chiou, S. -T., del Rio, C., Dore, G. J., Gao, G. F., Gostin, L. O., Hellard, M., Jimenez, J. L., Kang, G., Lee, N., Maticic, M., Mckee, M., Nsanzimana, S., Oliu-Barton, M., Pradelski, B., Pyzik, O., Rabin, K., Raina, S., Rashid, S. F., Rathe, M., Saenz, R., Singh, S., Trock-Hempler, M., Villapol, S., Yap, P., Binagwaho, A., Kamarulzaman, A., El-Mohandes, A., Barreto, M., Abdulla, S., Addleman, S., Aghayeva, G., Agius, R., Ahmed, M., Ramy, M. A., Aide, P., Aleman, S., Alfred, J. -P., Ali, S., Aliaga, J., Aloudat, T., Alqahtani, S. A., Al-Salman, J., Amuasi, J. H., Agrawal, A., Anwar, W., Araujo-Jorge, T., Artaza, O., Asadi, L., Awuku, Y., Baker, M., Barberia, L., Bascolo, E., Belcher, P., Bell, L., Benzaken, A., Bergholtz, E., Bhadelia, N., Bhan, A., Bilodeau, S., Bitran, R., Bluyssen, P., Bosman, A., Bozza, F. A., Brinkmann, M. M., Brown, A., Mellado, B., Bukusi, E., Bullen, C., Buonanno, G., Burgess, R., Butler, M., Byakika-Kibwika, P., Cabieses, B., Carlsson, G., Cascini, Fidelia, Chabala, C., Chakroun, M., Cheng, K. K., Chetty, A., Chumachenko, D., Consalves, G., Conway Morris, A., Cordie, A., Corrah, T., Crabtree-Ramirez, B., Dashdorj, N., Davidovitch, N., de Souza, L. E., Dhariwal, A. C., Druica, E., Ergonul, O., Erondu, N. A., Essar, M. Y., Ewing, A., Fanjul, G., Feierstein, D., Feigl-Ding, E., Figueroa, R., Figueroa, J. P., Fisher, D., Flores, W., Forero-Pena, D. A., Frumkin, H., Gamkrelidze, A., Gandhi, M., Garcia, P., Garcia-Basteiro, A. L., Garcia-Sastre, A., Garg, S., Gbeasor-Komlanvi, F. A., Gershenson, C., Gilada, I., Giovanella, L., Gonzalez, M., Green, M. S., Greenhalgh, T., Griffin, P., Griffin, S., Grinsztejn, B., Anand, T., Guerra, G., Guinto, R., Gujski, M., Guner, R., Hamdy, A., Hancean, M. -G., Haniffa, A., Hartigan-Go, K. Y., Hassan, H. K., Hay, S. I., Heino, M. T. J., Hel, Z., Hotez, P., Hu, J., Hukic, M., Ijsselmuiden, C., Iroko, D., Iskarous, M., Izugbara, C., Jacobs, C., Jadad, A. R., Jehan, F., Jordan, A., Jroundi, I., Kain, K., Kamberi, F., Karamov, E., Karan, A., Katz, R., Katzourakis, A., Kazembe, A., Khamis, F., Khamzayev, K., Khanyola, J., Khunti, K., Kiguli-Malwadde, E., Kim, W. J., Kirenga, B. J., Klimovsky, D., Kmush, B. L., Knaul, F., Kogevinas, M., Kristensen, F., Kumar, D., Kumar, R., Kvalsvig, A., Lacerda, M. V., Lal, A., Lawton, T., Lemery, J., Leonardi, A. J., Li, Y., Lottvall, J., Lounis, M., Maceira, D., Macintyre, C. R., Madani, A., Magiorkinis, G., Malekzadeh, R., Choisy, M., Marcelin, J. R., Marks, G. B., Marr, L., Marrazzo, J., Martina, A., Martin-Moreno, J. M., Mateos, C., Mayxay, M., Mazarati, J. B., Mboup, S., Mcdonald, J., Mcmillan, F., Mechili, E., Medici, A., Davis, S. L. M., Meier, P., Memish, Z. A., Menon, J., Menon, P., Mesiano-Crookston, J., Michie, S., Mikolasevic, I., Milicevic, O., Mishra, A. K., Mohamed, R., Mokdad, A. H., Monroy-Valle, M., Morawska, L., Moschos, S. A., Motawea, K., Mousavi, S. H., Mumtaz, G., Munene, P. K., Munoz Almagro, C., Muriuki, J., Muyingo, S., Naniche, D., Naylor, C. D., Ndembi, N., Nemec, J., Nesteruk, I., Ngaruiya, C., Nguyen, H., Nikolova, D., Nitzan, D., Norheim, O., Noushad, M., Ntoumi, F., Nyborg, G. A., Ochodo, E., Odabasi, Z., Okwen, M. P., Olivia, K., Ong, D. S. Y., Opara, I., Orozco, M., Oshitani, H., Pagel, C., Pai, M., Palsdottir, B., Papatheodoridis, G., Paraskevis, D., Leigh, J. P., Pecoul, B., Peichl, A., Perez-Then, E., Duc, P. P., Philippe, C., Pineda Rojas, A., Pladsen, C., Pozniak, A., Quiroga, R., Qureshi, H., Rampal, S., Ranney, M., Rathe, L., Ratzan, S., Raventos, H., Rees, H., Reis, R., Ricciardi, Walter, Rizk, N., Robalo, M., Robertson, E., Robinson, L., Rokx, C., Ros, T., Rottingen, J. -A., Rubin, M., Ruxrungtam, K., Sadirova, S., Saha, S., Salgado, N., Sanchez, L., Sangaramoorthy, T., Santamaria-Ulloa, C., Santos, R., Sawaf, B., Schneider, M. F., Schooley, R. T., Sener, A., Sepulveda, J., Shah, J., Shibani, M., Shoib, S., Sikazwe, I., Simaitis, A., Gill, A. S., Skhvitaridze, N., Sokolovic, M., Solomon, R., Solorzano, X., Springer, S. A., Srol, J., Staines, A., Stelfox, H. T., Strathdee, S., Sulaiman, L. H., Sutton, B., Svanaes, D., Swed, S., Sypsa, V., Sorensen, K., Tajudeen, R., Tan, A., Tang, J., Tanner, M., Sethi, T., Temmerman, M., Than, K. K., Tinto, H., Tometissi, S. P., Torres, I., Tshering, K. P., Tsiodras, S., Tsofa, B., Vahlne, A., Vargas, J. R., Bernal, I. D. V., Ventura, D., Vilasanjuan, R., Vipond, J., Wamala-Andersson, S., Wargocki, P., West, R., Weyand, A., White, T. M., Wolff, G., Yao, M., Yates, C. A., Yeboah, G., Yee-Sin, L., Yi, S., Teo, Y. -Y., Yong, P., Zamora-Mesia, V., Ovrehus, A., Cascini F. (ORCID:0000-0001-6499-0734), Ricciardi W. (ORCID:0000-0002-5655-688X), Lazarus, J. V., Romero, D., Kopka, C. J., Karim, S. A., Abu-Raddad, L. J., Almeida, G., Baptista-Leite, R., Barocas, J. A., Barreto, M. L., Bar-Yam, Y., Bassat, Q., Batista, C., Bazilian, M., Chiou, S. -T., del Rio, C., Dore, G. J., Gao, G. F., Gostin, L. O., Hellard, M., Jimenez, J. L., Kang, G., Lee, N., Maticic, M., Mckee, M., Nsanzimana, S., Oliu-Barton, M., Pradelski, B., Pyzik, O., Rabin, K., Raina, S., Rashid, S. F., Rathe, M., Saenz, R., Singh, S., Trock-Hempler, M., Villapol, S., Yap, P., Binagwaho, A., Kamarulzaman, A., El-Mohandes, A., Barreto, M., Abdulla, S., Addleman, S., Aghayeva, G., Agius, R., Ahmed, M., Ramy, M. A., Aide, P., Aleman, S., Alfred, J. -P., Ali, S., Aliaga, J., Aloudat, T., Alqahtani, S. A., Al-Salman, J., Amuasi, J. H., Agrawal, A., Anwar, W., Araujo-Jorge, T., Artaza, O., Asadi, L., Awuku, Y., Baker, M., Barberia, L., Bascolo, E., Belcher, P., Bell, L., Benzaken, A., Bergholtz, E., Bhadelia, N., Bhan, A., Bilodeau, S., Bitran, R., Bluyssen, P., Bosman, A., Bozza, F. A., Brinkmann, M. M., Brown, A., Mellado, B., Bukusi, E., Bullen, C., Buonanno, G., Burgess, R., Butler, M., Byakika-Kibwika, P., Cabieses, B., Carlsson, G., Cascini, Fidelia, Chabala, C., Chakroun, M., Cheng, K. K., Chetty, A., Chumachenko, D., Consalves, G., Conway Morris, A., Cordie, A., Corrah, T., Crabtree-Ramirez, B., Dashdorj, N., Davidovitch, N., de Souza, L. E., Dhariwal, A. C., Druica, E., Ergonul, O., Erondu, N. A., Essar, M. Y., Ewing, A., Fanjul, G., Feierstein, D., Feigl-Ding, E., Figueroa, R., Figueroa, J. P., Fisher, D., Flores, W., Forero-Pena, D. A., Frumkin, H., Gamkrelidze, A., Gandhi, M., Garcia, P., Garcia-Basteiro, A. L., Garcia-Sastre, A., Garg, S., Gbeasor-Komlanvi, F. A., Gershenson, C., Gilada, I., Giovanella, L., Gonzalez, M., Green, M. S., Greenhalgh, T., Griffin, P., Griffin, S., Grinsztejn, B., Anand, T., Guerra, G., Guinto, R., Gujski, M., Guner, R., Hamdy, A., Hancean, M. -G., Haniffa, A., Hartigan-Go, K. Y., Hassan, H. K., Hay, S. I., Heino, M. T. J., Hel, Z., Hotez, P., Hu, J., Hukic, M., Ijsselmuiden, C., Iroko, D., Iskarous, M., Izugbara, C., Jacobs, C., Jadad, A. R., Jehan, F., Jordan, A., Jroundi, I., Kain, K., Kamberi, F., Karamov, E., Karan, A., Katz, R., Katzourakis, A., Kazembe, A., Khamis, F., Khamzayev, K., Khanyola, J., Khunti, K., Kiguli-Malwadde, E., Kim, W. J., Kirenga, B. J., Klimovsky, D., Kmush, B. L., Knaul, F., Kogevinas, M., Kristensen, F., Kumar, D., Kumar, R., Kvalsvig, A., Lacerda, M. V., Lal, A., Lawton, T., Lemery, J., Leonardi, A. J., Li, Y., Lottvall, J., Lounis, M., Maceira, D., Macintyre, C. R., Madani, A., Magiorkinis, G., Malekzadeh, R., Choisy, M., Marcelin, J. R., Marks, G. B., Marr, L., Marrazzo, J., Martina, A., Martin-Moreno, J. M., Mateos, C., Mayxay, M., Mazarati, J. B., Mboup, S., Mcdonald, J., Mcmillan, F., Mechili, E., Medici, A., Davis, S. L. M., Meier, P., Memish, Z. A., Menon, J., Menon, P., Mesiano-Crookston, J., Michie, S., Mikolasevic, I., Milicevic, O., Mishra, A. K., Mohamed, R., Mokdad, A. H., Monroy-Valle, M., Morawska, L., Moschos, S. A., Motawea, K., Mousavi, S. H., Mumtaz, G., Munene, P. K., Munoz Almagro, C., Muriuki, J., Muyingo, S., Naniche, D., Naylor, C. D., Ndembi, N., Nemec, J., Nesteruk, I., Ngaruiya, C., Nguyen, H., Nikolova, D., Nitzan, D., Norheim, O., Noushad, M., Ntoumi, F., Nyborg, G. A., Ochodo, E., Odabasi, Z., Okwen, M. P., Olivia, K., Ong, D. S. Y., Opara, I., Orozco, M., Oshitani, H., Pagel, C., Pai, M., Palsdottir, B., Papatheodoridis, G., Paraskevis, D., Leigh, J. P., Pecoul, B., Peichl, A., Perez-Then, E., Duc, P. P., Philippe, C., Pineda Rojas, A., Pladsen, C., Pozniak, A., Quiroga, R., Qureshi, H., Rampal, S., Ranney, M., Rathe, L., Ratzan, S., Raventos, H., Rees, H., Reis, R., Ricciardi, Walter, Rizk, N., Robalo, M., Robertson, E., Robinson, L., Rokx, C., Ros, T., Rottingen, J. -A., Rubin, M., Ruxrungtam, K., Sadirova, S., Saha, S., Salgado, N., Sanchez, L., Sangaramoorthy, T., Santamaria-Ulloa, C., Santos, R., Sawaf, B., Schneider, M. F., Schooley, R. T., Sener, A., Sepulveda, J., Shah, J., Shibani, M., Shoib, S., Sikazwe, I., Simaitis, A., Gill, A. S., Skhvitaridze, N., Sokolovic, M., Solomon, R., Solorzano, X., Springer, S. A., Srol, J., Staines, A., Stelfox, H. T., Strathdee, S., Sulaiman, L. H., Sutton, B., Svanaes, D., Swed, S., Sypsa, V., Sorensen, K., Tajudeen, R., Tan, A., Tang, J., Tanner, M., Sethi, T., Temmerman, M., Than, K. K., Tinto, H., Tometissi, S. P., Torres, I., Tshering, K. P., Tsiodras, S., Tsofa, B., Vahlne, A., Vargas, J. R., Bernal, I. D. V., Ventura, D., Vilasanjuan, R., Vipond, J., Wamala-Andersson, S., Wargocki, P., West, R., Weyand, A., White, T. M., Wolff, G., Yao, M., Yates, C. A., Yeboah, G., Yee-Sin, L., Yi, S., Teo, Y. -Y., Yong, P., Zamora-Mesia, V., Ovrehus, A., Cascini F. (ORCID:0000-0001-6499-0734), and Ricciardi W. (ORCID:0000-0002-5655-688X)

Abstract

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

Published
2022

12. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series

Author

Scheltema, N.M., Gentile, A., Lucion, F., Nokes, D., Munywoki, P., Madhi, S., Groome, M., Cohen, C., Moyes, J., Thorburn, K., Thamthitiwat, S., Oshitani, H., Lupisan, S., Gordon, A., Sánchez, J., O’Brien, K., Gessner, B., Sutanto, A., Mejias, A., Ramilo, O., Khuri-Bulos, N., Halasa, N., de-Paris, F., Pires, M., Spaeder, M., Paes, B., Simões, E., Leung, T., Oliveira, M., Emediato, C., Bassat, Q., Butt, W., Chi, H., Aamir, U., Ali, A., Lucero, M., Fasce, R., Lopez, O., Rath, B., Polack, F., Papenburg, J., Roglic, S., Ito, H., Goka, E.A., Grobbee, D., Nair, H., and Bont, L.

Subjects
Medicine(all), RC0254, lcsh:Public aspects of medicine, RSV, lcsh:RA1-1270
Abstract

Background: Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data for fatal RSV infection are scarce. We aimed to identify clinical and socioeconomic characteristics of children aged younger than 5 years with RSV-related mortality using individual patient data. Methods: In this retrospective case series, we developed an online questionnaire to obtain individual patient data for clinical and socioeconomic characteristics of children aged younger than 5 years who died with community-acquired RSV infection between Jan 1, 1995, and Oct 31, 2015, through leading research groups for child pneumonia identified through a comprehensive literature search and existing research networks. For the literature search, we searched PubMed for articles published up to Feb 3, 2015, using the key terms “RSV”, “respiratory syncytial virus”, or “respiratory syncytial viral” combined with “mortality”, “fatality”, “death”, “died”, “deaths”, or “CFR” for articles published in English. We invited researchers and clinicians identified to participate between Nov 1, 2014, and Oct 31, 2015. We calculated descriptive statistics for all variables. Findings: We studied 358 children with RSV-related in-hospital death from 23 countries across the world, with data contributed from 31 research groups. 117 (33%) children were from low-income or lower middle-income countries, 77 (22%) were from upper middle-income countries, and 164 (46%) were from high-income countries. 190 (53%) were male. Data for comorbidities were missing for some children in low-income and middle-income countries. Available data showed that comorbidities were present in at least 33 (28%) children from low-income or lower middle-income countries, 36 (47%) from upper middle-income countries, and 114 (70%) from high-income countries. Median age for RSV-related deaths was 5·0 months (IQR 2·3–11·0) in low-income or lower middle-income countries, 4·0 years (2·0–10·0) in upper middle-income countries, and 7·0 years (3·6–16·8) in high-income countries. Interpretation: This study is the first large case series of children who died with community-acquired RSV infection. A substantial proportion of children with RSV-related death had comorbidities. Our results show that perinatal immunisation strategies for children aged younger than 6 months could have a substantial impact on RSV-related child mortality in low-income and middle-income countries. Funding: Bill & Melinda Gates Foundation.

Published
2017
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14. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study

Author

Shi, T, McAllister, DA, O'Brien, KL, Simoes, EAF, Madhi, SA, Gessner, BD, Polack, FP, Balsells, E, Acacio, S, Aguayo, C, Alassani, I, Ali, A, Antonio, M, Awasthi, S, Awori, JO, Azziz-Baumgartner, E, Baggett, HC, Baillie, VL, Balmaseda, A, Barahona, A, Basnet, S, Bassat, Q, Basualdo, W, Bigogo, G, Bont, L, Breiman, RF, Brooks, WA, Broor, S, Bruce, N, Bruden, D, Buchy, P, Campbell, S, Carosone-Link, P, Chadha, M, Chipeta, J, Chou, M, Clara, W, Cohen, C, de Cuellar, E, Dang, DA, Dash-yandag, B, Deloria-Knoll, M, Dherani, M, Eap, T, Ebruke, BE, Echavarria, M, de Freitas Lázaro Emediato, CC, Fasce, RA, Feikin, DR, Feng, L, Gentile, A, Gordon, A, Goswami, D, Goyet, S, Groome, M, Halasa, N, Hirve, S, Homaira, N, Howie, SRC, Jara, J, Jroundi, I, Kartasasmita, CB, Khuri-Bulos, N, Kotloff, KL, Krishnan, A, Libster, R, Lopez, O, Lucero, MG, Lucion, F, Lupisan, SP, Marcone, DN, McCracken, JP, Mejia, M, Moisi, JC, Montgomery, JM, Moore, DP, Moraleda, C, Moyes, J, Munywoki, P, Mutyara, K, Nicol, MP, Nokes, DJ, Nymadawa, P, da Costa Oliveira, MT, Oshitani, H, Pandey, N, Paranhos-Baccalà, G, Phillips, LN, Picot, VS, Rahman, M, Rakoto-Andrianarivelo, M, Rasmussen, ZA, Rath, BA, Robinson, A, Romero, C, Russomando, G, Salimi, V, Sawatwong, P, Scheltema, N, Schweiger, B, Shi, T, McAllister, DA, O'Brien, KL, Simoes, EAF, Madhi, SA, Gessner, BD, Polack, FP, Balsells, E, Acacio, S, Aguayo, C, Alassani, I, Ali, A, Antonio, M, Awasthi, S, Awori, JO, Azziz-Baumgartner, E, Baggett, HC, Baillie, VL, Balmaseda, A, Barahona, A, Basnet, S, Bassat, Q, Basualdo, W, Bigogo, G, Bont, L, Breiman, RF, Brooks, WA, Broor, S, Bruce, N, Bruden, D, Buchy, P, Campbell, S, Carosone-Link, P, Chadha, M, Chipeta, J, Chou, M, Clara, W, Cohen, C, de Cuellar, E, Dang, DA, Dash-yandag, B, Deloria-Knoll, M, Dherani, M, Eap, T, Ebruke, BE, Echavarria, M, de Freitas Lázaro Emediato, CC, Fasce, RA, Feikin, DR, Feng, L, Gentile, A, Gordon, A, Goswami, D, Goyet, S, Groome, M, Halasa, N, Hirve, S, Homaira, N, Howie, SRC, Jara, J, Jroundi, I, Kartasasmita, CB, Khuri-Bulos, N, Kotloff, KL, Krishnan, A, Libster, R, Lopez, O, Lucero, MG, Lucion, F, Lupisan, SP, Marcone, DN, McCracken, JP, Mejia, M, Moisi, JC, Montgomery, JM, Moore, DP, Moraleda, C, Moyes, J, Munywoki, P, Mutyara, K, Nicol, MP, Nokes, DJ, Nymadawa, P, da Costa Oliveira, MT, Oshitani, H, Pandey, N, Paranhos-Baccalà, G, Phillips, LN, Picot, VS, Rahman, M, Rakoto-Andrianarivelo, M, Rasmussen, ZA, Rath, BA, Robinson, A, Romero, C, Russomando, G, Salimi, V, Sawatwong, P, Scheltema, N, and Schweiger, B

Abstract

Background We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015. Methods We estimated the incidence and hospital admission rate of RSV-associated ALRI (RSV-ALRI) in children younger than 5 years stratified by age and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies. We estimated the RSV-ALRI incidence for 132 developing countries using a risk factor-based model and 2015 population estimates. We estimated the in-hospital RSV-ALRI mortality by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-ALRI mortality by identifying studies reporting monthly data for ALRI mortality in the community and RSV activity. Findings We estimated that globally in 2015, 33·1 million (uncertainty range [UR] 21·6–50·3) episodes of RSV-ALRI, resulted in about 3·2 million (2·7–3·8) hospital admissions, and 59 600 (48 000–74 500) in-hospital deaths in children younger than 5 years. In children younger than 6 months, 1·4 million (UR 1·2–1·7) hospital admissions, and 27 300 (UR 20 700–36 200) in-hospital deaths were due to RSV-ALRI. We also estimated that the overall RSV-ALRI mortality could be as high as 118 200 (UR 94 600–149 400). Incidence and mortality varied substantially from year to year in any given population. Interpretation Globally, RSV is a com

Published
2017

15. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series

Author

Scheltema, NM, Gentile, A, Lucion, F, Nokes, DJ, Munywoki, PK, Madhi, SA, Groome, MJ, Cohen, C, Moyes, J, Thorburn, K, Thamthitiwat, S, Oshitani, H, Lupisan, SP, Gordon, A, Sanchez, JF, O'Brien, KL, Gessner, BD, Sutanto, A, Mejias, A, Ramilo, O, Khuri-Bulos, N, Halasa, N, de-Paris, F, Pires, MR, Spaeder, MC, Paes, BA, Simoes, EAF, Leung, TF, Oliveira, MTDC, Emediato, CCDFL, Bassat, Q, Butt, W, Chi, H, Aamir, UB, Ali, A, Lucero, MG, Fasce, RA, Lopez, O, Rath, BA, Polack, FP, Papenburg, J, Roglic, S, Ito, H, Goka, EA, Grobbee, DE, Nair, H, Bont, LJ, Scheltema, NM, Gentile, A, Lucion, F, Nokes, DJ, Munywoki, PK, Madhi, SA, Groome, MJ, Cohen, C, Moyes, J, Thorburn, K, Thamthitiwat, S, Oshitani, H, Lupisan, SP, Gordon, A, Sanchez, JF, O'Brien, KL, Gessner, BD, Sutanto, A, Mejias, A, Ramilo, O, Khuri-Bulos, N, Halasa, N, de-Paris, F, Pires, MR, Spaeder, MC, Paes, BA, Simoes, EAF, Leung, TF, Oliveira, MTDC, Emediato, CCDFL, Bassat, Q, Butt, W, Chi, H, Aamir, UB, Ali, A, Lucero, MG, Fasce, RA, Lopez, O, Rath, BA, Polack, FP, Papenburg, J, Roglic, S, Ito, H, Goka, EA, Grobbee, DE, Nair, H, and Bont, LJ

Abstract

BACKGROUND: Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data for fatal RSV infection are scarce. We aimed to identify clinical and socioeconomic characteristics of children aged younger than 5 years with RSV-related mortality using individual patient data. METHODS: In this retrospective case series, we developed an online questionnaire to obtain individual patient data for clinical and socioeconomic characteristics of children aged younger than 5 years who died with community-acquired RSV infection between Jan 1, 1995, and Oct 31, 2015, through leading research groups for child pneumonia identified through a comprehensive literature search and existing research networks. For the literature search, we searched PubMed for articles published up to Feb 3, 2015, using the key terms "RSV", "respiratory syncytial virus", or "respiratory syncytial viral" combined with "mortality", "fatality", "death", "died", "deaths", or "CFR" for articles published in English. We invited researchers and clinicians identified to participate between Nov 1, 2014, and Oct 31, 2015. We calculated descriptive statistics for all variables. FINDINGS: We studied 358 children with RSV-related in-hospital death from 23 countries across the world, with data contributed from 31 research groups. 117 (33%) children were from low-income or lower middle-income countries, 77 (22%) were from upper middle-income countries, and 164 (46%) were from high-income countries. 190 (53%) were male. Data for comorbidities were missing for some children in low-income and middle-income countries. Available data showed that comorbidities were present in at least 33 (28%) children from low-income or lower middle-income countries, 36 (47%) from upper middle-income countries, and 114 (70%) from high-income countries. Median age for RSV-related deaths was 5·0 months (IQR 2·3-11·0) in low-income or lower middle-income countries, 4·0 years (2·0-1

Published
2017

26. Etiology of childhood pneumonia in Tacloban, the Philippines

Author

Suzuki, A., primary, Lupisan, S., additional, Fuji, N., additional, Ohno, A., additional, Furuse, Y., additional, Tamaki, R., additional, Saito, M., additional, Oreste, H., additional, Mondoy, M., additional, Sombrero, L., additional, De Leon, A., additional, Olveda, R., additional, and Oshitani, H., additional

Published
2010
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42. Enterovirus 68 among children with severe acute respiratory infection, the Philippines.

Author

Imamura T, Fuji N, Suzuki A, Tamaki R, Saito M, Aniceto R, Galang H, Sombrero L, Lupisan S, Oshitani H, Imamura, Tadatsugu, Fuji, Naoko, Suzuki, Akira, Tamaki, Raita, Saito, Mariko, Aniceto, Rapunzel, Galang, Hazel, Sombrero, Lydia, Lupisan, Soccoro, and Oshitani, Hitoshi

Abstract

Enterovirus 68 (EV68) is a rare enterovirus associated with respiratory illness that, unlike other enteroviruses, has been identified only from respiratory specimens. We identified EV68 from respiratory specimens of children hospitalized with a diagnosis of severe pneumonia in Leyte, Republic of the Philippines. Twenty-one samples showed high similarity with EV68 by sequencing of 5' nontranslated region; 17 of these samples were confirmed as EV68 by sequencing of viral protein 1 capsid coding region. Most previously reported EV68 cases had been identified as sporadic cases. All 21 patients we identified had severe illness, and 2 died, possibly the first reported fatal cases associated with EV68 infection. Our study suggests that EV68 may be a possible causative agent of severe respiratory illnesses. [ABSTRACT FROM AUTHOR]

Published
2011
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43. Major issues and challenges of influenza pandemic preparedness in developing countries.

Author

Oshitani H, Kamigaki T, Suzuki A, Oshitani, Hitoshi, Kamigaki, Taro, and Suzuki, Akira

Abstract

Better preparedness for an influenza pandemic mitigates its impact. Many countries have started developing and implementing national influenza pandemic preparedness plans. However, the level of preparedness varies among countries. Developing countries encounter unique and difficult issues and challenges in preparing for a pandemic. Deaths attributable to an influenza pandemic could be substantially higher in developing countries than in industrialized countries. Pharmaceutical interventions such as vaccines and antiviral agents are less likely to be available in developing countries. The public health and clinical infrastructure of developing countries are often inadequate to deal with a widespread health crisis such as an influenza pandemic. Such an event will inevitably have a global effect. Therefore, improving pandemic preparedness in every country, particularly developing ones, is urgently needed. [ABSTRACT FROM AUTHOR]

Published
2008
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44. Respiratory syncytial virus infection in children with acute respiratory infections in Zambia

Author

*, M. SAIJO, §, TERUNUMA, H., *, K. MIZUTA, †, MPABALWANI, E. M., MONZE, M., OSHITANI, H., LUO, N., and SUZUKI, H.

Abstract

Epidemiological research on respiratory syncytial virus (RSV) infections in children was carried out at the Virology Laboratory, University Teaching Hospital (UTH), in Lusaka, Zambia, from January–December 1996. Specimens including 736 nasal washings and 2424 throat swabs were collected from children with acute respiratory infections (ARI) and tested for RSV by enzyme immunoassay and by virus isolation. RSV was isolated in 62 (4·1%) of 1496 throat swabs collected from March to September and was detected in 99 (16·3%) of 609 nasal washings from March to November. The average RSV isolation rate was 2·6% and the average RSV detection rate was 13·5%. The highest RSV isolation (8·1%) and detection (30·5%) rates were in June 1996. RSV antibody in the 278 serum specimens collected from Zambian children, who were hospitalized in the paediatric ward, UTH, was detected using a standard neutralization test. The antibody positive rate was 60–80% in children >4 years. It is evident that RSV is one of the main causal agents of ARI in children in Zambia.

Published
1998

46. Global health 2050: the path to halving premature death by mid-century.

Author

Jamison DT, Summers LH, Chang AY, Karlsson O, Mao W, Norheim OF, Ogbuoji O, Schäferhoff M, Watkins D, Adeyi O, Alleyne G, Alwan A, Anand S, Belachew R, Berkley SF, Bertozzi SM, Bolongaita S, Bundy D, Bustreo F, Castro MC, Chen S, Fan VY, Fawole A, Feachem R, Gebremedhin L, Ghosh J, Goldie SJ, Gonzalez-Pier E, Guo Y, Gupta S, Jha P, Knaul FM, Kruk ME, Kurowski C, Liu GG, Makimoto S, Mataria A, Nugent R, Oshitani H, Pablos-Mendez A, Peto R, Sekhri Feachem N, Reddy S, Salti N, Saxenian H, Seyi-Olajide J, Soucat A, Verguet S, Zimmerman A, and Yamey G

Abstract

Competing Interests: Declaration of interests OA declares consulting fees from the Asian Development Bank, WHO, the World Bank, and Pharos Global Health Advisors and speaker's fees from Pfizer. SA declares research grants from the US National Institutes of Health (NIH R01 R01DK127138, NIH R21MD019394, and NIH U01AI169477); consulting fees from Travere Therapeutics, Vera Therapeutics, and Mendara; support for travel or attending meetings from Travere Therapeutics; unpaid leadership or fiduciary roles with the International Society of Nephrology, the Kidney Health Initiative, and American Nephrologists of Indian Origin; and receipt of assay materials for work conducted under U01AI169477 from Abbott Laboratory and Ascend Laboratory. SFB declares consulting fees from the Serum Institute of India, Micron Biomedical, VAXCO, Global Health Investment Corporation, Brown University, Gavi, the Vaccine Alliance, and SICPA; payment or honoraria from University of California Press; support for attending meetings or travel from UN Office for Project Services and STOP TB, Gavi, SICPA, and Serum Life Sciences; participation on data safety monitoring or advisory boards for CEPI, COVAX, and Gavi; membership of the board of PHARE BIO and of the strategic oversight board of Apriori Bio; and stock or stock options in VAXCO and Apriori Bio. SMB declares that two graduate students reporting to him received support from the University of Bergen for work on pandemic preparedness as part of the 4th edition of the Disease Control Priorities Project; received support for travel from the University of Bergen, the Japan International Cooperation Agency, and the AIDS Healthcare Foundation; and is a board member for HopeLab and the Bay Area Global Health Alliance. SB declares research support from the University of Bergen and consulting fees from the World Bank. FB declares travel support from the Partnership for Maternal, Newborn and Child Health and Fondation Botnar and is chair of the Governance and Ethics Committee for the Partnership for Maternal, Newborn and Child Health, international advisory board chair of the UN University International Institute for Global Health, co-chair of the Lancet Commission on Gender-Based Violence and the Maltreatment of Young People, interim board chair of Fondation Botnar, a member of the Lancet Future of Neonatology Commission, and a member of the Lancet and Chatham House Commission on Universal Health. EG-P declares consulting fees from the International Monetary Fund and the World Bank, is board chair of Aceso Global, and has participated in advisory committees for Roche and Medtronic. WM declares research support to her institution from WHO, the Bill & Melinda Gates Foundation, the Pfizer Foundation, the Open Society Foundation, the Hilton Foundation, and the Rockefeller Foundation, and an unpaid role as a member of the Research Committee of the Consortium of Universities for Global Health. OO is a member of the Africa Centres for Disease Control and Prevention Health Economics and Financing Programme Advisory Board and a member of the Partnership for Maternal, Newborn and Child Health Economics and Financing Working Group. AP-M is a member of the board of the Global Alliance for TB Drug Development and Iliad Biotechnologies and a member of the Cabrini Global Health Commission, and has stock or stock options in Iliad Biotechnologies. DW declares a grant from the Research Council of Norway Centre of Excellence. GY declares research funding from WHO, the Gates Foundation, the Carnegie Corporation of New York, the UN Economic and Social Commission for Asia and the Pacific, and the Economic and Social Research Council, is co-chair of the Economics and Finance Working Group of the Partnership for Maternal, Newborn and Child Health, and has served as a paid adviser to the evaluation of Partners for a Malaria-Free Zambia Program of Scale (conducted by Metrics 4 Management). All other authors declare no competing interests.

Published
2024
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47. Identification of Various Recombinants in a Patient Coinfected With the Different SARS-CoV-2 Variants.

Author

Sayama Y, Sakagami A, Okamoto M, Sakamoto M, Koizumi H, Kimura Y, Dapat C, Saito M, Suzuki Y, Sasaki M, Sugawara N, and Oshitani H

Subjects
Humans, Middle Aged, Japan, Mutation, Phylogeny, Spike Glycoprotein, Coronavirus genetics, Coinfection virology, COVID-19 virology, COVID-19 complications, Genome, Viral genetics, Recombination, Genetic, SARS-CoV-2 genetics, SARS-CoV-2 isolation & purification, Whole Genome Sequencing
Abstract

Background: Viral recombination that occurs by exchanging genetic materials between two viral genomes coinfecting the same host cells is associated with the emergence of new viruses with different virulence. Herein, we detected a patient coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants and identified various recombinants in the SARS-CoV-2 full-length spike gene using long-read and Sanger sequencing., Methods: Samples from five patients in Japan with household transmission of coronavirus disease 2019 (COVID-19) were analyzed using molecular assays for detection and identification of SARS-CoV-2. Whole-genome sequencing was conducted using multiplex PCR with short-read sequencing., Results: Among the five SARS-CoV-2-positive patients, the mutation-specific assay identified the Delta variant in three, the Omicron variant in one, and an undetermined in one. The undermined patient was identified as Delta using whole-genome sequencing, but samples showed a mixed population of Delta and Omicron variants. This patient was analyzed for viral quasispecies by long-read and Sanger sequencing using a full-length spike gene amplicon. In addition to the Delta and Omicron sequences, the viral quasispecies analysis identified nine different genetic recombinant sequences with various breakpoints between Delta and Omicron sequences. The nine detected recombinant sequences in the spike gene showed over 99% identity with viruses that were detected during the Delta and Omicron cocirculation period from the United States and Europe., Conclusions: This study demonstrates that patients coinfected with different SARS-CoV-2 variants can generate various viral recombinants and that various recombinant viruses may be produced during the cocirculation of different variants., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Published
2024
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48. Characterization of human respiratory syncytial virus in children with severe acute respiratory infection before and during the COVID-19 pandemic.

Author

Simusika P, Okamoto M, Dapat C, Muleya W, Malisheni M, Azam S, Imamura T, Saito M, Mwape I, Mpabalwani E, Monze M, and Oshitani H

Abstract

Objectives: Annual outbreaks of human respiratory syncytial virus (HRSV) are caused by newly introduced and locally persistent strains. During the COVID-19 pandemic, global and local circulation of HRSV significantly decreased. This study was conducted to characterize HRSV in 2018-2022 and to analyze the impact of COVID-19 on the evolution of HRSV., Design/methods: Combined oropharyngeal and nasopharyngeal swabs were collected from children hospitalized with severe acute respiratory infection at two hospitals in Zambia. The second hypervariable region of the attachment gene G was targeted for phylogenetic analysis., Results: Of 3113 specimens, 504 (16.2%) were positive for HRSV, of which 131 (26.0%) and 66 (13.1%) were identified as HRSVA and HRSVB, respectively. In early 2021, an increase in HRSV was detected, caused by multiple distinct clades of HRSVA and HRSVB. Some were newly introduced, whereas others resulted from local persistence., Conclusions: This study provides insights into the evolution of HRSV, driven by global and local circulation. The COVID-19 pandemic had a temporal impact on the evolution pattern of HRSV. Understanding the evolution of HRSV is vital for developing strategies for its control., Competing Interests: The authors have no competing interests to declare., (© 2024 The Author(s).)

Published
2024
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49. Respiratory syncytial virus: Time for surveillance across all ages, with a focus on adults.

Author

Bont L, Krone M, Harrington L, Nair H, Nolan T, Oshitani H, and Salisbury D

Subjects
Adult, Humans, Respiratory Syncytial Virus, Human, Respiratory Syncytial Virus Infections epidemiology
Abstract

Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and relationships: LB has regular interaction with pharmaceutical and other industrial partners; he has not received personal fees or other personal benefits. LB is the founding chairman of the ReSViNET Foundation. His institution, the University Medical Centre Utrecht, has received funding for investigator-initiated studies from AbbVie, MedImmune, AstraZeneca, Sanofi, Janssen, Pfizer, MSD, and MeMed Diagnostics; for the RSV GOLD study from the Bill and Melinda Gates Foundation; as part of the public-private partnership IMI-funded RESCEU and PROMISE projects with partners GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi; by Julius Clinical for participating in clinical studies sponsored by MedImmune and Pfizer; for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavarian Nordic, mAbxience, GSK, Novavax, Pfizer, Moderna, AstraZeneca, MSD, Sanofi, Genzyme, and Janssen. MK reports receiving consulting fees from Pfizer and Abbott; payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events from GSK outside the submitted work. LH is an employee of GSK. HN reports grants from Innovative Medicines Initiative, Pfizer, and Icosavax to his institution; consulting fees from World Health Organization, Pfizer, Bill and Melinda Gates Foundation, and Sanofi to his institution; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie to his institution; support for attending meetings and/or travel from Sanofi; participation in a Data Safety Monitoring Board or Advisory Board from GSK, Sanofi, Merck, World Health Organization (unpaid), Janssen, Novavax, ReSViNET (unpaid), Icosavax, and Pfizer to his institution, outside the submitted work. TN reports contract funding from GSK to his institution for clinical trials of meningococcal and other vaccines, and personal funding from GSK for scientific advice on various vaccines. He also participated on several Data Safety Monitoring Boards for vaccine trials conducted by other sponsors. HO reports grants from Japan Agency for Medical Research and Development for research in the Philippines including RSV research and from Japan Society for the Promotion of Science for RSV research, outside the submitted work. DS reports consulting fees from GSK, Seqirus, Sanofi, MSD, Pfizer, AstraZeneca, J&J, BioNTech, Moderna, and Clover BioPharmaceuticals.

Published
2024
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50. Patient Admission and Mechanical Ventilator Allocation Decision-Making Processes by Frontline Medical Professionals in a Japanese ICU During the COVID-19 Pandemic: A Qualitative Study.

Author

Ishizaki S, Jindai K, Saito H, Oshitani H, and Kulstad Gonzalez T

Subjects
Humans, Emergencies, Intensive Care Units, Pandemics, Patient Admission, Ventilators, Mechanical, Japan, COVID-19
Abstract

During the COVID-19 pandemic, the need to triage COVID-19 patients in ICUs emerged globally. Triage guidelines were established in many countries; however, the actual triage decision-making processes and decisions themselves made by frontline medical providers may not have exactly reflected those guidelines. Despite the need to understand decisions and processes in practice regarding patient ICU admission and mechanical ventilator usage to identify areas of improvement for medical care provision, such research is limited. This qualitative study was conducted to identify the decision-making processes regarding COVID-19 patient ICU admissions and mechanical ventilator allocation by frontline medical providers and issues associated with those processes in an ICU during the COVID-19 pandemic. Semi-structured, in-depth interviews were conducted with ICU physicians and nurses working at an urban tertiary referral hospital in Japan between February and April 2022. Patient characteristics that influenced triage decisions made by physicians and the interaction between physicians, nurses, and senior management staff upon making such decisions are discussed in this article. An implicated issue was the lack of legal support for Japanese physicians to practice withdrawal of life-sustaining treatments even during emergencies. Another issue was the impact of non-clinical forces-likely specific to health emergencies-on physicians' decisions regarding mechanical ventilator allocation, where such forces imposed a significant mental burden on the medical providers. We consider public policy and legal implications for future pandemics., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2023
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