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Institute for International Programs

Neonatal and Child Morbidities and Etiologies

Etiology-specific morbidity and mortality estimates for conditions such as pneumonia, meningitis, and neonatal infections

The objective of this activity is to provide pathogen-specific estimates of mortality and morbidity for significant childhood conditions. Expanding on the work of the CHERG over the past decade to provide estimates of important child syndromes, this activity seeks to improve understanding of the contribution of specific pathogens to morbidity and mortality from childhood pneumonia, meningitis, and neonatal infections. Substantial new information on pathogen-specific morbidity and mortality has become available in recent years, particularly from low- and middle-income countries. This new information is being incorporated into national, regional, and global estimates disease burden estimates.

Partners at the International Vaccine Access Center (IVAC) at JHU are working to estimate the burden of Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), two major causes of pneumonia and meningitis for which safe and effective vaccines are now available. In 2015, the team expanded their estimation work to estimates the burden of meningitis caused by Neisseria meningitidis (meningococcus). In 2016, subnational etiology estimates were also produced for India.

Through a subgrant from JHU/IIP, the University of Edinburgh (UoE) is conducting comprehensive systematic reviews on 1) morbidity of post-neonatal childhood pneumonia; 2) etiology-specific morbidity of post-neonatal childhood pneumonia, specifically Respiratory Syncytial Virus (RSV), Metapnuemovirus (hMPV), and parainfluenza; and 3) etiology-specific morbidity of neonatal infections. UoE is also developing improved methods to estimate country specific estimates of childhood pneumonia (with uncertainty ranges) using information on risk factors and their population attributable fractions, including HIV-attributable burden.


Global role and burden of influenza in pediatric respiratory hospitalizations, 1982–2012: a systematic analysis. Lafond KE, Nair H, Rasooly MH, Valent F, Booy R, Rahman M, et al. PLoS Medicine. 2016. doi:10.1371/journal.pmed.1001977.

Aetiological role of common respiratory viruses in acute lower respiratory infections in children under five years: a systematic review and meta–analysis. Shi T, McLean K, Campbell H, Nair H. J Glob Health. 2015. doi: 10.7189/jogh.05.010408

Global, regional, and national estimates of pneumonia burden in HIV-infected children in 2010: a meta-analysis and modelling study. Theodoratou E, McAllister DA, Reed C, Adeloye DO, Rudan I, Muhe LM, Madhi SA, Campbell H, Nair H. Lancet Infect Dis. 2014. doi:10.1016/S1473-3099(14)70990-9

Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. Rudan I, O'Brien KL, Nair H, Liu L, Theodoratou E, Qazi S, Lukšić I, Fischer Walker CL, Black RE, Campbell H; Child Health Epidemiology Reference Group (CHERG). J Glob Health. 2013. doi: 10.7189/jogh.03.010401

Risk factors for severe acute lower respiratory infections in children: a systematic review and meta-analysis. Jackson S, Mathews KH, Pulanic D, Falconer R, Rudan I, Campbell H, Nair H. Croat Med J. 2013. doi:10.3325/cmj.2013.54.110

Estimating global and regional morbidity from acute bacterial meningitis in children: assessment of the evidence. Luksic I, Mulic R, Falconer R, Orban M, Sidhu S, Rudan I. Croat Med J. 2013. doi:10.3325/cmj.2013.54.510

Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age -- a systematic review and meta-analysis. Luksic I, Kearns PK, Scott F, Rudan I, Campbell H, Nair H. Croat Med J. 2013. doi:10.3325/cmj.2013.54.122

Series on Respiratory Syncytial Virus (RSV)
Respiratory syncytial virus (RSV) disease – new data needed to guide future policy. Campbell H, Bont L, Nair H. J Glob Health. 2015. doi: 10.7189/jogh.05.020101

Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: systematic review and meta–analysis. Shi T, Balsells E, Wastnedge E, Singleton R, Rasmussen ZA, Zar HJ, Rath BA, Madhi SA, Campbell S, Vaccari LC, Bulkow LR, Thomas ED, Barnett W, Hoppe C, Campbell H, Nair H. J Glob Health. 2015. doi: 10.7189/jogh.05.020416

Burden of respiratory syncytial virus infections in China: Systematic review and meta–analysis. Zhang Y, Yuan L, Zhang Y, Zhang X, Zheng M, Kyaw MH. J Glob Health 2015. doi: 10.7189/jogh.05.020417

Etiology of community acquired pneumonia among children in India: prospective, cohort study. Mathew JL, Singhi S, Ray P, Hagel E, Saghafian-Hedengren S, Bansal A, Ygberg S, Sodhi KS, Kumar BVR, Nilsson A. J Glob Health. 2015. doi: 10.7189/jogh.05.020418

Evaluation of case definitions for estimation of respiratory syncytial virus associated hospitalizations among children in a rural community of northern India. Saha S, Pandey BG, Choudekar A, Krishnan A, Gerber SI, Rai SK, Singh P, Chadha M, Lal RB, Broor S. J Glob Health. 2015. doi: 10.7189/jogh.05.020419