Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements.
<h4>Background</h4>Rotavirus is a leading cause of diarrhoeal mortality in children but there is considerable disagreement about how many deaths occur each year.<h4>Methods and findings</h4>We compared CHERG, GBD and WHO/CDC estimates of age under 5 years (U5) rotavirus death...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183392&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849766314871095296 |
|---|---|
| author | Andrew Clark Robert Black Jacqueline Tate Anna Roose Karen Kotloff Diana Lam William Blackwelder Umesh Parashar Claudio Lanata Gagandeep Kang Christopher Troeger James Platts-Mills Ali Mokdad Global Rotavirus Surveillance Network Colin Sanderson Laura Lamberti Myron Levine Mathuram Santosham Duncan Steele |
| author_facet | Andrew Clark Robert Black Jacqueline Tate Anna Roose Karen Kotloff Diana Lam William Blackwelder Umesh Parashar Claudio Lanata Gagandeep Kang Christopher Troeger James Platts-Mills Ali Mokdad Global Rotavirus Surveillance Network Colin Sanderson Laura Lamberti Myron Levine Mathuram Santosham Duncan Steele |
| author_sort | Andrew Clark |
| collection | DOAJ |
| description | <h4>Background</h4>Rotavirus is a leading cause of diarrhoeal mortality in children but there is considerable disagreement about how many deaths occur each year.<h4>Methods and findings</h4>We compared CHERG, GBD and WHO/CDC estimates of age under 5 years (U5) rotavirus deaths at the global, regional and national level using a standard year (2013) and standard list of 186 countries. The global estimates were 157,398 (CHERG), 122,322 (GBD) and 215,757 (WHO/CDC). The three groups used different methods: (i) to select data points for rotavirus-positive proportions; (ii) to extrapolate data points to individual countries; (iii) to account for rotavirus vaccine coverage; (iv) to convert rotavirus-positive proportions to rotavirus attributable fractions; and (v) to calculate uncertainty ranges. We conducted new analyses to inform future estimates. We found that acute watery diarrhoea was associated with 87% (95% CI 83-90%) of U5 diarrhoea hospitalisations based on data from 84 hospital sites in 9 countries, and 65% (95% CI 57-74%) of U5 diarrhoea deaths based on verbal autopsy reports from 9 country sites. We reanalysed data from the Global Enteric Multicenter Study (GEMS) and found 44% (55% in Asia, and 32% in Africa) rotavirus-positivity among U5 acute watery diarrhoea hospitalisations, and 28% rotavirus-positivity among U5 acute watery diarrhoea deaths. 97% (95% CI 95-98%) of the U5 diarrhoea hospitalisations that tested positive for rotavirus were entirely attributable to rotavirus. For all clinical syndromes combined the rotavirus attributable fraction was 34% (95% CI 31-36%). This increased by a factor of 1.08 (95% CI 1.02-1.14) when the GEMS results were reanalysed using a more sensitive molecular test.<h4>Conclusions</h4>We developed consensus on seven proposals for improving the quality and transparency of future rotavirus mortality estimates. |
| format | Article |
| id | doaj-art-18ed7a934e924a6ea57c1c9cc7af5a0d |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-18ed7a934e924a6ea57c1c9cc7af5a0d2025-08-20T03:04:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01129e018339210.1371/journal.pone.0183392Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements.Andrew ClarkRobert BlackJacqueline TateAnna RooseKaren KotloffDiana LamWilliam BlackwelderUmesh ParasharClaudio LanataGagandeep KangChristopher TroegerJames Platts-MillsAli MokdadGlobal Rotavirus Surveillance NetworkColin SandersonLaura LambertiMyron LevineMathuram SantoshamDuncan Steele<h4>Background</h4>Rotavirus is a leading cause of diarrhoeal mortality in children but there is considerable disagreement about how many deaths occur each year.<h4>Methods and findings</h4>We compared CHERG, GBD and WHO/CDC estimates of age under 5 years (U5) rotavirus deaths at the global, regional and national level using a standard year (2013) and standard list of 186 countries. The global estimates were 157,398 (CHERG), 122,322 (GBD) and 215,757 (WHO/CDC). The three groups used different methods: (i) to select data points for rotavirus-positive proportions; (ii) to extrapolate data points to individual countries; (iii) to account for rotavirus vaccine coverage; (iv) to convert rotavirus-positive proportions to rotavirus attributable fractions; and (v) to calculate uncertainty ranges. We conducted new analyses to inform future estimates. We found that acute watery diarrhoea was associated with 87% (95% CI 83-90%) of U5 diarrhoea hospitalisations based on data from 84 hospital sites in 9 countries, and 65% (95% CI 57-74%) of U5 diarrhoea deaths based on verbal autopsy reports from 9 country sites. We reanalysed data from the Global Enteric Multicenter Study (GEMS) and found 44% (55% in Asia, and 32% in Africa) rotavirus-positivity among U5 acute watery diarrhoea hospitalisations, and 28% rotavirus-positivity among U5 acute watery diarrhoea deaths. 97% (95% CI 95-98%) of the U5 diarrhoea hospitalisations that tested positive for rotavirus were entirely attributable to rotavirus. For all clinical syndromes combined the rotavirus attributable fraction was 34% (95% CI 31-36%). This increased by a factor of 1.08 (95% CI 1.02-1.14) when the GEMS results were reanalysed using a more sensitive molecular test.<h4>Conclusions</h4>We developed consensus on seven proposals for improving the quality and transparency of future rotavirus mortality estimates.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183392&type=printable |
| spellingShingle | Andrew Clark Robert Black Jacqueline Tate Anna Roose Karen Kotloff Diana Lam William Blackwelder Umesh Parashar Claudio Lanata Gagandeep Kang Christopher Troeger James Platts-Mills Ali Mokdad Global Rotavirus Surveillance Network Colin Sanderson Laura Lamberti Myron Levine Mathuram Santosham Duncan Steele Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. PLoS ONE |
| title | Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. |
| title_full | Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. |
| title_fullStr | Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. |
| title_full_unstemmed | Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. |
| title_short | Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements. |
| title_sort | estimating global regional and national rotavirus deaths in children aged 5 years current approaches new analyses and proposed improvements |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0183392&type=printable |
| work_keys_str_mv | AT andrewclark estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT robertblack estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT jacquelinetate estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT annaroose estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT karenkotloff estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT dianalam estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT williamblackwelder estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT umeshparashar estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT claudiolanata estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT gagandeepkang estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT christophertroeger estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT jamesplattsmills estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT alimokdad estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT globalrotavirussurveillancenetwork estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT colinsanderson estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT lauralamberti estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT myronlevine estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT mathuramsantosham estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements AT duncansteele estimatingglobalregionalandnationalrotavirusdeathsinchildrenaged5yearscurrentapproachesnewanalysesandproposedimprovements |