Evidence map›Paper›PMID 23369797›Full record

SynthesisLancet (London, England)2013

Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis.

Harish Nair, Eric Af Simões, Igor Rudan, Bradford D Gessner, Eduardo Azziz-Baumgartner, Jian Shayne F Zhang, Daniel R Feikin, Grant A Mackenzie, Jennifer C Moiïsi, Anna Roca and 27 more

4 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 426 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
426citing papers in PubMed, 13 pooled it
38.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03750747 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Assessing the Feasibility and Effectiveness of Introducing Pulse Oximetry in IMCI Services to Manage Acute Respiratory Infections at First Level Health Facilities of Bangladesh

TypeinterventionalSponsorInternational Centre for Diarrhoeal Disease Research, BangladeshRan2018 to 2022Enrolled612ConditionsChildhood Pneumonia, HypoxemiaArmsPulse Oximeter
NCT04126304 unknown statusnot on this mapstarted 2019, after this paper: background citation

Multi-center Investigation and Study of Mycoplasma Pneumoniae Infection and Macrolide Drug Resistance in Outpatient and In-hospital Pediatric Acute Respiratory Diseases Illness in China

TypeobservationalSponsorShanghai Children's Medical CenterRan2019 to 2021Enrolled2,312ConditionsRespiratory Tract InfectionsArmsAzithromycin, non-macrolides antibiotics, Mycoplasma detection, Data collection
NCT05691127 unknown statusnot on this mapstarted 2023, after this paper: background citation

Burden of Respiratory Illnesses in Pediatric Intensive Care Unit and Its Outcome

TypeobservationalSponsorSohag UniversityRan2023 to 2024Enrolled150ConditionsRespiratory IllnessesArmsComplete blood count (CBC), C reactive protein (CRP(., Chest x ray, ABG, Electrolytes, Random blood sugar, Creatinine
NCT06583317 not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Recurrent Pneumonia in Children at Assiut University Children's Hospital

TypeobservationalSponsorAssiut UniversityRan2025 to 2026Enrolled53ConditionsPneumonia, Lower Respiratory Tract Infection, Chest Infection
3 · Its place in the literature

Who cites it

426 citing papers in PubMed, 13 syntheses or guidelines pooled it, 794 citations in OpenAlex.

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  19. Randomized Trial of Amoxicillin for Pneumonia in Pakistan.The New England journal of medicine · 2020
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366 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

37 authors at 20 institutions in 20 countries.

Harish NairCentre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK; Public Health Foundation of India, New Delhi, India. Electronic address: harish.nair@ed.ac.uk.
Eric Af SimõesUniversity of Colorado Denver and Children's Hospital, Denver, CO, USA; The University of Padjadjaran, Bandung, Indonesia.
Igor RudanCentre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK.
Bradford D GessnerAgence de Médecine Préventive, Paris, France.
Eduardo Azziz-BaumgartnerInfluenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Jian Shayne F ZhangSchool of Population Health, The University of Melbourne, VIC, Australia; Social Insurance Fund Management Centre, Jiangsu, China.
Daniel R FeikinCenters for Disease Control and Prevention, Nairobi, Kenya; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Grant A MackenzieChild Survival Theme, The Gambia Unit, Medical Research Council, Banjul, The Gambia.
Jennifer C MoiïsiKenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Anna RocaBarcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde da Manhiça, Ministerio de Saúde, Maputo, Mozambique.
Henry C BaggettInternational Emerging Infections Program, Global Disease Detection Regional Centre, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.
Syed Ma ZamanChild Survival Theme, The Gambia Unit, Medical Research Council, Banjul, The Gambia; Health Protection Services Colindale, Health Protection Agency, London, UK.
Rosalyn J SingletonArctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Anchorage, AK, USA; Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
Marilla G LuceroResearch Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa, Philippines.
Aruna ChandranJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Angela GentileRicardo Gutierrez Children's Hospital, Buenos Aires, Argentina.
Cheryl CohenCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Sandringham, South Africa; School of Public Health and Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Anand KrishnanCentre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Zulfiqar A BhuttaDivision of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Adriano ArguedasInstituto de Atención Pediatrica, Universidad de Ciencias Médicas de Centro América, San José, Costa Rica.
Alexey Wilfrido ClaraCDC-Central American Region, Guatemala City, Guatemala.
Ana Lucia AndradeFederal University of Goiás, Goiânia, Brazil.
Maurice OpeEast African Community Secretariat, Arusha, Tanzania.
Raúl Oscar RuvinskyNational University of Buenos Aires, Buenos Aires, Argentina.
María HortalProgram for Basic Sciences Development, National University/PNUD, Montevideo, Uruguay.
John P McCrackenCenter for Health Studies, Universidad del Valle de Guatemala, Guatemala.
Shabir A MadhiCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Sandringham, South Africa; Department of Science and Technology, and National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa.
Nigel BruceUniversity of Liverpool, Liverpool, UK.
Shamim A QaziDepartment of Maternal, Neonatal and Child and Adolescent Health, WHO, Geneva, Switzerland.
Saul S MorrisBill & Melinda Gates Foundation, Seattle, WA, USA.
Shams El ArifeenInternational Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
Martin W WeberWHO, Indonesia Country Office, Jakarta, Indonesia.
J Anthony G ScottKenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
W Abdullah BrooksInternational Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
Robert F BreimanCenters for Disease Control and Prevention, Nairobi, Kenya.
Harry CampbellCentre for Population Health Sciences, Global Health Academy, The University of Edinburgh, Edinburgh, UK.
Severe Acute Lower Respiratory Infections Working Group
International Centre for Diarrhoeal Disease Research · BDJohns Hopkins University · USKenya Medical Research Institute · KEMRC Unit the Gambia · GMUniversity of Edinburgh · GBAga Khan University · PKAgence de Médecine Préventive · FRAlaska Native Tribal Health Consortium · USAll India Institute of Medical Sciences · INBill & Melinda Gates Foundation · USCenters for Disease Control and Prevention · USCenters for Disease Control and Prevention · KEEast, Central and Southern Africa Health Community · TZHospital General de Niños Ricardo Gutierrez · ARIndonesian Pediatric Society · IDInstitute of Nutrition of Central America and Panama · GTMinistry of Public Health · THNational Institute for Communicable DiseasesPublic Health Foundation of India · INResearch Institute for Tropical Medicine · PH

Funding

Medical Research Council MC_UP_A900_1124Wellcome Trust 092654Wellcome Trust 098532
6 · The paper itself

Abstract

backgroundThe annual number of hospital admissions and in-hospital deaths due to severe acute lower respiratory infections (ALRI) in young children worldwide is unknown. We aimed to estimate the incidence of admissions and deaths for such infections in children younger than 5 years in 2010.

methodsWe estimated the incidence of admissions for severe and very severe ALRI in children younger than 5 years, stratified by age and region, with data from a systematic review of studies published between Jan 1, 1990, and March 31, 2012, and from 28 unpublished population-based studies. We applied these incidence estimates to population estimates for 2010, to calculate the global and regional burden in children admitted with severe ALRI in that year. We estimated in-hospital mortality due to severe and very severe ALRI by combining incidence estimates with case fatality ratios from hospital-based studies.

findingsWe identified 89 eligible studies and estimated that in 2010, 11·9 million (95% CI 10·3-13·9 million) episodes of severe and 3·0 million (2·1-4·2 million) episodes of very severe ALRI resulted in hospital admissions in young children worldwide. Incidence was higher in boys than in girls, the sex disparity being greatest in South Asian studies. On the basis of data from 37 hospital studies reporting case fatality ratios for severe ALRI, we estimated that roughly 265,000 (95% CI 160,000-450,000) in-hospital deaths took place in young children, with 99% of these deaths in developing countries. Therefore, the data suggest that although 62% of children with severe ALRI are treated in hospitals, 81% of deaths happen outside hospitals.

interpretationSevere ALRI is a substantial burden on health services worldwide and a major cause of hospital referral and admission in young children. Improved hospital access and reduced inequities, such as those related to sex and rural status, could substantially decrease mortality related to such infection. Community-based management of severe disease could be an important complementary strategy to reduce pneumonia mortality and health inequities.

fundingWHO.

Indexed as

Acute DiseaseChild, PreschoolFemaleGlobal HealthHospitalizationHospital MortalityHumansIncidenceInfantInfluenza A Virus, H1N1 SubtypeInfluenza, HumanMaleRespiratory Tract Infections

Identifiers

PMID23369797
PMCPMC3986472
OpenAlexW2113629675

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.