Evidence map›Paper›PMID 39489292›Full record

ArticleClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2025

Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the Pneumonia Etiology Research for Child Health (PERCH) study experience.

Ryo Miyakawa, Haijun Zhang, W Abdullah Brooks, Christine Prosperi, Henry C Baggett, Daniel R Feikin, Laura L Hammitt, Stephen R C Howie, Karen L Kotloff, Orin S Levine and 25 more

Abstract read
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Article in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Ryo MiyakawaDepartment of Pediatrics, Weill Cornell Medicine, New York, NY, USA.
Haijun ZhangInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China. Electronic address: zhanghj966@gmail.com.
W Abdullah BrooksDepartment of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka and Matlab, Bangladesh.
Christine ProsperiInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Henry C BaggettDivision of Global Health Protection, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Division of Global Health Protection, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Daniel R FeikinInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Laura L HammittInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Stephen R C HowieMedical Research Council Unit at the London School of Hygiene and Tropical Medicine, Basse, The Gambia; Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand; College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
Karen L KotloffDivision of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Orin S LevineInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Shabir A MadhiSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Wits Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
David R MurdochDepartment of Pathology and Biomedical Sciences, University of Otago, Christchurch, New Zealand; Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand.
Katherine L O'BrienInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
J Anthony G ScottKenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Donald M TheaDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.
Martin AntonioMedical Research Council Unit at the London School of Hygiene and Tropical Medicine, Basse, The Gambia; Department of Pathogen Molecular Biology, London School of Hygiene & Tropical Medicine, Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Juliet O AworiKenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Charatdao BunthiDivision of Global Health Protection, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
Amanda J DriscollInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Bernard EbrukeMedical Research Council Unit at the London School of Hygiene and Tropical Medicine, Basse, The Gambia.
Nicholas S FancourtChildren's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Microbiology Laboratory, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Melissa M HigdonInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Ruth A KarronDepartment of International Health, Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
David P MooreSouth African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Wits Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatrics & Child Health, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa.
Susan C MorpethKenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Justin M MulindwaDepartment of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia.
Daniel E ParkInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Mohammed Ziaur RahmanInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka and Matlab, Bangladesh.
Mustafizur RahmanInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka and Matlab, Bangladesh.
Rasheed A SalaudeenMedical Research Council Unit at the London School of Hygiene and Tropical Medicine, Basse, The Gambia; Medical Microbiology Department, Lagos University Teaching Hospital, Lagos, Nigeria.
Pongpun SawatwongDivision of Global Health Protection, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
Phil SeidenbergDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA; Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, USA.
Samba O SowCentre pour le Développement des Vaccins (CVD-Mali), Bamako, Mali.
Milagritos D TapiaDivision of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Maria Deloria KnollInternational Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

objectivesAfter respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high-burden settings, which have limited data, by comparing with RSV-positive and other cases.

methodsChildren aged 1-59 months hospitalized with suspected severe pneumonia and age/season-matched community controls in seven African and Asian countries had nasopharyngeal/oropharyngeal swabs tested by multiplex PCR for 32 respiratory pathogens, among other clinical and lab assessments at admission. Odds ratios adjusted for age and site (adjusted OR [aOR]) were calculated using logistic regression. Aetiologic probability was estimated using Bayesian nested partial latent class analysis. Latent class analysis identified syndromic constellations of clinical characteristics.

resultshMPV was detected more frequently among cases (267/3887, 6.9%) than controls (115/4976, 2.3%), among cases with pneumonia chest X-ray findings (8.5%) than without (5.5%), and among controls with respiratory tract illness (3.8%) than without (1.8%; all p ≤ 0.001). HMPV-positive cases were negatively associated with the detection of other viruses (aOR, 0.18), especially RSV (aOR, 0.11; all p < 0.0001), and positively associated with the detection of bacteria (aORs, 1.77; p 0.03). No single clinical syndrome distinguished hMPV-positive from other cases. Among hMPV-positive cases, 65.2% were aged <1 year and 27.5% had pneumonia danger signs; positive predictive value for hMPV aetiology was 74.5%; mortality was 3.9%, similar to RSV-positive (2.4%) and lower than that among other cases (9.6%). DISCUSSION: HMPV-associated severe paediatric pneumonia in high-burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives.

Indexed as

MetapneumovirusParamyxoviridae InfectionsPneumoniaPneumonia, ViralAfricaAsiaCase-Control StudiesChild, PreschoolFemaleHumansInfantMaleMultiplex Polymerase Chain ReactionNasopharynxRespiratory Syncytial Virus InfectionsSeverity of Illness IndexAfricaAsiaHuman metapneumovirus (hMPV)PaediatricSevere pneumonia

Identifiers

PMID39489292
PMCPMC13076004

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Registered trials

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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.