Model-estimated impacts of pediatric respiratory syncytial virus prevention programs in Mali on asthma prevalence

Justin R. Ortiz, Rachel S. Laufer, Steven M. Brunwasser, Flanon Coulibaly, Fatoumata Diallo, Moussa Doumbia, Amanda J. Driscoll, Deshayne B. Fell, Fadima C. Haidara, Tina V. Hartert, Adama M. Keita, Kathleen M. Neuzil, Brittney M. Snyder, Samba Sow, Meagan C. Fitzpatrick

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI) in young children and is associated with subsequent recurrent wheezing illness and asthma (wheeze/asthma). RSV prevention may therefore reduce wheeze/asthma prevalence. Objectives: We estimated the contribution of RSV LRTI and the impact of RSV prevention on recurrent wheeze/asthma in Mali. Methods: We simulated 12 consecutive monthly birth cohorts in Mali and estimated RSV LRTI cases through 2 years and recurrent wheeze/asthma prevalence at 6 years under different RSV prevention scenarios: status quo, seasonal birth-dose extended half-life mAb, and seasonal birth-dose extended half-life mAb followed by 2 doses of pediatric vaccine (mAb + vaccine). We used World Health Organization (WHO) Preferred Product Characteristics for RSV prevention, demographic and RSV epidemiologic data from Mali, regional recurrent wheeze/asthma prevalence, and relative risk of recurrent wheeze/asthma given early childhood RSV LRTI. Results: Among the simulated cohort of 778,680 live births, 10.0% had RSV LRTI by 2 years and 89.6% survived to 6 years. We estimated that 13.4% of all recurrent wheeze/asthma at 6 years was attributable to RSV LRTI. Recurrent wheeze/asthma prevalence at 6 years was 145.0 per 10,000 persons (RSV LRTI attributable) and 1084.2 per 10,000 persons (total). In mAb and mAb + vaccine scenarios, RSV LRTI cases decreased by 11.8% and 44.4%, respectively, and recurrent wheeze/asthma prevalence decreased by 11.8% and 44.4% (RSV LRTI attributable) and 1.6% and 5.9% (total). Conclusion: In Mali, RSV prevention programs may have a meaningful impact on chronic respiratory disease, strengthening the case for investment in RSV prevention.

Original languageEnglish (US)
Article number100092
JournalJournal of Allergy and Clinical Immunology: Global
Issue number2
StatePublished - May 2023

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy


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