Details:

Alternative Title:
Clin Infect Dis
Publisher's site:
http://dx.doi.org/10.1093/cid/ciu095
Personal Author:
Tempia, Stefano ; Walaza, Sibongile ; Viboud, Cecile ; Cohen, Adam L. ; Madhi, Shabir A. ; ... More +
Tempia, Stefano ; Walaza, Sibongile ; Viboud, Cecile ; Cohen, Adam L. ; Madhi, Shabir A. ; Venter, Marietjie ; McAnerney, Johanna M. ; Cohen, Cheryl Less -
Description:
Background.

There are few published data describing the mortality burden associated with influenza and respiratory syncytial virus (RSV) infection in children in low- and middle-income countries and particularly from Africa and settings with high prevalence of human immunodeficiency virus (HIV).

Methods.

We modeled the excess mortality attributable to influenza (seasonal and pandemic) and RSV infection by applying Poisson regression models to monthly all-respiratory and pneumonia and influenza deaths, using national influenza and RSV laboratory surveillance data as covariates. In addition, we estimated the seasonal influenza– and RSV-associated deaths among HIV-infected and -uninfected children using Poisson regression models that incorporated HIV prevalence and highly active antiretroviral therapy coverage as covariates.

Results.

In children <5 years of age, the mean annual numbers of seasonal influenza– and RSV-associated all-respiratory deaths were 452 (8 per 100 000 person-years [PY]) and 546 (10 per 100 000 PY), respectively. Infants <1 year of age experienced higher mortality rates compared with children 1–4 years of age for both influenza (22 vs 5 per 100 000 PY) and RSV (35 vs 4 per 100 000 PY). HIV-infected compared with HIV-uninfected children <5 years of age were at increased risk of death associated with influenza (age-adjusted relative risk [aRR], 11.5; 95% confidence interval [CI], 9.6–12.6) and RSV (aRR, 8.1; 95% CI, 6.9–9.3) infection. In 2009, we estimated 549 (11 per 100 000 PY) all-respiratory influenza A(H1N1)pdm09-associated deaths among children aged <5 years.

Conclusions.

Our findings support increased research efforts to guide and prioritize interventions such as influenza vaccination and HIV prevention in low- and middle-income countries with high HIV prevalence such as South Africa.


Subjects:
[+]
Child, Preschool Child Mortality Epidemiological Monitoring Female HIV Infections Humans Infant Infant, Newborn Influenza, Human Influenza A Virus, H1N1 Subtype Male Pandemics Pneumonia Poisson Distribution Prevalence Regression Analysis Respiratory Syncytial Viruses Respiratory Syncytial Virus Infections Risk Assessment Seasons
Source:
Clin Infect Dis. 58(9):1241-1249
Pubmed ID:
24567249
Pubmed Central ID:
PMC9096151
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Place as Subject:
South Africa
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:46911adfc8d4b7445a796e84680c5bacf998108cacc21914921dd5a91754eb7c
Download URL:
https://stacks.cdc.gov/view/cdc/117323/cdc_117323_DS1.pdf
File Type:

Supporting Files

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  	nihms-1796151-f0001.jpg	jpeg
  	nihms-1796151.nxml	xml
  	NIHMS1796151-supplement-Supplemental_material.docx	docx

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