Estimation of the National Disease Burden of Influenza-Associated Severe Acute Respiratory Illness in Kenya and Guatemala: A Novel Methodology

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Fuller, James A. ; Summers, Aimee ; Katz, Mark A. ; Lindblade, Kim A. ; Njuguna, Henry ; Arvelo, Wences ; Khagayi, Sammy ; Emukule, Gideon ; Linares-Perez, Nivaldo ; McCracken, John ; Nokes, D. James ; Ngama, Mwanajuma ; Kazungu, Sidi ; Mott, Joshua A. ; Olsen, Sonja J. ; Widdowson, Marc-Alain ; Feikin, Daniel R.
• Description:
  Background
  
  Knowing the national disease burden of severe influenza in low-income countries can inform policy decisions around influenza treatment and prevention. We present a novel methodology using locally generated data for estimating this burden.
  
  Methods and Findings
  
  This method begins with calculating the hospitalized severe acute respiratory illness (SARI) incidence for children <5 years old and persons ≥5 years old from population-based surveillance in one province. This base rate of SARI is then adjusted for each province based on the prevalence of risk factors and healthcare-seeking behavior. The percentage of SARI with influenza virus detected is determined from provincial-level sentinel surveillance and applied to the adjusted provincial rates of hospitalized SARI. Healthcare-seeking data from healthcare utilization surveys is used to estimate non-hospitalized influenza-associated SARI. Rates of hospitalized and non-hospitalized influenza-associated SARI are applied to census data to calculate the national number of cases. The method was field-tested in Kenya, and validated in Guatemala, using data from August 2009–July 2011. In Kenya (2009 population 38.6 million persons), the annual number of hospitalized influenza-associated SARI cases ranged from 17,129–27,659 for children <5 years old (2.9–4.7 per 1,000 persons) and 6,882–7,836 for persons ≥5 years old (0.21–0.24 per 1,000 persons), depending on year and base rate used. In Guatemala (2011 population 14.7 million persons), the annual number of hospitalized cases of influenza-associated pneumonia ranged from 1,065–2,259 (0.5–1.0 per 1,000 persons) among children <5 years old and 779–2,252 cases (0.1–0.2 per 1,000 persons) for persons ≥5 years old, depending on year and base rate used. In both countries, the number of non-hospitalized influenza-associated cases was several-fold higher than the hospitalized cases.
  
  Conclusions
  
  Influenza virus was associated with a substantial amount of severe disease in Kenya and Guatemala. This method can be performed in most low and lower-middle income countries.
  
  
• Subjects:
  Biology Demography Hospitalization Humans Incidence Influenza, Human Medicine Research Article Sentinel Surveillance Severe Acute Respiratory Syndrome
• Source:
  PLoS One. 2013; 8(2).
• Document Type:
  Journal Article
• Place as Subject:
  Guatemala ; Kenya
• Volume:
  8
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7a0324473b444155f9c3a88f735c98ac430390e7166bbb7662c5fc9c394badcb
• Download URL:
  https://stacks.cdc.gov/view/cdc/13408/cdc_13408_DS1.pdf
• File Type:
  [PDF - 378.50 KB ]