Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Walaza, Sibongile ; Cohen, Cheryl ; Nanoo, Ananta ; Cohen, Adam L. ; McAnerney, Johanna ; von Mollendorf, Claire ; Moyes, Jocelyn ; Tempia, Stefano
• Description:
  Background
  
  Published data on the interaction between influenza and pulmonary tuberculosis (PTB) are limited. We aimed to estimate the influenza-associated mortality among individuals with PTB in South Africa from 1999–2009.
  
  Methods
  
  We modelled the excess influenza-associated mortality by applying Poisson regression models to monthly PTB and non-tuberculosis respiratory deaths, using laboratory-confirmed influenza as a covariate.
  
  Results
  
  PTB deaths increased each winter, coinciding with influenza virus circulation. Among individuals of any age, mean annual influenza-associated PTB mortality rate was 164/100,000 person-years (n = 439). The rate of non-tuberculosis respiratory deaths was 27/100,000 (n = 1125) for HIV-infected and 5/100,000 (n = 2367) for HIV-uninfected individuals of all ages. Among individuals aged <65 years, influenza-associated PTB mortality risk was elevated compared to influenza-associated non-tuberculosis respiratory deaths in HIV-infected (relative risk (RR): 5.2; 95% CI: 4.6–5.9) and HIV-uninfected individuals (RR: 61.0; CI: 41.4–91.0). Among individuals aged ≥65 years, influenza-associated PTB mortality risk was elevated compared to influenza-associated non-tuberculosis respiratory deaths in HIV-uninfected individuals (RR: 13.0; 95% CI: 12.0–14.0).
  
  Conclusion
  
  We observed an increased risk of influenza-associated mortality in persons with PTB compared to non-tuberculosis respiratory deaths. If confirmed in other settings, our findings may support recommendations for active inclusion of patients with TB for influenza vaccination and empiric influenza anti-viral treatment of patients with TB during influenza epidemics.
  
  
• Subjects:
  Epidemiological Monitoring Humans Influenza, Human Poisson Distribution Regression Analysis Risk Factors Seasons Severity Of Illness Index Tuberculosis
• Source:
  PLoS One. 2015; 10(6).
• Pubmed ID:
  26076197
• Pubmed Central ID:
  PMC4467974
• Document Type:
  Journal Article
• Place as Subject:
  South Africa
• Volume:
  10
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d8c72d67d3d1aa7cb08548a4fefbe41ee1de85c0ed0bd2d8fc321a719a821cd5
• Download URL:
  https://stacks.cdc.gov/view/cdc/31964/cdc_31964_DS1.pdf
• File Type:
  [PDF - 785.99 KB ]