Mortality Associated With Seasonal and Pandemic Influenza Among Pregnant and Nonpregnant Women of Childbearing Age in a High-HIV-Prevalence Setting—South Africa, 1999–2009

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Tempia, Stefano ; Walaza, Sibongile ; Cohen, Adam L. ; von Mollendorf, Claire ; Moyes, Jocelyn ; McAnerney, Johanna M. ; Cohen, Cheryl
• Description:
  Background
  
  Information on the mortality burden associated with seasonal and pandemic influenza virus infection among pregnant women is scarce in most settings, particularly in sub-Saharan Africa where pregnancy and maternal mortality rates as well as human immunodeficiency virus (HIV) prevalence are elevated.
  
  Methods
  
  We used an ecological study design to estimate the seasonal and A(H1N1)pdm09 influenza-associated mortality among pregnant and nonpregnant women of childbearing age (15–49 years) by HIV serostatus during 1999–2009 in South Africa. Mortality rates were expressed per 100 000 person-years.
  
  Results
  
  During 1999–2009, the estimated mean annual seasonal influenza–associated mortality rates were 12.6 (123 deaths) and 7.3 (914 deaths) among pregnant and nonpregnant women, respectively. Among pregnant women, the estimated mean annual seasonal influenza–associated mortality rates were 74.9 (109 deaths) among HIV-infected and 1.5 (14 deaths) among HIV–uninfected individuals. Among nonpregnant women, the estimated mean annual seasonal influenza–associated mortality rate was 41.2 (824 deaths) among HIV-infected and 0.9 (90 deaths) among HIV-uninfected individuals. Pregnant women experienced an increased risk of seasonal influenza–associated mortality compared with nonpregnant women (relative risk [RR], 2.8; 95% confidence interval [CI], 1.7–3.9). In 2009, the estimated influenza A(H1N1)pdm09–associated mortality rates were 19.3 (181 deaths) and 9.4 (1189 deaths) among pregnant and nonpregnant women, respectively (RR, 3.2; 95% CI, 2.3–4.1).
  
  Conclusions
  
  Among women of childbearing age, the majority of estimated seasonal influenza–associated deaths occurred in HIV-infected individuals. Pregnant women experienced an increased risk of death associated with seasonal and A(H1N1)pdm09 influenza infection compared with nonpregnant women.
  
  
• Subjects:
  Adolescent Adult Female HIV Infections Humans Influenza, Human Middle Aged Pandemics Pregnancy Pregnancy Complications, Infectious Prevalence Young Adult

  More +
• Source:
  Clin Infect Dis. 61(7):1063-1070
• Pubmed ID:
  26060287
• Pubmed Central ID:
  PMC5700004
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  South Africa
• Volume:
  61
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:887178b37dfc0676bde04a8900396ef64d276c9401a9bbea36b1ba5532b5bd28
• Download URL:
  https://stacks.cdc.gov/view/cdc/49954/cdc_49954_DS1.pdf
• File Type:
  [PDF - 288.14 KB ]