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Determining the Provincial and National Burden of Influenza-Associated Severe Acute Respiratory Illness in South Africa Using a Rapid Assessment Methodology.

Murray J, Cohen A, Walaza S, Groome M, Madhi S, Variava E, Kahn K, Dawood H, Tempia S, Tshangela A, Venter M, Feikin D, Cohen C - PLoS ONE (2015)

Bottom Line: These rates were adjusted for each of the remaining 8 provinces based on their prevalence of risk factors for pneumonia and healthcare-seeking behavior.We applied rates of hospitalized and non-hospitalized influenza-associated SARI to census data to calculate the national number of cases.The incidence of influenza-associated SARI was highest in children <5 years and was higher in HIV-infected than HIV-uninfected persons in all age groups.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins International Vaccine Access Center, Baltimore, Maryland, United States of America.

ABSTRACT
Local disease burden data are necessary to set national influenza vaccination policy. In 2010 the population of South Africa was 50 million and the HIV prevalence was 11%. We used a previously developed methodology to determine severe influenza burden in South Africa. Hospitalized severe acute respiratory illness (SARI) incidence was calculated, stratified by HIV status, for four age groups using data from population-based surveillance in one site situated in Gauteng Province for 2009-2011. These rates were adjusted for each of the remaining 8 provinces based on their prevalence of risk factors for pneumonia and healthcare-seeking behavior. We estimated non-hospitalized influenza-associated SARI from healthcare utilization surveys at two sites and used the percent of SARI cases positive for influenza from sentinel surveillance to derive the influenza-associated SARI rate. We applied rates of hospitalized and non-hospitalized influenza-associated SARI to census data to calculate the national number of cases. The percent of SARI cases that tested positive for influenza ranged from 7-17% depending on age group, year, province and HIV status. In 2010, there were an estimated 21,555 total severe influenza cases in HIV-uninfected individuals and 13,876 in HIV-infected individuals. In 2011, there were an estimated 29,892 total severe influenza cases in HIV-uninfected individuals and 17,289 in HIV-infected individuals. The incidence of influenza-associated SARI was highest in children <5 years and was higher in HIV-infected than HIV-uninfected persons in all age groups. Influenza virus was associated with a substantial amount of severe disease, especially in young children and HIV-infected populations in South Africa.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of methods.Visual depiction of the method used to calculate the rates and numbers of hospitalized and non-hospitalized SARI and influenza-associated SARI cases in of South Africa.
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pone.0132078.g001: Flow diagram of methods.Visual depiction of the method used to calculate the rates and numbers of hospitalized and non-hospitalized SARI and influenza-associated SARI cases in of South Africa.

Mentions: We utilized a multiplier model to estimate numbers of individuals with hospitalized and non-hospitalized influenza-associated SARI for each province in South Africa in four age groups (<5, 5–24, 25–44 and ≥45 years) for 2009–2011, stratified by HIV serostatus (Fig 1). Non-hospitalized SARI includes cases from the population that do not reach the hospital due to health care access barriers. This method was previously used in Kenya and Guatemala but was modified to include stratification by HIV serostatus to reflect the impact of HIV on influenza burden in South Africa [2].


Determining the Provincial and National Burden of Influenza-Associated Severe Acute Respiratory Illness in South Africa Using a Rapid Assessment Methodology.

Murray J, Cohen A, Walaza S, Groome M, Madhi S, Variava E, Kahn K, Dawood H, Tempia S, Tshangela A, Venter M, Feikin D, Cohen C - PLoS ONE (2015)

Flow diagram of methods.Visual depiction of the method used to calculate the rates and numbers of hospitalized and non-hospitalized SARI and influenza-associated SARI cases in of South Africa.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496064&req=5

pone.0132078.g001: Flow diagram of methods.Visual depiction of the method used to calculate the rates and numbers of hospitalized and non-hospitalized SARI and influenza-associated SARI cases in of South Africa.
Mentions: We utilized a multiplier model to estimate numbers of individuals with hospitalized and non-hospitalized influenza-associated SARI for each province in South Africa in four age groups (<5, 5–24, 25–44 and ≥45 years) for 2009–2011, stratified by HIV serostatus (Fig 1). Non-hospitalized SARI includes cases from the population that do not reach the hospital due to health care access barriers. This method was previously used in Kenya and Guatemala but was modified to include stratification by HIV serostatus to reflect the impact of HIV on influenza burden in South Africa [2].

Bottom Line: These rates were adjusted for each of the remaining 8 provinces based on their prevalence of risk factors for pneumonia and healthcare-seeking behavior.We applied rates of hospitalized and non-hospitalized influenza-associated SARI to census data to calculate the national number of cases.The incidence of influenza-associated SARI was highest in children <5 years and was higher in HIV-infected than HIV-uninfected persons in all age groups.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins International Vaccine Access Center, Baltimore, Maryland, United States of America.

ABSTRACT
Local disease burden data are necessary to set national influenza vaccination policy. In 2010 the population of South Africa was 50 million and the HIV prevalence was 11%. We used a previously developed methodology to determine severe influenza burden in South Africa. Hospitalized severe acute respiratory illness (SARI) incidence was calculated, stratified by HIV status, for four age groups using data from population-based surveillance in one site situated in Gauteng Province for 2009-2011. These rates were adjusted for each of the remaining 8 provinces based on their prevalence of risk factors for pneumonia and healthcare-seeking behavior. We estimated non-hospitalized influenza-associated SARI from healthcare utilization surveys at two sites and used the percent of SARI cases positive for influenza from sentinel surveillance to derive the influenza-associated SARI rate. We applied rates of hospitalized and non-hospitalized influenza-associated SARI to census data to calculate the national number of cases. The percent of SARI cases that tested positive for influenza ranged from 7-17% depending on age group, year, province and HIV status. In 2010, there were an estimated 21,555 total severe influenza cases in HIV-uninfected individuals and 13,876 in HIV-infected individuals. In 2011, there were an estimated 29,892 total severe influenza cases in HIV-uninfected individuals and 17,289 in HIV-infected individuals. The incidence of influenza-associated SARI was highest in children <5 years and was higher in HIV-infected than HIV-uninfected persons in all age groups. Influenza virus was associated with a substantial amount of severe disease, especially in young children and HIV-infected populations in South Africa.

No MeSH data available.


Related in: MedlinePlus