Mortality Associated With Seasonal and Pandemic Influenza and Respiratory Syncytial Virus Among Children <5 Years of Age in a High HIV Prevalence Setting—South Africa, 1998–2009
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). Met...
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Published in | Clinical infectious diseases Vol. 58; no. 9; pp. 1241 - 1249 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Oxford
OXFORD UNIVERSITY PRESS
01.05.2014
Oxford University Press |
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Abstract | 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. |
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AbstractList | 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. 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). 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. 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. 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. BACKGROUNDThere 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). METHODSWe 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. RESULTSIn 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. CONCLUSIONSOur 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. 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). 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. 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. 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. |
Author | Tempia, Stefano Walaza, Sibongile Cohen, Adam L. McAnerney, Johanna M. Viboud, Cecile Venter, Marietjie Cohen, Cheryl Madhi, Shabir A. |
AuthorAffiliation | 3 Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa 2 Influenza Division, Centers for Disease Control and Prevention, Pretoria, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa 8 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa 6 Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg 5 Faculty of Health Sciences, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg 1 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia 4 Fogarty International Center, National Institutes of Health, Bethesda, Maryland 7 Zoonoses Research Unit, Department of Medical Virology, University of Pretoria, Johannesburg, South Africa |
AuthorAffiliation_xml | – name: 7 Zoonoses Research Unit, Department of Medical Virology, University of Pretoria, Johannesburg, South Africa – name: 1 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia – name: 5 Faculty of Health Sciences, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg – name: 8 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa – name: 3 Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa – name: 4 Fogarty International Center, National Institutes of Health, Bethesda, Maryland – name: 6 Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg – name: 2 Influenza Division, Centers for Disease Control and Prevention, Pretoria, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa |
Author_xml | – sequence: 1 givenname: Stefano surname: Tempia fullname: Tempia, Stefano – sequence: 2 givenname: Sibongile surname: Walaza fullname: Walaza, Sibongile – sequence: 3 givenname: Cecile surname: Viboud fullname: Viboud, Cecile – sequence: 4 givenname: Adam L. surname: Cohen fullname: Cohen, Adam L. – sequence: 5 givenname: Shabir A. surname: Madhi fullname: Madhi, Shabir A. – sequence: 6 givenname: Marietjie surname: Venter fullname: Venter, Marietjie – sequence: 7 givenname: Johanna M. surname: McAnerney fullname: McAnerney, Johanna M. – sequence: 8 givenname: Cheryl surname: Cohen fullname: Cohen, Cheryl |
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Copyright | Copyright © 2014 Oxford University Press on behalf of the Infectious Diseases Society of America 2015 INIST-CNRS Copyright Oxford University Press, UK May 1, 2014 |
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Keywords | Human respiratory syncytial virus Prognosis Prevalence Epidemiology Paramyxoviridae Respiratory tract Seasonal variation Pneumovirus Child Age Human Immunopathology Pneumovirinae Respiratory disease Mortality Retroviridae AIDS Immune deficiency Lentivirus Infection Virus Mononegavirales Viral disease Influenza Human immunodeficiency virus influenza mortality South Africa HIV respiratory syncytial virus |
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References | Nair ( key 20170522103413_CIU095C6) 2011; 378 Nair ( key 20170522103413_CIU095C7) 2010; 375 Ribas Freitas ( key 20170522103413_CIU095C45) 2013 Beeler ( key 20170522103413_CIU095C46) 2012; 55 Ope ( key 20170522103413_CIU095C17) 2011; 6 Madhi ( key 20170522103413_CIU095C19) 2006; 36 Simonsen ( key 20170522103413_CIU095C28) 2013; 10 Darikwa ( key 20170522103413_CIU095C33) 2011; 25 Charu ( key 20170522103413_CIU095C40) 2011; 53 Pretorius ( key 20170522103413_CIU095C10) 2012; 206 Lin ( key 20170522103413_CIU095C14) 2001; 161 Fleming ( key 20170522103413_CIU095C37) 2005; 59 Gessner ( key 20170522103413_CIU095C8) 2011; 11 Pitman ( key 20170522103413_CIU095C27) 2007; 54 Statistics South Africa ( key 20170522103413_CIU095C34) 2012 Neuzil ( key 20170522103413_CIU095C15) 2003; 34 Statistics South Africa. ( key 20170522103413_CIU095C31) 2009 Van der Wijngaard ( key 20170522103413_CIU095C43) 2012; 7 Cohen ( key 20170522103413_CIU095C41) 2010; 51 Actuarial Society of South Africa (ASSA) ( key 20170522103413_CIU095C24) Rudan ( key 20170522103413_CIU095C2) 2008; 86 Nunes ( key 20170522103413_CIU095C38) 2011; 6 Lemaitre ( key 20170522103413_CIU095C39) 2012; 7 Nannan ( key 20170522103413_CIU095C32) 2012 Thompson ( key 20170522103413_CIU095C4) 2003; 289 United Nations Joint Programme on HIV/AIDS ( key 20170522103413_CIU095C22) 2011 Sheth ( key 20170522103413_CIU095C12) 2011; 52 Statistics South Africa ( key 20170522103413_CIU095C35) 2012 Moyes ( key 20170522103413_CIU095C11) 2013; 208 Hardelid ( key 20170522103413_CIU095C26) 2012; 7 Peters ( key 20170522103413_CIU095C18) 2011; 52 Thompson ( key 20170522103413_CIU095C29) 2009; 3 Nair ( key 20170522103413_CIU095C25) 2011; 11 Charu ( key 20170522103413_CIU095C44) 2013; 7 Weinberger ( key 20170522103413_CIU095C36) 2012; 205 Katz ( key 20170522103413_CIU095C42) 2012; 206 Goldstein ( key 20170522103413_CIU095C30) 2012; 23 McAnerney ( key 20170522103413_CIU095C9) 2012; 206 Liu ( key 20170522103413_CIU095C1) 2012; 379 Zhou ( key 20170522103413_CIU095C5) 2012; 54 Dorrington ( key 20170522103413_CIU095C23) 2009 Madhi ( key 20170522103413_CIU095C16) 2002; 21 Simonsen ( key 20170522103413_CIU095C3) 1998; 178 Madhi ( key 20170522103413_CIU095C13) 2000; 137 Cohen ( key 20170522103413_CIU095C20) 2012; 55 Cohen ( key 20170522103413_CIU095C21) 2013; 19 |
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Snippet | Background. There are few published data describing the mortality burden associated with influenza and respiratory syncytial virus (RSV) infection in children... There are few published data describing the mortality burden associated with influenza and respiratory syncytial virus (RSV) infection in children in low- and... BACKGROUNDThere are few published data describing the mortality burden associated with influenza and respiratory syncytial virus (RSV) infection in children in... |
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SubjectTerms | Age groups AIDS ARTICLES AND COMMENTARIES Biological and medical sciences Child Mortality Child mortality rates Child, Preschool Children Epidemiological Monitoring Female HIV HIV infections HIV Infections - complications HIV Infections - epidemiology Human immunodeficiency virus Human respiratory syncytial virus Human viral diseases Humans Immunization Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infant Infant, Newborn Infectious diseases Influenza Influenza A Virus, H1N1 Subtype Influenza, Human - epidemiology Influenza, Human - mortality Male Medical sciences Mortality Mortality rates Pandemics Pediatrics Pneumonia - complications Pneumonia - epidemiology Pneumonia - mortality Poisson Distribution Prevalence Regression Analysis Respiratory syncytial virus Respiratory Syncytial Virus Infections - epidemiology Respiratory Syncytial Virus Infections - mortality Respiratory Syncytial Viruses Risk Assessment Seasons South Africa - epidemiology Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral diseases of the respiratory system and ent viral diseases Viral infections |
Title | Mortality Associated With Seasonal and Pandemic Influenza and Respiratory Syncytial Virus Among Children <5 Years of Age in a High HIV Prevalence Setting—South Africa, 1998–2009 |
URI | https://www.jstor.org/stable/24031941 https://www.ncbi.nlm.nih.gov/pubmed/24567249 https://www.proquest.com/docview/1518537495 https://search.proquest.com/docview/1515647618 https://search.proquest.com/docview/1540240617 https://pubmed.ncbi.nlm.nih.gov/PMC9096151 |
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