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Estimation of the national disease burden of influenza-associated severe acute respiratory illness in Kenya and Guatemala : a novel methodology
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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 and Feikin, Daniel R. (2013) Estimation of the national disease burden of influenza-associated severe acute respiratory illness in Kenya and Guatemala : a novel methodology. PLoS One, Volume 8 (Mumber 2). Article number e56882. doi:10.1371/journal.pone.0056882 ISSN 1932-6203.
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Official URL: http://dx.doi.org/10.1371/journal.pone.0056882
Abstract
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.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||
Library of Congress Subject Headings (LCSH): | Influenza -- Kenya, Influenza -- Guatemala, Respiratory infections -- Kenya, Respiratory infections -- Guatemala, SARS (Disease) -- Kenya, SARS (Disease) -- Guatemala | ||||
Journal or Publication Title: | PLoS One | ||||
Publisher: | Public Library of Science | ||||
ISSN: | 1932-6203 | ||||
Official Date: | 2013 | ||||
Dates: |
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Volume: | Volume 8 | ||||
Number: | Mumber 2 | ||||
Page Range: | Article number e56882 | ||||
DOI: | 10.1371/journal.pone.0056882 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Date of first compliant deposit: | 25 December 2015 | ||||
Date of first compliant Open Access: | 25 December 2015 | ||||
Funder: | Center for Disease Control (CDC), Wellcome Trust (London, England) | ||||
Grant number: | UU01 GH000028-02 (CDC) |
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