tetano
Editor, Senior Moderator
Clin Infect Dis. 2018 Dec 2. doi: 10.1093/cid/ciy1017. [Epub ahead of print]
[h=1]Quantifying how Different Clinical Presentations, Levels of Severity and Healthcare Attendance Shape the Burden of Influenza-Associated Illness: a Modeling Study from South Africa.[/h] Tempia S[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Walaza S[SUP]3,[/SUP][SUP]4[/SUP], Moyes J[SUP]3,[/SUP][SUP]4[/SUP], Cohen AL[SUP]1,[/SUP][SUP]5[/SUP], McMorrow ML[SUP]1,[/SUP][SUP]2[/SUP], Treurnicht FK[SUP]3,[/SUP][SUP]6[/SUP], Hellferscee O[SUP]3,[/SUP][SUP]6[/SUP], Wolter N[SUP]3,[/SUP][SUP]6[/SUP], Gottberg AV[SUP]3,[/SUP][SUP]6[/SUP], Nguweneza A[SUP]3[/SUP], McAnerney JM[SUP]3[/SUP], Dawood H[SUP]7,[/SUP][SUP]8[/SUP], Variava E[SUP]9,[/SUP][SUP]10,[/SUP][SUP]11[/SUP], Madhi SA[SUP]12,[/SUP][SUP]13[/SUP], Cohen C[SUP]3,[/SUP][SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Burden estimates of medically- and non-medically-attended influenza-associated illness across syndromes and levels of severity are lacking.
[h=4]Methods:[/h] We estimated the national burden of medically- and non-medically-attended influenza-associated illness among individuals with different clinical presentations (all-respiratory, all-circulatory and non-respiratory/non-circulatory) and levels of severity (mild, severe-non-fatal and fatal) using a combination of case-based (from laboratory-confirmed influenza surveillance) and ecological studies as well as data from healthcare utilization surveys in South Africa during 2013-2015. In addition, we compared estimates of medically-attended influenza-associated respiratory illness obtained from case-based and ecological studies. Rates were reported per 100,000 population.
[h=4]Results:[/h] The estimated mean annual number of influenza-associated illness episodes was 10,737,847 (19.8% of 54,096,705 inhabitants). Of these episodes, 10,598,138 (98.7%), 128,173 (1.2%) and 11,536 (0.1%) were mild, severe-non-fatal and fatal, respectively. 2,718,140 (25.6%) mild, 56,226 (43.9%) severe-non-fatal and 4,945 (42.8%) fatal episodes were medically-attended. Influenza-associated respiratory illness accounted for 99.2% (10,576,146), 65.5% (83,941) and 33.7% (3,893) of any mild, severe-non-fatal and fatal illness, respectively. Ecological and case-based estimates of medically-attended influenza-associated respiratory mild (rates: ecological: 1,778.8 vs. case-based: 1,703.3; % difference: 4.4%), severe-non-fatal (rates: ecological: 88.6 vs. case-based: 75.3; % difference: 15.0%) and fatal (rates: ecological: 3.8 vs. case-based: 3.5; % difference: 8.4%) illness were similar.
[h=4]Conclusion:[/h] There was a substantial burden of influenza-associated symptomatic illness, including severe-non-fatal and fatal illness and a large proportion was non-medically-attended. Estimates including only influenza-associated respiratory illness substantially underestimated influenza-associated severe-non-fatal and fatal illness. Ecological and case-based estimates were found to be similar for the compared categories.
PMID: 30508065 DOI: 10.1093/cid/ciy1017
[h=1]Quantifying how Different Clinical Presentations, Levels of Severity and Healthcare Attendance Shape the Burden of Influenza-Associated Illness: a Modeling Study from South Africa.[/h] Tempia S[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Walaza S[SUP]3,[/SUP][SUP]4[/SUP], Moyes J[SUP]3,[/SUP][SUP]4[/SUP], Cohen AL[SUP]1,[/SUP][SUP]5[/SUP], McMorrow ML[SUP]1,[/SUP][SUP]2[/SUP], Treurnicht FK[SUP]3,[/SUP][SUP]6[/SUP], Hellferscee O[SUP]3,[/SUP][SUP]6[/SUP], Wolter N[SUP]3,[/SUP][SUP]6[/SUP], Gottberg AV[SUP]3,[/SUP][SUP]6[/SUP], Nguweneza A[SUP]3[/SUP], McAnerney JM[SUP]3[/SUP], Dawood H[SUP]7,[/SUP][SUP]8[/SUP], Variava E[SUP]9,[/SUP][SUP]10,[/SUP][SUP]11[/SUP], Madhi SA[SUP]12,[/SUP][SUP]13[/SUP], Cohen C[SUP]3,[/SUP][SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Burden estimates of medically- and non-medically-attended influenza-associated illness across syndromes and levels of severity are lacking.
[h=4]Methods:[/h] We estimated the national burden of medically- and non-medically-attended influenza-associated illness among individuals with different clinical presentations (all-respiratory, all-circulatory and non-respiratory/non-circulatory) and levels of severity (mild, severe-non-fatal and fatal) using a combination of case-based (from laboratory-confirmed influenza surveillance) and ecological studies as well as data from healthcare utilization surveys in South Africa during 2013-2015. In addition, we compared estimates of medically-attended influenza-associated respiratory illness obtained from case-based and ecological studies. Rates were reported per 100,000 population.
[h=4]Results:[/h] The estimated mean annual number of influenza-associated illness episodes was 10,737,847 (19.8% of 54,096,705 inhabitants). Of these episodes, 10,598,138 (98.7%), 128,173 (1.2%) and 11,536 (0.1%) were mild, severe-non-fatal and fatal, respectively. 2,718,140 (25.6%) mild, 56,226 (43.9%) severe-non-fatal and 4,945 (42.8%) fatal episodes were medically-attended. Influenza-associated respiratory illness accounted for 99.2% (10,576,146), 65.5% (83,941) and 33.7% (3,893) of any mild, severe-non-fatal and fatal illness, respectively. Ecological and case-based estimates of medically-attended influenza-associated respiratory mild (rates: ecological: 1,778.8 vs. case-based: 1,703.3; % difference: 4.4%), severe-non-fatal (rates: ecological: 88.6 vs. case-based: 75.3; % difference: 15.0%) and fatal (rates: ecological: 3.8 vs. case-based: 3.5; % difference: 8.4%) illness were similar.
[h=4]Conclusion:[/h] There was a substantial burden of influenza-associated symptomatic illness, including severe-non-fatal and fatal illness and a large proportion was non-medically-attended. Estimates including only influenza-associated respiratory illness substantially underestimated influenza-associated severe-non-fatal and fatal illness. Ecological and case-based estimates were found to be similar for the compared categories.
PMID: 30508065 DOI: 10.1093/cid/ciy1017