Burden of influenza-associated respiratory hospitalizations in the Americas, 2010-2015.
Adolescent
Adult
Aged
Americas
/ epidemiology
Analysis of Variance
Child
Child, Preschool
Costs and Cost Analysis
Female
Hospitalization
/ statistics & numerical data
Humans
Influenza, Human
/ complications
Male
Middle Aged
Respiratory Tract Infections
/ complications
Seasons
Vaccination Coverage
/ economics
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
20
03
2019
accepted:
07
08
2019
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
10
3
2020
Statut:
epublish
Résumé
Despite having influenza vaccination policies and programs, countries in the Americas underutilize seasonal influenza vaccine, in part because of insufficient evidence about severe influenza burden. We aimed to estimate the annual burden of influenza-associated respiratory hospitalizations in the Americas. Thirty-five countries in the Americas with national influenza surveillance were invited to provide monthly laboratory data and hospital discharges for respiratory illness (International Classification of Diseases 10th edition J codes 0-99) during 2010-2015. In three age-strata (<5, 5-64, and ≥65 years), we estimated the influenza-associated hospitalizations rate by multiplying the monthly number of respiratory hospitalizations by the monthly proportion of influenza-positive samples and dividing by the census population. We used random effects meta-analyses to pool age-group specific rates and extrapolated to countries that did not contribute data, using pooled rates stratified by age group and country characteristics found to be associated with rates. Sixteen of 35 countries (46%) contributed primary data to the analyses, representing 79% of the America's population. The average pooled rate of influenza-associated respiratory hospitalization was 90/100,000 population (95% confidence interval 61-132) among children aged <5 years, 21/100,000 population (13-32) among persons aged 5-64 years, and 141/100,000 population (95-211) among persons aged ≥65 years. We estimated the average annual number of influenza-associated respiratory hospitalizations in the Americas to be 772,000 (95% credible interval 716,000-829,000). Influenza-associated respiratory hospitalizations impose a heavy burden on health systems in the Americas. Countries in the Americas should use this information to justify investments in seasonal influenza vaccination-especially among young children and the elderly.
Sections du résumé
BACKGROUND
Despite having influenza vaccination policies and programs, countries in the Americas underutilize seasonal influenza vaccine, in part because of insufficient evidence about severe influenza burden. We aimed to estimate the annual burden of influenza-associated respiratory hospitalizations in the Americas.
METHODS
Thirty-five countries in the Americas with national influenza surveillance were invited to provide monthly laboratory data and hospital discharges for respiratory illness (International Classification of Diseases 10th edition J codes 0-99) during 2010-2015. In three age-strata (<5, 5-64, and ≥65 years), we estimated the influenza-associated hospitalizations rate by multiplying the monthly number of respiratory hospitalizations by the monthly proportion of influenza-positive samples and dividing by the census population. We used random effects meta-analyses to pool age-group specific rates and extrapolated to countries that did not contribute data, using pooled rates stratified by age group and country characteristics found to be associated with rates.
RESULTS
Sixteen of 35 countries (46%) contributed primary data to the analyses, representing 79% of the America's population. The average pooled rate of influenza-associated respiratory hospitalization was 90/100,000 population (95% confidence interval 61-132) among children aged <5 years, 21/100,000 population (13-32) among persons aged 5-64 years, and 141/100,000 population (95-211) among persons aged ≥65 years. We estimated the average annual number of influenza-associated respiratory hospitalizations in the Americas to be 772,000 (95% credible interval 716,000-829,000).
CONCLUSIONS
Influenza-associated respiratory hospitalizations impose a heavy burden on health systems in the Americas. Countries in the Americas should use this information to justify investments in seasonal influenza vaccination-especially among young children and the elderly.
Identifiants
pubmed: 31490961
doi: 10.1371/journal.pone.0221479
pii: PONE-D-19-07766
pmc: PMC6730873
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0221479Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Soc Sci Med. 2003 Mar;56(6):1173-82
pubmed: 12600356
JAMA. 2004 Sep 15;292(11):1333-40
pubmed: 15367555
PLoS Med. 2006 Apr;3(4):e121
pubmed: 16515368
J Clin Microbiol. 2006 Jul;44(7):2382-8
pubmed: 16825353
Epidemiol Infect. 2007 Aug;135(6):951-8
pubmed: 17156502
Public Health Rep. 1963 Jun;78(6):494-506
pubmed: 19316455
J Pediatr. 2010 Nov;157(5):808-14
pubmed: 20580018
Clin Ther. 2010 Aug;32(8):1448-67
pubmed: 20728759
J Infect Dis. 2011 Jun 15;203(12):1701-4
pubmed: 21606526
BMC Public Health. 2011 Nov 24;11:885
pubmed: 22111590
Vaccine. 2012 Mar 23;30(14):2448-52
pubmed: 22300721
Clin Infect Dis. 2012 May;54(10):1427-36
pubmed: 22495079
Lancet Infect Dis. 2012 Sep;12(9):687-95
pubmed: 22738893
Bull World Health Organ. 2012 Oct 1;90(10):756-63
pubmed: 23109743
PLoS One. 2012;7(10):e47540
pubmed: 23118877
J Infect Dis. 2012 Dec 15;206 Suppl 1:S87-93
pubmed: 23169978
Influenza Other Respir Viruses. 2013 Sep;7(5):710-7
pubmed: 23210456
Influenza Other Respir Viruses. 2013 Nov;7(6):1017-32
pubmed: 23210504
J Epidemiol Glob Health. 2012 Jun;2(2):73-81
pubmed: 23856423
PLoS One. 2013 Dec 31;8(12):e83600
pubmed: 24391792
Influenza Other Respir Viruses. 2014 Mar;8(2):159-68
pubmed: 24393336
J Infect Dis. 2014 Aug 15;210(4):535-44
pubmed: 24731959
Emerg Infect Dis. 2014 May;20(5):878-81
pubmed: 24750897
PLoS One. 2014 Aug 18;9(8):e105543
pubmed: 25133576
Glob Heart. 2014 Sep;9(3):325-36
pubmed: 25667184
PLoS One. 2015 Mar 04;10(3):e0118369
pubmed: 25738736
Influenza Other Respir Viruses. 2015 Aug;9 Suppl 1:13-21
pubmed: 26256291
BMC Infect Dis. 2015 Oct 24;15:447
pubmed: 26497393
Influenza Other Respir Viruses. 2016 Jul;10(4):340-5
pubmed: 26946216
PLoS Med. 2016 Mar 24;13(3):e1001977
pubmed: 27011229
Hum Vaccin Immunother. 2016 Aug 2;12(8):2206-2214
pubmed: 27196006
Hum Vaccin Immunother. 2017 Apr 3;13(4):867-876
pubmed: 27858509
PLoS One. 2017 Jan 26;12(1):e0170550
pubmed: 28125629
Int J Environ Res Public Health. 2017 Feb 22;14(2):
pubmed: 28241447
Clin Infect Dis. 2017 Oct 16;65(9):1532-1541
pubmed: 29020267
Influenza Other Respir Viruses. 2018 Jan;12(1):38-45
pubmed: 29197152
Lancet. 2018 Mar 31;391(10127):1285-1300
pubmed: 29248255
Influenza Other Respir Viruses. 2018 Jan;12(1):138-145
pubmed: 29446231
Influenza Other Respir Viruses. 2018 Jan;12(1):132-137
pubmed: 29446233
Influenza Other Respir Viruses. 2018 Jan;12(1):153-160
pubmed: 29460423
Influenza Other Respir Viruses. 2019 Mar;13(2):138-147
pubmed: 30596225
Arch Intern Med. 1993 Sep 27;153(18):2105-11
pubmed: 8379801