Estimating influenza and respiratory syncytial virus-associated mortality in Western Kenya using health and demographic surveillance system data, 2007-2013.

Abstract

BACKGROUND:

Influenza and respiratory syncytial virus (RSV) associated mortality has not been well-established in tropical Africa.

METHODS:

We used the negative binomial regression method and the rate-difference method (i.e. deaths during low and high influenza/RSV activity months), to estimate excess mortality attributable to influenza and RSV using verbal autopsy data collected through a health and demographic surveillance system in Western Kenya, 2007-2013. Excess mortality rates were calculated for a) all-cause mortality, b) respiratory deaths (including pneumonia), c) HIV-related deaths, and d) pulmonary tuberculosis (TB) related deaths.

RESULTS:

Using the negative binomial regression method, the mean annual all-cause excess mortality rate associated with influenza and RSV was 14.1 (95% confidence interval [CI] 0.0-93.3) and 17.1 (95% CI 0.0-111.5) per 100,000 person-years (PY) respectively; and 10.5 (95% CI 0.0-28.5) and 7.3 (95% CI 0.0-27.3) per 100,000 PY for respiratory deaths, respectively. Highest mortality rates associated with influenza were among ≥50 years, particularly among persons with TB (41.6[95% CI 0.0-122.7]); and with RSV were among <5 years. Using the rate-difference method, the excess mortality rate for influenza and RSV was 44.8 (95% CI 36.8-54.4) and 19.7 (95% CI 14.7-26.5) per 100,000 PY, respectively, for all-cause deaths; and 9.6 (95% CI 6.3-14.7) and 6.6 (95% CI 3.9-11.0) per 100,000 PY, respectively, for respiratory deaths.

CONCLUSIONS:

Our study shows a substantial excess mortality associated with influenza and RSV in Western Kenya, especially among children <5 years and older persons with TB, supporting recommendations for influenza vaccination and efforts to develop RSV vaccines.

• Authors: Gideon O Emukule, Peter Spreeuwenberg, Sandra S Chaves, Joshua A Mott, Stefano Tempia, Godfrey Bigogo, Bryan Nyawanda, Amek Nyaguara, Marc-Alain Widdowson, Koos van der Velden, John W Paget
• Journal: PloS one (PLoS One) Vol. 12 Issue 7 Pg. e0180890 ( 2017) ISSN: 1932-6203 [Electronic] United States
• PMID: 28686692 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Age Distribution
• Aged
• Cause of Death (trends)
• Child
• Child, Preschool
• Female
• HIV Infections (epidemiology, mortality)
• Humans
• Infant
• Influenza, Human (epidemiology, mortality)
• Kenya (epidemiology)
• Male
• Middle Aged
• Pneumonia, Viral (epidemiology, mortality)
• Public Health Surveillance
• Regression Analysis
• Respiratory Syncytial Virus Infections (epidemiology, mortality)
• Respiratory Syncytial Virus, Human (pathogenicity, physiology)
• Survival Analysis
• Tuberculosis, Pulmonary (epidemiology, mortality)