Trang Q T Khieu1, Nevil Pierse2, Lucy Frances Telfar-Barnard2, Q Sue Huang3, Michael G Baker2. 1. Department of Public Health, University of Otago, Wellington, New Zealand; Health Environment Management Agency, Ministry of Health of Vietnam, Hanoi, Viet Nam. Electronic address: khith138@student.otago.ac.nz. 2. Department of Public Health, University of Otago, Wellington, New Zealand. 3. WHO National Influenza Centre, Institute of Environmental Science & Research, Wellington, New Zealand.
Abstract
BACKGROUND: Influenza has a substantially but poorly measured impact on population health. Estimating its true contribution to hospitalisations remains a challenge. METHODS: We used simple and comprehensive negative binomial regression models with weekly counts of hospitalisations and isolates of influenza A, B and respiratory syncytial virus for the period 1994- 2008. RESULTS: The estimated annual national average number of hospitalisations attributable to influenza was 822.1(95% CI: 815.3, 828.9) for pneumonia and influenza, 1861.3 (95% CI: 1842.9, 1879.7) for respiratory illness, 12.1 (95% CI: 2.6, 21.6) for circulatory illness, 2260.0 (95% CI: 2212.2, 2307.8) for all medical illness and 2419.9 (95% CI: 2356.4, 2483.4) for all causes. The contribution of influenza to total hospitalisations was about nine times larger than indicated by routine discharge data. New Zealanders 80 years of age and older had the highest annual excess rates of influenza-related hospitalisations (327.8 per 100,000); followed by infants under 1 year (244.5 per 100,000). Estimated influenza hospitalisation rates were also markedly higher in Pacific (83.3 per 100,000) and Māori (80.0 per 100,000) compared with European/Others (58.1 per 100,000). Respiratory illness was the major contributor to all cause hospitalisations attributed to influenza accounting for 77%. Influenza hospitalisations included only a negligible contribution from circulatory illness. CONCLUSION: These findings support efforts to reduce the impact of influenza, particularly for the most vulnerable population groups highlighted here. Analysis of the cost-effectiveness of such interventions needs to consider these higher modelled estimates of disease impact.
BACKGROUND: Influenza has a substantially but poorly measured impact on population health. Estimating its true contribution to hospitalisations remains a challenge. METHODS: We used simple and comprehensive negative binomial regression models with weekly counts of hospitalisations and isolates of influenza A, B and respiratory syncytial virus for the period 1994- 2008. RESULTS: The estimated annual national average number of hospitalisations attributable to influenza was 822.1(95% CI: 815.3, 828.9) for pneumonia and influenza, 1861.3 (95% CI: 1842.9, 1879.7) for respiratory illness, 12.1 (95% CI: 2.6, 21.6) for circulatory illness, 2260.0 (95% CI: 2212.2, 2307.8) for all medical illness and 2419.9 (95% CI: 2356.4, 2483.4) for all causes. The contribution of influenza to total hospitalisations was about nine times larger than indicated by routine discharge data. New Zealanders 80 years of age and older had the highest annual excess rates of influenza-related hospitalisations (327.8 per 100,000); followed by infants under 1 year (244.5 per 100,000). Estimated influenza hospitalisation rates were also markedly higher in Pacific (83.3 per 100,000) and Māori (80.0 per 100,000) compared with European/Others (58.1 per 100,000). Respiratory illness was the major contributor to all cause hospitalisations attributed to influenza accounting for 77%. Influenza hospitalisations included only a negligible contribution from circulatory illness. CONCLUSION: These findings support efforts to reduce the impact of influenza, particularly for the most vulnerable population groups highlighted here. Analysis of the cost-effectiveness of such interventions needs to consider these higher modelled estimates of disease impact.
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Authors: Q Sue Huang; Don Bandaranayake; Tim Wood; E Claire Newbern; Ruth Seeds; Jacqui Ralston; Ben Waite; Ange Bissielo; Namrata Prasad; Angela Todd; Lauren Jelley; Wendy Gunn; Anne McNicholas; Thomas Metz; Shirley Lawrence; Emma Collis; Amanda Retter; Sook-San Wong; Richard Webby; Judy Bocacao; Jennifer Haubrock; Graham Mackereth; Nikki Turner; Barbara McArdle; John Cameron; Edwin G Reynolds; Michael G Baker; Cameron C Grant; Colin McArthur; Sally Roberts; Adrian Trenholme; Conroy Wong; Susan Taylor; Paul Thomas; Jazmin Duque; Diane Gross; Mark G Thompson; Marc-Alain Widdowson Journal: J Infect Dis Date: 2019-01-09 Impact factor: 5.226