Stefano Tempia1, Sibongile Walaza2, Jocelyn Moyes2, Meredith L McMorrow3, Adam L Cohen4, Ijeoma Edoka5, Heather Fraser5, Florette K Treurnicht6, Orienka Hellferscee7, Nicole Wolter7, Anne von Gottberg7, Johanna M McAnerney6, Halima Dawood8, Ebrahim Variava9, Cheryl Cohen10. 1. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; MassGenics, Duluth, GA, United States. Electronic address: stefanot@nicd.ac.za. 2. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 3. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa. 4. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Department of Immunization, Vaccines and Biological, World Health Organization, Geneva, Switzerland. 5. South Africa Medical Research Council/Wits Centre for Health Economics and Decision Science, PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburga South Africa. 6. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. 7. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 8. Department of Medicine, Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa; Department of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa. 9. Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa; Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa. 10. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: cherylc@nicd.ac.za.
Abstract
BACKGROUND: Data on influenza burden in risk groups for severe influenza are important to guide targeted influenza immunization, especially in resource limited settings. However, this information is limited overall and in particular in low- and middle-income countries. We sought to assess the mean annual national burden of medically and non-medically attended influenza-associated mild, severe-non-fatal and fatal illness among potential target groups for influenza immunization in South Africa during 2013-2015. METHODS: We used published mean national annual estimates of mild, severe-non-fatal, and fatal influenza-associated illness in South Africa during 2013-2015 and estimated the number of such illnesses occurring among the following risk groups: (i) children aged 6-59 months; (ii) individuals aged 5-64 years with HIV, and/or pulmonary tuberculosis (PTB), and/or selected underlying medical conditions (UMC); (iii) pregnant women; and (iv) individuals aged ≥65 years. We also estimated the number of individuals among the same risk groups in the population. RESULTS: During 2013-2015, individuals in the selected risk groups accounted for 45.3% (24,569,328/54,086,144) of the population and 43.5% (4,614,763/10,598,138), 86.8% (111,245/128,173) and 94.5% (10,903/11,536) of the mean annual estimated number of influenza-associated mild, severe-non-fatal and fatal illness episodes, respectively. The rates of influenza-associated illness were highest in children aged 6-59 months (23,983 per 100,000 population) for mild illness, in pregnant women (930 per 100,000 population) for severe-non-fatal illness and in individuals aged ≥65 years (138 per 100,000 population) for fatal illness. CONCLUSION: Influenza immunization of the selected risk groups has the potential to prevent a substantial number of influenza-associated severe illness. Nonetheless, because of the high number of individuals at risk, South Africa, due to financial resources constrains, may need to further prioritize interventions among risk populations. Cost-burden and cost-effectiveness estimates may assist with further prioritization.
BACKGROUND: Data on influenza burden in risk groups for severe influenza are important to guide targeted influenza immunization, especially in resource limited settings. However, this information is limited overall and in particular in low- and middle-income countries. We sought to assess the mean annual national burden of medically and non-medically attended influenza-associated mild, severe-non-fatal and fatal illness among potential target groups for influenza immunization in South Africa during 2013-2015. METHODS: We used published mean national annual estimates of mild, severe-non-fatal, and fatal influenza-associated illness in South Africa during 2013-2015 and estimated the number of such illnesses occurring among the following risk groups: (i) children aged 6-59 months; (ii) individuals aged 5-64 years with HIV, and/or pulmonary tuberculosis (PTB), and/or selected underlying medical conditions (UMC); (iii) pregnant women; and (iv) individuals aged ≥65 years. We also estimated the number of individuals among the same risk groups in the population. RESULTS: During 2013-2015, individuals in the selected risk groups accounted for 45.3% (24,569,328/54,086,144) of the population and 43.5% (4,614,763/10,598,138), 86.8% (111,245/128,173) and 94.5% (10,903/11,536) of the mean annual estimated number of influenza-associated mild, severe-non-fatal and fatal illness episodes, respectively. The rates of influenza-associated illness were highest in children aged 6-59 months (23,983 per 100,000 population) for mild illness, in pregnant women (930 per 100,000 population) for severe-non-fatal illness and in individuals aged ≥65 years (138 per 100,000 population) for fatal illness. CONCLUSION:Influenza immunization of the selected risk groups has the potential to prevent a substantial number of influenza-associated severe illness. Nonetheless, because of the high number of individuals at risk, South Africa, due to financial resources constrains, may need to further prioritize interventions among risk populations. Cost-burden and cost-effectiveness estimates may assist with further prioritization.
Authors: Shabir A Madhi; Clare L Cutland; Locadiah Kuwanda; Adriana Weinberg; Andrea Hugo; Stephanie Jones; Peter V Adrian; Nadia van Niekerk; Florette Treurnicht; Justin R Ortiz; Marietjie Venter; Avy Violari; Kathleen M Neuzil; Eric A F Simões; Keith P Klugman; Marta C Nunes Journal: N Engl J Med Date: 2014-09-04 Impact factor: 91.245
Authors: A Danielle Iuliano; Katherine M Roguski; Howard H Chang; David J Muscatello; Rakhee Palekar; Stefano Tempia; Cheryl Cohen; Jon Michael Gran; Dena Schanzer; Benjamin J Cowling; Peng Wu; Jan Kyncl; Li Wei Ang; Minah Park; Monika Redlberger-Fritz; Hongjie Yu; Laura Espenhain; Anand Krishnan; Gideon Emukule; Liselotte van Asten; Susana Pereira da Silva; Suchunya Aungkulanon; Udo Buchholz; Marc-Alain Widdowson; Joseph S Bresee Journal: Lancet Date: 2017-12-14 Impact factor: 79.321
Authors: Jeanette A Dawa; Sandra S Chaves; Bryan Nyawanda; Henry N Njuguna; Carolyne Makokha; Nancy A Otieno; Omu Anzala; Marc-Alain Widdowson; Gideon O Emukule Journal: Influenza Other Respir Viruses Date: 2017-12-15 Impact factor: 4.380
Authors: Andros Theo; Stefano Tempia; Adam L Cohen; Paul Simusika; Edward Chentulo; Chikama Mukwangole Chikamukwa; Mwaka Monze Journal: Influenza Other Respir Viruses Date: 2017-12-15 Impact factor: 4.380
Authors: Stefano Tempia; Sibongile Walaza; Jinal N Bhiman; Meredith L McMorrow; Jocelyn Moyes; Thulisa Mkhencele; Susan Meiring; Vanessa Quan; Kate Bishop; Johanna M McAnerney; Anne von Gottberg; Nicole Wolter; Mignon Du Plessis; Florette K Treurnicht; Orienka Hellferscee; Halima Dawood; Fathima Naby; Ebrahim Variava; Comfort Siwele; Neydis Baute; Jeremy Nel; Gary Reubenson; Heather J Zar; Cheryl Cohen Journal: Euro Surveill Date: 2021-07