Dataset Information

Influenza-associated mortality in South Africa, 2009-2013: The importance of choices related to influenza infection proxies.

ABSTRACT:

Background

Regression modeling methods are commonly used to estimate influenza-associated mortality using covariates such as laboratory-confirmed influenza activity in the population as a proxy of influenza incidence.

Objective

We examined the choices of influenza proxies that can be used from influenza laboratory surveillance data and their impact on influenza-associated mortality estimates.

Method

Semiparametric generalized additive models with a smoothing spline were applied on national mortality data from South Africa and influenza surveillance data as covariates to obtain influenza-associated mortality estimates from respiratory causes from 2009 to 2013. Proxies examined included alternative ways of expressing influenza laboratory surveillance data such as weekly or yearly proportion or rate of positive samples, using influenza subtypes, or total influenza data and expressing the data as influenza season-specific or across all seasons.

Result

Based on model fit, weekly proportion and influenza subtype-specific proxy formulation provided the best fit. The choice of proxies used gave large differences to mortality estimates, but the 95% confidence interval of these estimates overlaps.

Conclusion

Regardless of proxy chosen, mortality estimates produced may be broadly consistent and not statistically significant for public health practice.

SUBMITTER: Gul D

PROVIDER: S-EPMC5818357 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Publications

Influenza-associated mortality in South Africa, 2009-2013: The importance of choices related to influenza infection proxies.

Gul Desmond D Cohen Cheryl C Tempia Stefano S Newall Anthony T AT Muscatello David J DJ

Influenza and other respiratory viruses 20171202 1

<h4>Background</h4>Regression modeling methods are commonly used to estimate influenza-associated mortality using covariates such as laboratory-confirmed influenza activity in the population as a proxy of influenza incidence.<h4>Objective</h4>We examined the choices of influenza proxies that can be used from influenza laboratory surveillance data and their impact on influenza-associated mortality estimates.<h4>Method</h4>Semiparametric generalized additive models with a smoothing spline were app ...[more]

PMID: 29197161

Similar Datasets

Project description:BackgroundSevere acute respiratory illness (SARI) is an important cause of mortality in young children, especially in children living with HIV infection. Disparities in SARI death in children aged <5 years exist in urban and rural areas.ObjectiveTo compare the factors associated with in-hospital death among children aged <5 years hospitalized with SARI in an urban vs. a rural setting in South Africa from 2009-2013.MethodsData were collected from hospitalized children with SARI in one urban and two rural sentinel surveillance hospitals. Nasopharyngeal aspirates were tested for ten respiratory viruses and blood for pneumococcal DNA using polymerase chain reaction. We used multivariable logistic regression to identify patient and clinical characteristics associated with in-hospital death.ResultsFrom 2009 through 2013, 5,297 children aged <5 years with SARI-associated hospital admission were enrolled; 3,811 (72%) in the urban and 1,486 (28%) in the rural hospitals. In-hospital case-fatality proportion (CFP) was higher in the rural hospitals (6.9%) than the urban hospital (1.3%, p<0.001), and among HIV-infected than the HIV-uninfected children (9.6% vs. 1.6%, p<0.001). In the urban hospital, HIV infection (odds ratio (OR):11.4, 95% confidence interval (CI):5.4-24.1) and presence of any other underlying illness (OR: 3.0, 95% CI: 1.0-9.2) were the only factors independently associated with death. In the rural hospitals, HIV infection (OR: 4.1, 95% CI: 2.3-7.1) and age <1 year (OR: 3.7, 95% CI: 1.9-7.2) were independently associated with death, whereas duration of hospitalization ≥5 days (OR: 0.5, 95% CI: 0.3-0.8) and any respiratory virus detection (OR: 0.4, 95% CI: 0.3-0.8) were negatively associated with death.ConclusionWe found that the case-fatality proportion was substantially higher among children admitted to rural hospitals and HIV infected children with SARI in South Africa. While efforts to prevent and treat HIV infections in children may reduce SARI deaths, further efforts to address health care inequality in rural populations are needed.

Dataset Information

Influenza-associated mortality in South Africa, 2009-2013: The importance of choices related to influenza infection proxies.

Background

Objective

Method

Result

Conclusion

Publications

Influenza-associated mortality in South Africa, 2009-2013: The importance of choices related to influenza infection proxies.

Similar Datasets

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