Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries

Meredith L McMorrow; Emile Okitolonda Wemakoy; Joelle Kabamba Tshilobo; Gideon O Emukule; Joshua A Mott; Henry Njuguna; Lilian Waiboci; Jean-Michel Heraud; Soatianana Rajatonirina; Norosoa H Razanajatovo; Moses Chilombe; Dean Everett; Robert S Heyderman; Amal Barakat; Thierry Nyatanyi; Joseph Rukelibuga; Adam L Cohen; Cheryl Cohen; Stefano Tempia; Juno Thomas; Marietjie Venter; Elibariki Mwakapeje; Marcelina Mponela; Julius Lutwama; Jazmin Duque; Kathryn Lafond; Ndahwouh Talla Nzussouo; Thelma Williams; Marc-Alain Widdowson

doi:10.1093/infdis/jiv100

Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries

Meredith L McMorrow, Emile Okitolonda Wemakoy, Joelle Kabamba Tshilobo, Gideon O Emukule, Joshua A Mott, Henry Njuguna, Lilian Waiboci, Jean-Michel Heraud, Soatianana Rajatonirina, Norosoa H Razanajatovo, Moses Chilombe, Dean Everett, Robert S Heyderman, Amal Barakat, Thierry Nyatanyi, Joseph Rukelibuga, Adam L Cohen, Cheryl Cohen, Stefano Tempia, Juno ThomasMarietjie Venter, Elibariki Mwakapeje, Marcelina Mponela, Julius Lutwama, Jazmin Duque, Kathryn Lafond, Ndahwouh Talla Nzussouo, Thelma Williams, Marc-Alain Widdowson

Institute of Tropical Medicine

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

BACKGROUND: Data on causes of death due to respiratory illness in Africa are limited.

METHODS: From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)-associated deaths identified from influenza surveillance during 2009-2012.

RESULTS: Twenty-three countries (82%) responded, 11 (48%) collect mortality data, and 8 provided data. Data were collected from 37 714 SARI cases, and 3091 (8.2%; range by country, 5.1%-25.9%) tested positive for influenza virus. There were 1073 deaths (2.8%; range by country, 0.1%-5.3%) reported, among which influenza virus was detected in 57 (5.3%). Case-fatality proportion (CFP) was higher among countries with systematic death reporting than among those with sporadic reporting. The influenza-associated CFP was 1.8% (57 of 3091), compared with 2.9% (1016 of 34 623) for influenza virus-negative cases (P < .001). Among 834 deaths (77.7%) tested for other respiratory pathogens, rhinovirus (107 [12.8%]), adenovirus (64 [6.0%]), respiratory syncytial virus (60 [5.6%]), and Streptococcus pneumoniae (57 [5.3%]) were most commonly identified. Among 1073 deaths, 402 (37.5%) involved people aged 0-4 years, 462 (43.1%) involved people aged 5-49 years, and 209 (19.5%) involved people aged ≥50 years.

CONCLUSIONS: Few African countries systematically collect data on outcomes of people hospitalized with respiratory illness. Stronger surveillance for deaths due to respiratory illness may identify risk groups for targeted vaccine use and other prevention strategies.

Original language	English
Journal	Journal of Infectious Diseases
Volume	212
Issue number	6
Pages (from-to)	853-60
Number of pages	8
ISSN	0022-1899
DOIs	https://doi.org/10.1093/infdis/jiv100
Publication status	Published - 2015

Keywords

Adolescent
Adult
Africa South of the Sahara/epidemiology
Age Distribution
Aged
Bacterial Infections/epidemiology
Child
Child, Preschool
Humans
Infant
Infant, Newborn
Influenza, Human/epidemiology
Middle Aged
Population Surveillance
Respiratory Tract Infections/epidemiology
Young Adult

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10.1093/infdis/jiv100

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McMorrow, M. L., Wemakoy, E. O., Tshilobo, J. K., Emukule, G. O., Mott, J. A., Njuguna, H., Waiboci, L., Heraud, J.-M., Rajatonirina, S., Razanajatovo, N. H., Chilombe, M., Everett, D., Heyderman, R. S., Barakat, A., Nyatanyi, T., Rukelibuga, J., Cohen, A. L., Cohen, C., Tempia, S., ... Widdowson, M.-A. (2015). Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries. Journal of Infectious Diseases, 212(6), 853-60. https://doi.org/10.1093/infdis/jiv100

@article{fdf18fb661ab4b919576437d0b3430e9,

title = "Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries",

abstract = "BACKGROUND: Data on causes of death due to respiratory illness in Africa are limited.METHODS: From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)-associated deaths identified from influenza surveillance during 2009-2012.RESULTS: Twenty-three countries (82%) responded, 11 (48%) collect mortality data, and 8 provided data. Data were collected from 37 714 SARI cases, and 3091 (8.2%; range by country, 5.1%-25.9%) tested positive for influenza virus. There were 1073 deaths (2.8%; range by country, 0.1%-5.3%) reported, among which influenza virus was detected in 57 (5.3%). Case-fatality proportion (CFP) was higher among countries with systematic death reporting than among those with sporadic reporting. The influenza-associated CFP was 1.8% (57 of 3091), compared with 2.9% (1016 of 34 623) for influenza virus-negative cases (P < .001). Among 834 deaths (77.7%) tested for other respiratory pathogens, rhinovirus (107 [12.8%]), adenovirus (64 [6.0%]), respiratory syncytial virus (60 [5.6%]), and Streptococcus pneumoniae (57 [5.3%]) were most commonly identified. Among 1073 deaths, 402 (37.5%) involved people aged 0-4 years, 462 (43.1%) involved people aged 5-49 years, and 209 (19.5%) involved people aged ≥50 years.CONCLUSIONS: Few African countries systematically collect data on outcomes of people hospitalized with respiratory illness. Stronger surveillance for deaths due to respiratory illness may identify risk groups for targeted vaccine use and other prevention strategies.",

keywords = "Adolescent, Adult, Africa South of the Sahara/epidemiology, Age Distribution, Aged, Bacterial Infections/epidemiology, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Influenza, Human/epidemiology, Middle Aged, Population Surveillance, Respiratory Tract Infections/epidemiology, Young Adult",

author = "McMorrow, {Meredith L} and Wemakoy, {Emile Okitolonda} and Tshilobo, {Joelle Kabamba} and Emukule, {Gideon O} and Mott, {Joshua A} and Henry Njuguna and Lilian Waiboci and Jean-Michel Heraud and Soatianana Rajatonirina and Razanajatovo, {Norosoa H} and Moses Chilombe and Dean Everett and Heyderman, {Robert S} and Amal Barakat and Thierry Nyatanyi and Joseph Rukelibuga and Cohen, {Adam L} and Cheryl Cohen and Stefano Tempia and Juno Thomas and Marietjie Venter and Elibariki Mwakapeje and Marcelina Mponela and Julius Lutwama and Jazmin Duque and Kathryn Lafond and Nzussouo, {Ndahwouh Talla} and Thelma Williams and Marc-Alain Widdowson",

note = "PPU; Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.",

year = "2015",

doi = "10.1093/infdis/jiv100",

language = "English",

volume = "212",

pages = "853--60",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "6",

}

McMorrow, ML, Wemakoy, EO, Tshilobo, JK, Emukule, GO, Mott, JA, Njuguna, H, Waiboci, L, Heraud, J-M, Rajatonirina, S, Razanajatovo, NH, Chilombe, M, Everett, D, Heyderman, RS, Barakat, A, Nyatanyi, T, Rukelibuga, J, Cohen, AL, Cohen, C, Tempia, S, Thomas, J, Venter, M, Mwakapeje, E, Mponela, M, Lutwama, J, Duque, J, Lafond, K, Nzussouo, NT, Williams, T & Widdowson, M-A 2015, 'Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries', Journal of Infectious Diseases, vol. 212, no. 6, pp. 853-60. https://doi.org/10.1093/infdis/jiv100

TY - JOUR

T1 - Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries

AU - McMorrow, Meredith L

AU - Wemakoy, Emile Okitolonda

AU - Tshilobo, Joelle Kabamba

AU - Emukule, Gideon O

AU - Mott, Joshua A

AU - Njuguna, Henry

AU - Waiboci, Lilian

AU - Heraud, Jean-Michel

AU - Rajatonirina, Soatianana

AU - Razanajatovo, Norosoa H

AU - Chilombe, Moses

AU - Everett, Dean

AU - Heyderman, Robert S

AU - Barakat, Amal

AU - Nyatanyi, Thierry

AU - Rukelibuga, Joseph

AU - Cohen, Adam L

AU - Cohen, Cheryl

AU - Tempia, Stefano

AU - Thomas, Juno

AU - Venter, Marietjie

AU - Mwakapeje, Elibariki

AU - Mponela, Marcelina

AU - Lutwama, Julius

AU - Duque, Jazmin

AU - Lafond, Kathryn

AU - Nzussouo, Ndahwouh Talla

AU - Williams, Thelma

AU - Widdowson, Marc-Alain

N1 - PPU; Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Data on causes of death due to respiratory illness in Africa are limited.METHODS: From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)-associated deaths identified from influenza surveillance during 2009-2012.RESULTS: Twenty-three countries (82%) responded, 11 (48%) collect mortality data, and 8 provided data. Data were collected from 37 714 SARI cases, and 3091 (8.2%; range by country, 5.1%-25.9%) tested positive for influenza virus. There were 1073 deaths (2.8%; range by country, 0.1%-5.3%) reported, among which influenza virus was detected in 57 (5.3%). Case-fatality proportion (CFP) was higher among countries with systematic death reporting than among those with sporadic reporting. The influenza-associated CFP was 1.8% (57 of 3091), compared with 2.9% (1016 of 34 623) for influenza virus-negative cases (P < .001). Among 834 deaths (77.7%) tested for other respiratory pathogens, rhinovirus (107 [12.8%]), adenovirus (64 [6.0%]), respiratory syncytial virus (60 [5.6%]), and Streptococcus pneumoniae (57 [5.3%]) were most commonly identified. Among 1073 deaths, 402 (37.5%) involved people aged 0-4 years, 462 (43.1%) involved people aged 5-49 years, and 209 (19.5%) involved people aged ≥50 years.CONCLUSIONS: Few African countries systematically collect data on outcomes of people hospitalized with respiratory illness. Stronger surveillance for deaths due to respiratory illness may identify risk groups for targeted vaccine use and other prevention strategies.

AB - BACKGROUND: Data on causes of death due to respiratory illness in Africa are limited.METHODS: From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)-associated deaths identified from influenza surveillance during 2009-2012.RESULTS: Twenty-three countries (82%) responded, 11 (48%) collect mortality data, and 8 provided data. Data were collected from 37 714 SARI cases, and 3091 (8.2%; range by country, 5.1%-25.9%) tested positive for influenza virus. There were 1073 deaths (2.8%; range by country, 0.1%-5.3%) reported, among which influenza virus was detected in 57 (5.3%). Case-fatality proportion (CFP) was higher among countries with systematic death reporting than among those with sporadic reporting. The influenza-associated CFP was 1.8% (57 of 3091), compared with 2.9% (1016 of 34 623) for influenza virus-negative cases (P < .001). Among 834 deaths (77.7%) tested for other respiratory pathogens, rhinovirus (107 [12.8%]), adenovirus (64 [6.0%]), respiratory syncytial virus (60 [5.6%]), and Streptococcus pneumoniae (57 [5.3%]) were most commonly identified. Among 1073 deaths, 402 (37.5%) involved people aged 0-4 years, 462 (43.1%) involved people aged 5-49 years, and 209 (19.5%) involved people aged ≥50 years.CONCLUSIONS: Few African countries systematically collect data on outcomes of people hospitalized with respiratory illness. Stronger surveillance for deaths due to respiratory illness may identify risk groups for targeted vaccine use and other prevention strategies.

KW - Adolescent

KW - Adult

KW - Africa South of the Sahara/epidemiology

KW - Age Distribution

KW - Aged

KW - Bacterial Infections/epidemiology

KW - Child

KW - Child, Preschool

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Influenza, Human/epidemiology

KW - Middle Aged

KW - Population Surveillance

KW - Respiratory Tract Infections/epidemiology

KW - Young Adult

U2 - 10.1093/infdis/jiv100

DO - 10.1093/infdis/jiv100

M3 - A1: Web of Science-article

C2 - 25712970

SN - 0022-1899

VL - 212

SP - 853

EP - 860

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 6

ER -

Severe acute respiratory illness deaths in sub-Saharan Africa and the role of influenza: a case series from 8 countries

Abstract

Keywords

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