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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005
Clinical Infectious Diseases, Volume 51, No. 12, Year 2010
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Description
Background. Although essential to guide control measures, published estimates of influenza-related seasonal mortality for low- and middle-income countries are few. We aimed to compare influenza-related mortality among individuals aged ≥65 years in South Africa and the United States. Methods. We estimated influenza-related excess mortality due to all causes, pneumonia and influenza, and other influenza-associated diagnoses from monthly age-specific mortality data for 1998-2005 using a Serfling regression model. We controlled for between-country differences in population age structure and nondemographic factors (baseline mortality and coding practices) by generating age-standardized estimates and by estimating the percentage excess mortality attributable to influenza. Results. Age-standardized excess mortality rates were higher in South Africa than in the United States: 545 versus 133 deaths per 100,000 population for all causes (P < .001) and 63 vs 21 deaths per 100,000 population for pneumonia and influenza (P = .03). Standardization for nondemographic factors decreased but did not eliminate between-country differences; for example, the mean percentage of winter deaths attributable to influenza was 16% in South Africa and 6% in the United States (P < .001). For all respiratory causes, cerebrovascular disease, and diabetes, age-standardized excess death rates were 4-8-fold greater in South Africa than in the United States, and the percentage increase in winter deaths attributable to influenza was 2-4-fold higher. Conclusions. These data suggest that the impact of seasonal influenza on mortality among elderly individuals may be substantially higher in an African setting, compared with in the United States, and highlight the potential for influenza vaccination programs to decrease mortality. © 2010 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Cohen, Cheryl D.
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Johannesburg
Wits School of Public Health
Simonsen, Lone
United States, Bethesda
National Institutes of Health Nih
United States, Washington, D.c.
The George Washington University
Kang, Jongwon
United States, Bethesda
National Institutes of Health Nih
Miller, Mark A.
United States, Bethesda
National Institutes of Health Nih
McAnerney, Johanna M.
South Africa, Johannesburg
University of the Witwatersrand
Blumberg, Lucille Hellen
South Africa, Johannesburg
University of the Witwatersrand
Schoub, Barry David
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Johannesburg
School of Pathology
Madhi, Shabir A.
South Africa, Johannesburg
School of Pathology
South Africa, Johannesburg
University of the Witwatersrand
Viboud, Cécile G.
United States, Bethesda
National Institutes of Health Nih
Statistics
Citations: 93
Authors: 9
Affiliations: 5
Identifiers
Doi:
10.1086/657314
ISSN:
10584838
Research Areas
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Locations
South Africa