Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005

Cheryl Cohen, Lone Simonsen, Jong-Won Kang, Mark Miller, Jo McAnerney, Lucille Blumberg, Barry Schoub, Shabir A. Mahdi, Cecile Viboud

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.
OriginalsprogEngelsk
TidsskriftClinical Infectious Diseases
Vol/bind51
Udgave nummer12
Sider (fra-til)1362-1369
ISSN1058-4838
StatusUdgivet - 2010

Citer dette

Cohen, C., Simonsen, L., Kang, J-W., Miller, M., McAnerney, J., Blumberg, L., ... Viboud, C. (2010). Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005. Clinical Infectious Diseases, 51(12), 1362-1369.
Cohen, Cheryl ; Simonsen, Lone ; Kang, Jong-Won ; Miller, Mark ; McAnerney, Jo ; Blumberg, Lucille ; Schoub, Barry ; Mahdi, Shabir A. ; Viboud, Cecile. / Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005. I: Clinical Infectious Diseases. 2010 ; Bind 51, Nr. 12. s. 1362-1369.
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title = "Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005",
abstract = "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.",
author = "Cheryl Cohen and Lone Simonsen and Jong-Won Kang and Mark Miller and Jo McAnerney and Lucille Blumberg and Barry Schoub and Mahdi, {Shabir A.} and Cecile Viboud",
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Cohen, C, Simonsen, L, Kang, J-W, Miller, M, McAnerney, J, Blumberg, L, Schoub, B, Mahdi, SA & Viboud, C 2010, 'Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005', Clinical Infectious Diseases, bind 51, nr. 12, s. 1362-1369.

Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005. / Cohen, Cheryl; Simonsen, Lone; Kang, Jong-Won; Miller, Mark; McAnerney, Jo; Blumberg, Lucille; Schoub, Barry; Mahdi, Shabir A.; Viboud, Cecile.

I: Clinical Infectious Diseases, Bind 51, Nr. 12, 2010, s. 1362-1369.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Elevated influenza-related excess mortality in South African elderly individuals, 1998-2005

AU - Cohen, Cheryl

AU - Simonsen, Lone

AU - Kang, Jong-Won

AU - Miller, Mark

AU - McAnerney, Jo

AU - Blumberg, Lucille

AU - Schoub, Barry

AU - Mahdi, Shabir A.

AU - Viboud, Cecile

PY - 2010

Y1 - 2010

N2 - 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.

AB - 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.

M3 - Journal article

VL - 51

SP - 1362

EP - 1369

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 12

ER -