Mortality Attributable to Seasonal Influenza A and B Infections in Thailand, 2005-2009: A Longitudinal Study


Cooper, BS; Kotirum, S; Kulpeng, W; Praditsitthikorn, N; Chittaganpitch, M; Limmathurotsakul, D; Day, NPJ; Coker, R; Teerawattananon, Y; Meeyai, A; (2014) Mortality Attributable to Seasonal Influenza A and B Infections in Thailand, 2005-2009: A Longitudinal Study. American journal of epidemiology, 181 (11). pp. 898-907. ISSN 0002-9262 DOI: https://doi.org/10.1093/aje/kwu360

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Abstract

Influenza epidemiology differs substantially in tropical and temperate zones, but estimates of seasonal influenza mortality in developing countries in the tropics are lacking. We aimed to quantify mortality due to seasonal influenza in Thailand, a tropical middle-income country. Time series of polymerase chain reaction-confirmed influenza infections between 2005 and 2009 were constructed from a sentinel surveillance network. These were combined with influenza-like illness data to derive measures of influenza activity and relationships to mortality by using a Bayesian regression framework. We estimated 6.1 (95% credible interval: 0.5, 12.4) annual deaths per 100,000 population attributable to influenza A and B, predominantly in those aged >= 60 years, with the largest contribution from influenza A(H1N1) in 3 out of 4 years. For A(H3N2), the relationship between influenza activity and mortality varied over time. Influenza was associated with increases in deaths classified as resulting from respiratory disease (posterior probability of positive association, 99.8%), cancer (98.6%), renal disease (98.0%), and liver disease (99.2%). No association with circulatory disease mortality was found. Seasonal influenza infections are associated with substantial mortality in Thailand, but evidence for the strong relationship between influenza activity and circulatory disease mortality reported in temperate countries is lacking.

Item Type: Article
Keywords: Bayesian regression, burden, developing country, influenza, middle-income country, mortality, seasonal variation, tropics, united-states, excess mortality, hong-kong, virus, transmission, subtropics, deaths, cities, Public, Environmental & Occupational Health, Adolescent, Adult, Age Distribution, Bayes Theorem, Cause of Death, Female, Humans, Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype, Influenza A virus, Influenza B virus, Influenza, Human, epidemiology, mortality, Longitudinal Studies, Male, Middle Aged, Seasons, Sentinel Surveillance, Thailand, Young Adult
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 25899091
Web of Science ID: 356180300009
URI: http://researchonline.lshtm.ac.uk/id/eprint/2729038

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