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

By BS Cooper, S Kotirum, W Kulpeng, N Praditsitthikorn, M Chittaganpitch, D Limmathurotsakul, NPJ Day, R Coker, Y Teerawattananon and A Meeyai

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

Publisher: Oxford University Press (OUP)
Year: 2015
OAI identifier: oai:researchonline.lshtm.ac.uk:2729038
Provided by: LSHTM Research Online
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