Risk factors associated with hospitalisation for influenza-associated severe acute respiratory illness in South Africa: A case-population study.

Abadom, T; Smith, A; Tempia, S; Madhi, S; Cohen, C; Cohen, A

Journal article

Risk factors associated with hospitalisation for influenza-associated severe acute respiratory illness in South Africa: A case-population study.

Abstract:: Background

Influenza is a common cause of severe respiratory illness, but risk factors for hospitalization in low income settings with a high HIV prevalence are not well described. We aimed to assess risk factors associated with influenza-associated severe acute respiratory illness (SARI) hospitalisation in South Africa.

Methods

We conducted a case-population study using data on risk conditions in patients hospitalised with SARI and the national prevalence of these conditions. Data on hospitalised cases were from the national SARI surveillance program while data on the referent population were from the latest national census or health and demographic surveillance surveys.

Findings

From 2009 to 2012, we identified 3,646 (7.9%) of 46,031 enrolled cases of SARI that were associated with influenza infection. Risk factors associated with hospitalisation included previous history of smoking [case-population ratio (CPR) 3.82, 95% confidence interval (CI) 3.5-4.16], HIV infection (CPR 3.61, 95% CI 3.5-3.71), asthma (CPR 2.45, 95% CI 2.19-2.73), previous history of hospital admission in the past 12 months (CPR 2.07, 95% CI 1.92-2.23), and tuberculosis (CPR 1.85, 95% CI 1.68-2.02). When stratified by age, there is increased risk of hospitalization in those ≤5 years of age (CPR 3.07, 95% CI 2.93-3.21) and among those 35 years of age and above (CPR 1.23, 95% CI 1.28-1.18). Male sex (CPR 0.85, 95% CI 0.82-0.88) and completion of pneumococcal conjugate vaccination schedule in children <5 years of age (CPR 0.74, 95% CI 0.71-0.77) were associated with decreased risk of hospitalisation.

Conclusion

These results identify groups at high-risk for severe influenza who should be considered potential targets for influenza vaccination in South Africa and similar settings.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Abadom, T., Smith, A., Tempia, S., Madhi, S., Cohen, C., & Cohen, A. (2016). Risk factors associated with hospitalisation for influenza-associated severe acute respiratory illness in South Africa: A case-population study. Vaccine, 34(46), 5649–5655.

MLA Style

Abadom, T, et al. “Risk Factors Associated with Hospitalisation for Influenza-Associated Severe Acute Respiratory Illness in South Africa: A Case-Population Study.” Vaccine, vol. 34, no. 46, 2016, pp. 5649–55.

Chicago Style

Abadom, T, A Smith, S Tempia, S Madhi, C Cohen, and A Cohen. 2016. “Risk Factors Associated with Hospitalisation for Influenza-Associated Severe Acute Respiratory Illness in South Africa: A Case-Population Study.” Vaccine 34 (46): 5649–55.
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