Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis.
In: PLoS Medicine, Jg. 18 (2021-03-01), Heft 3, S. e1003550
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BackgroundInfluenza illness burden is substantial, particularly among young children, older adults, and those with underlying conditions. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower-income settings.Methods and findingsWe aggregated published data from a systematic review and unpublished data from surveillance platforms to generate global meta-analytic estimates for the proportion of acute respiratory hospitalizations associated with influenza viruses among adults. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996-31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle-Ottawa scale for observational data. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults ≥20 years and by age groups (20-64 years and ≥65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%-16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. The 63 data sources represent published observational studies (n = 28) and unpublished surveillance data (n = 35), from all World Health Organization regions (Africa, n = 8; Americas, n = 11; Eastern Mediterranean, n = 7; Europe, n = 8; Southeast Asia, n = 11; Western Pacific, n = 18). Data quality for published data sources was predominantly moderate or high (75%, n = 56/75). We estimate 32,126,000 (95% CI 20,484,000-46,129,000) influenza-associated LRI episodes and 5,678,000 (95% CI 3,205,000-9,432,000) LRI hospitalizations occur each year among adults. While adults ConclusionsIn this meta-analysis, we estimated that influenza viruses are associated with over 5 million hospitalizations worldwide per year. Inclusion of both published and unpublished findings allowed for increased power to generate stratified estimates, and improved representation from lower-income countries. Together, the available data demonstrate the importance of influenza viruses as a cause of severe disease and hospitalizations in younger and older adults worldwide.
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Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis.
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Autor/in / Beteiligte Person: | Kathryn E Lafond ; Rachael M Porter ; Melissa J Whaley ; Suizan, Zhou ; Ran, Zhang ; Mohammad Abdul Aleem ; Thapa, Binay ; Sar, Borann ; Viviana Sotomayor Proschle ; Peng, Zhibin ; Feng, Luzhao ; Coulibaly, Daouda ; Nkwembe, Edith ; Olmedo, Alfredo ; Ampofo, William ; Saha, Siddhartha ; Chadha, Mandeep ; Mangiri, Amalya ; Setiawaty, Vivi ; Sami Sheikh Ali ; Sandra S Chaves ; Otorbaeva, Dinagul ; Keosavanh, Onechanh ; Saleh, Majd ; Ho, Antonia ; Alexander, Burmaa ; Oumzil, Hicham ; Kedar Prasad Baral ; Q Sue Huang ; Adedeji A Adebayo ; Al-Abaidani, Idris ; Marta von Horoch ; Cohen, Cheryl ; Tempia, Stefano ; Mmbaga, Vida ; Chittaganpitch, Malinee ; Casal, Mariana ; Duc Anh Dang ; Couto, Paula ; Nair, Harish ; Joseph S Bresee ; Sonja J Olsen ; Azziz-Baumgartner, Eduardo ; J Pekka Nuorti ; Widdowson, Marc-Alain ; Global Respiratory Hospitalizations–Influenza Proportion Positive (GRIPP) Working Group |
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Zeitschrift: | PLoS Medicine, Jg. 18 (2021-03-01), Heft 3, S. e1003550 |
Veröffentlichung: | Public Library of Science (PLoS), 2021 |
Medientyp: | academicJournal |
ISSN: | 1549-1277 (print) ; 1549-1676 (print) |
DOI: | 10.1371/journal.pmed.1003550 |
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