Abstract
BackgroundIndonesia's hospital‐based Severe Acute Respiratory Infection (SARI) surveillance system, Surveilans Infeksi Saluran Pernafasan Akut Berat Indonesia (SIBI), was established in 2013. While respiratory illnesses such as SARI pose a significant problem, there are limited incidence‐based data on influenza disease burden in Indonesia. This study aimed to estimate the incidence of influenza‐associated SARI in Indonesia during 2013‐2016 at three existing SIBI surveillance sites.MethodsFrom May 2013 to April 2016, inpatients from sentinel hospitals in three districts of Indonesia (Gunung Kidul, Balikpapan, Deli Serdang) were screened for SARI. Respiratory specimens were collected from eligible inpatients and screened for influenza viruses. Annual incidence rates were calculated using these SIBI‐enrolled influenza‐positive SARI cases as a numerator, with a denominator catchment population defined through hospital admission survey (HAS) to identify respiratory‐coded admissions by age to hospitals in the sentinel site districts.ResultsFrom May 2013 to April 2016, there were 1527 SARI cases enrolled, of whom 1392 (91%) had specimens tested and 199 (14%) were influenza‐positive. The overall estimated annual incidence of influenza‐associated SARI ranged from 13 to 19 per 100 000 population. Incidence was highest in children aged 0‐4 years (82‐114 per 100 000 population), followed by children 5‐14 years (22‐36 per 100 000 population).ConclusionsIncidence rates of influenza‐associated SARI in these districts indicate a substantial burden of influenza hospitalizations in young children in Indonesia. Further studies are needed to examine the influenza burden in other potential risk groups such as pregnant women and the elderly.
Highlights
Influenza epidemics are estimated to result in about 3-5 million cases of severe illness, and 250 000-500 000 deaths globally each year, with the heaviest burden of disease among certain high-risk groups.[1]Increasing awareness of influenza in Indonesia and other tropical countries has highlighted the need for surveillance to provide timely and high-quality epidemiology and virology data to enable monitoring of influenza seasonality, identify and monitor high-risk groups, establish influenza activity baseline levels, facilitate vaccine strain selection, and determine influenza burden to guide policymakers.[2]
The greatest impact was among young children aged
For one site where incidence rates could be calculated for older age-groups, a bimodal distribution was observed where incidence rates were highest in young children, low in the productive age-groups, and higher in those aged 60 years or more
Summary
Influenza epidemics are estimated to result in about 3-5 million cases of severe illness, and 250 000-500 000 deaths globally each year, with the heaviest burden of disease among certain high-risk groups (children, elderly, and chronically ill).[1]Increasing awareness of influenza in Indonesia and other tropical countries has highlighted the need for surveillance to provide timely and high-quality epidemiology and virology data to enable monitoring of influenza seasonality, identify and monitor high-risk groups, establish influenza activity baseline levels, facilitate vaccine strain selection, and determine influenza burden to guide policymakers.[2]. In Indonesia, a SARI surveillance system was established in 2013 through a collaboration between National Institute of Health Research and Development (NIHRD) and the Directorate General of Disease Control and Prevention (Acute Respiratory Infection (ARI) Sub-Directorate), called Surveilans Infeksi Saluran Pernafasan Akut Berat Indonesia (SIBI). This system provides comprehensive epidemiology and virology data for acute respiratory hospitalizations. Indonesia’s hospital-based Severe Acute Respiratory Infection (SARI) surveillance system, Surveilans Infeksi Saluran Pernafasan Akut Berat Indonesia (SIBI), was established in 2013 While respiratory illnesses such as SARI pose a significant problem, there are limited incidence-based data on influenza disease burden in Indonesia. Further studies are needed to examine the influenza burden in other potential risk groups such as pregnant women and the elderly
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