Abstract

Influenza-associated mortality has not been quantified in the Philippines. Here, we constructed multiple negative binomial regression models to estimate the overall and age-specific excess mortality rates (EMRs) associated with influenza in the Philippines from 2006 to 2015. The regression analyses used all-cause mortality as the dependent variable and meteorological controls, time, influenza A and B positivity rates (lagged for up to two time periods), and annual and semiannual cyclical seasonality controls as independent variables. The regression models closely matched observed all-cause mortality. Influenza was estimated to account for a mean of 5,347 excess deaths per year (1.1% of annual all-cause deaths) in the Philippines, most of which (67.1%) occurred in adults aged ≥60 years. Influenza A accounted for 85.7% of all estimated excess influenza deaths. The annual estimated influenza-attributable EMR was 5.09 (95% CI: 2.20-5.09) per 100,000 individuals. The EMR was highest for individuals aged ≥60 years (44.63 [95% CI: 4.51-44.69] per 100,000), second highest for children aged less than 5 years (2.14 [95% CI: 0.44-2.19] per 100,000), and lowest for individuals aged 10 to 19 years (0.48 [95% CI: 0.10-0.50] per 100,000). Estimated numbers of excess influenza-associated deaths were considerably higher than the numbers of influenza deaths registered nationally. Our results suggest that influenza causes considerable mortality in the Philippines-to an extent far greater than observed from national statistics-especially among older adults and young children.

Highlights

  • Influenza is a serious public health concern that causes 3−5 million cases of severe illness and about 290,000 to 650,000 deaths worldwide each year [1, 2]

  • All-cause deaths were obtained from the death registration dataset of the Philippine Statistics Authority [9]

  • The estimated annual influenza-associated deaths were compared with influenza deaths registered by the Philippine Statistics Authority (Table 3)

Read more

Summary

Introduction

Influenza is a serious public health concern that causes 3−5 million cases of severe illness and about 290,000 to 650,000 deaths worldwide each year [1, 2]. The funder provided support in the form of salaries for authors (JN and RD), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This is important to protect those at greater risk of developing lifethreatening influenza complications, such as young children, older adults, and people with chronic illnesses [2, 3]. Direct mortality measurements can miss deaths from secondary complications triggered by influenza infection (e.g., influenza-triggered exacerbation of preexisting chronic illnesses). The mean annual influenza incidence rate has been estimated as 5.4 per 1,000 individuals in an urban region of the country, with high incidence (22.6 per 1,000) in young children [6]. We used negative binomial regression models to estimate the influenza-attributable excess mortality in the Philippines from 2006 to 2015, and compared these influenza mortality estimates with death registry data to quantify under-reporting of influenza deaths

Study design
Results
Discussion
Conclusions
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call