Abstract
BackgroundIn Kenya, detailed data on the age-specific burden of influenza and RSV are essential to inform use of limited vaccination and treatment resources.MethodsWe analyzed surveillance data from August 2009 to July 2012 for hospitalized severe acute respiratory illness (SARI) and outpatient influenza-like illness (ILI) at two health facilities in western Kenya to estimate the burden of influenza and respiratory syncytial virus (RSV). Incidence rates were estimated by dividing the number of cases with laboratory-confirmed virus infections by the mid-year population. Rates were adjusted for healthcare-seeking behavior, and to account for patients who met the SARI/ILI case definitions but were not tested.ResultsThe average annual incidence of influenza-associated SARI hospitalization per 1,000 persons was 2.7 (95% CI 1.8–3.9) among children <5 years and 0.3 (95% CI 0.2–0.4) among persons ≥5 years; for RSV-associated SARI hospitalization, it was 5.2 (95% CI 4.0–6.8) among children <5 years and 0.1 (95% CI 0.0–0.2) among persons ≥5 years. The incidence of influenza-associated medically-attended ILI per 1,000 was 24.0 (95% CI 16.6–34.7) among children <5 years and 3.8 (95% CI 2.6–5.7) among persons ≥5 years. The incidence of RSV-associated medically-attended ILI was 24.6 (95% CI 17.0–35.4) among children <5 years and 0.8 (95% CI 0.3–1.9) among persons ≥5 years.ConclusionsInfluenza and RSV both exact an important burden in children. This highlights the possible value of influenza vaccines, and future RSV vaccines, for Kenyan children.
Highlights
Acute lower respiratory tract infections account for an estimated 1.9 million deaths in children,5 years of age annually, up to 90% of which occur in the developing world [1,2,3]
A large fraction of human respiratory tract infections are associated with viruses including influenza A and B, and respiratory syncytial virus (RSV) [6]
We estimated rates of non-medically attended influenza-like illness (ILI) and severe acute respiratory illness (SARI) using the proportion of persons that sought care for acute respiratory infections (ARI), and pneumonia, respectively, from a health utilization survey implemented in Western Kenya in 2005 [21]
Summary
Acute lower respiratory tract infections account for an estimated 1.9 million deaths in children ,5 years of age annually, up to 90% of which occur in the developing world [1,2,3]. In Africa and Asia, acute lower respiratory tract infections are two to ten times more common than in the USA [4], and have three to seven-fold worse outcomes than in the industrialized world [5]. Additional and more detailed data on burden of disease may be required before these vaccines are used more widely. In Kenya, detailed data on the age-specific burden of influenza and RSV are essential to inform use of limited vaccination and treatment resources
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