[Source: PLoS One, full page: (LINK). Abstract, edited.]
OPEN ACCESS / PEER-REVIEWED / RESEARCH ARTICLE
Influenza-associated pneumonia hospitalizations in Uganda, 2013-2016
Gideon O. Emukule , Barbara Namagambo, Nicholas Owor, Barnabas Bakamutumaho, John T. Kayiwa, Joyce Namulondo, Timothy Byaruhanga, Stefano Tempia, Sandra S. Chaves, Julius J. Lutwama
Published: July 15, 2019 / DOI: https://doi.org/10.1371/journal.pone.0219012
Influenza is an important contributor to acute respiratory illness, including pneumonia, and results in substantial morbidity and mortality globally. Understanding the local burden of influenza-associated severe disease can inform decisions on allocation of resources toward influenza control programs. Currently, there is no national influenza vaccination program in Uganda.
In this study, we used data on pneumonia hospitalizations that were collected and reported through the Health Management Information System (HMIS) of the Ministry of Health, Uganda, and the laboratory-confirmed influenza positivity data from severe acute respiratory illness (SARI) surveillance in three districts (Wakiso, Mbarara, and Tororo) to estimate the age-specific incidence of influenza-associated pneumonia hospitalizations from January 2013 through December 2016.
The overall estimated mean annual rate of pneumonia hospitalizations in the three districts was 371 (95% confidence interval [CI] 323–434) per 100,000 persons, and was highest among children aged <5 years (1,524 [95% CI 1,286–1,849]) compared to persons aged ≥5 years (123 [95% CI 105–144]) per 100,000 persons. The estimated mean annual rate of influenza-associated pneumonia hospitalization was 34 (95% CI 23–48) per 100,000 persons (116 [95% CI 78–165] and 16 [95% CI 6–28] per 100,000 persons among children aged <5 years and those ≥5 years, respectively). Among children aged <5 years, the rate of hospitalized influenza-associated pneumonia was highest among those who were <2 years old (178 [95% CI 109–265] per 100,000 persons). Over the period of analysis, the estimated mean annual number of hospitalized influenza-associated pneumonia cases in the three districts ranged between 672 and 1,436, of which over 70% represent children aged <5 years.
The burden of influenza-associated pneumonia hospitalizations was substantial in Uganda, and was highest among young children aged <5 years. Influenza vaccination may be considered, especially for very young children.
Citation: Emukule GO, Namagambo B, Owor N, Bakamutumaho B, Kayiwa JT, Namulondo J, et al. (2019) Influenza-associated pneumonia hospitalizations in Uganda, 2013-2016. PLoS ONE 14(7): e0219012. https://doi.org/10.1371/journal.pone.0219012
Editor: Ray Borrow, Public Health England, UNITED KINGDOM
Received: February 7, 2019; Accepted: June 13, 2019; Published: July 15, 2019
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Data Availability: All relevant data are within the manuscript and its Supporting Information files. However, should there be need for additional data, a request can be made directly to Dr. Julius Lutwama (Program Coordinator, and Head of the Department of Arbovirology and Emerging Viral Infections at Uganda Virus Research Institute, Uganda; Email: firstname.lastname@example.org).
Funding: This study was supported by U.S. Centers for Disease Control and Prevention. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Keywords: Seasonal Influenza; Pneumonia; SARI; Uganda.