ArticlePloS one2013
Estimation of the national disease burden of influenza-associated severe acute respiratory illness in Kenya and Guatemala: a novel methodology.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Diagnostic Accuracy of Severe Acute Respiratory Infection Definitions in Hospitalized Children: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- The epidemiology of seasonal influenza after the 2009 influenza pandemic in Africa: a systematic review.African health sciences · 2020Pooled it
- Variability in published rates of influenza-associated hospitalizations: A systematic review, 2007-2018.Journal of global health · 2020Pooled it
- Pooled it
- Comparable burden of severe acute respiratory illness among children and older adults in Kenya: evidence from a multi-site health utilization survey.IJID regions · 2026Article
- The National Burden of Influenza-Associated Respiratory Illness Across Levels of Severity in Egypt, 2016-2019.Influenza and other respiratory viruses · 2024Article
- Article
- The burden of RSV-associated illness in children aged < 5 years, South Africa, 2011 to 2016.BMC medicine · 2023Article
- Estimates of the national burden of respiratory syncytial virus in Kenyan children aged under 5 years, 2010-2018.BMC medicine · 2023Article
- Estimating the cost-effectiveness of maternal vaccination and monoclonal antibodies for respiratory syncytial virus in Kenya and South Africa.BMC medicine · 2023Article
- Approaches to use the WHO respiratory syncytial virus surveillance platform to estimate disease burden.Influenza and other respiratory viruses · 2020Article
- Seasonal influenza vaccination in Kenya: an economic evaluation using dynamic transmission modelling.BMC medicine · 2020Article
- Article
- The Epidemiology and Burden of Influenza B/Victoria and B/Yamagata Lineages in Kenya, 2012-2016.Open forum infectious diseases · 2019Article
- Estimation of influenza and respiratory syncytial virus hospitalizations using sentinel surveillance data-La Paz, Bolivia. 2012-2017.Influenza and other respiratory viruses · 2019Article
- Quantifying How Different Clinical Presentations, Levels of Severity, and Healthcare Attendance Shape the Burden of Influenza-associated Illness: A Modeling Study From South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Building laboratory capacity to detect and characterize pathogens of public and global health security concern in Kenya.BMC public health · 2019Article
- The cost of influenza-associated hospitalizations and outpatient visits in Kenya.BMC public health · 2019Article
- Burden and epidemiology of influenza- and respiratory syncytial virus-associated severe acute respiratory illness hospitalization in Madagascar, 2011-2016.Influenza and other respiratory viruses · 2019Article
- The national and provincial burden of medically attended influenza-associated influenza-like illness and severe acute respiratory illness in the Democratic Republic of Congo, 2013-2015.Influenza and other respiratory viruses · 2018Article
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Authors and funding
17 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundKnowing the national disease burden of severe influenza in low-income countries can inform policy decisions around influenza treatment and prevention. We present a novel methodology using locally generated data for estimating this burden. METHODS AND
findingsThis method begins with calculating the hospitalized severe acute respiratory illness (SARI) incidence for children <5 years old and persons ≥5 years old from population-based surveillance in one province. This base rate of SARI is then adjusted for each province based on the prevalence of risk factors and healthcare-seeking behavior. The percentage of SARI with influenza virus detected is determined from provincial-level sentinel surveillance and applied to the adjusted provincial rates of hospitalized SARI. Healthcare-seeking data from healthcare utilization surveys is used to estimate non-hospitalized influenza-associated SARI. Rates of hospitalized and non-hospitalized influenza-associated SARI are applied to census data to calculate the national number of cases. The method was field-tested in Kenya, and validated in Guatemala, using data from August 2009-July 2011. In Kenya (2009 population 38.6 million persons), the annual number of hospitalized influenza-associated SARI cases ranged from 17,129-27,659 for children <5 years old (2.9-4.7 per 1,000 persons) and 6,882-7,836 for persons ≥5 years old (0.21-0.24 per 1,000 persons), depending on year and base rate used. In Guatemala (2011 population 14.7 million persons), the annual number of hospitalized cases of influenza-associated pneumonia ranged from 1,065-2,259 (0.5-1.0 per 1,000 persons) among children <5 years old and 779-2,252 cases (0.1-0.2 per 1,000 persons) for persons ≥5 years old, depending on year and base rate used. In both countries, the number of non-hospitalized influenza-associated cases was several-fold higher than the hospitalized cases.
conclusionsInfluenza virus was associated with a substantial amount of severe disease in Kenya and Guatemala. This method can be performed in most low and lower-middle income countries.
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