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Comparative Study
. 2013 Feb 7:13:118.
doi: 10.1186/1471-2458-13-118.

Social factors related to the clinical severity of influenza cases in Spain during the A (H1N1) 2009 virus pandemic

José María Mayoral  1 , Jordi Alonso, Olatz Garín, Zaida Herrador, Jenaro Astray, Maretva Baricot, Jesús Castilla, Rafael Cantón, Ady Castro, Miguel Delgado-Rodríguez, Alicia Ferri, Pere Godoy, Fernando Gónzález-Candelas, Vicente Martín, Tomás Pumarola, José María Quintana, Núria Soldevila, Sonia Tamames, Angela Domínguez; CIBERESP Cases and Controls in Pandemic Influenza Working Group, Spain
Collaborators, Affiliations
Comparative Study

Social factors related to the clinical severity of influenza cases in Spain during the A (H1N1) 2009 virus pandemic

José María Mayoral et al. BMC Public Health. .

Abstract

Background: During the 2009 influenza pandemic, a change in the type of patients most often affected by influenza was observed. The objective of this study was to assess the role of individual and social determinants in hospitalizations due to influenza A (H1N1) 2009 infection.

Methods: We studied hospitalized patients (cases) and outpatients (controls) with confirmed influenza A (H1N1) 2009 infection. A standardized questionnaire was used to collect data. Variables that might be related to the hospitalization of influenza cases were compared by estimation of the odds ratio (OR) and 95% confidence intervals (CI) and the variables entered into binomial logistic regression models.

Results: Hospitalization due to pandemic A (H1N1) 2009 influenza virus infections was associated with non-Caucasian ethnicity (OR: 2.18, 95% CI 1.17 - 4.08), overcrowding (OR: 2.84, 95% CI 1.20 - 6.72), comorbidity and the lack of previous preventive information (OR: 2.69, 95% CI: 1.50 - 4.83). Secondary or higher education was associated with a lower risk of hospitalization (OR 0.56, 95% CI: 0.36 - 0.87)

Conclusions: In addition to individual factors such as comorbidity, other factors such as educational level, ethnicity or overcrowding were associated with hospitalization due to A (H1N1) 2009 influenza virus infections.

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