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. 2018 Jan;12(1):38-45.
doi: 10.1111/irv.12494. Epub 2017 Dec 2.

The national burden of influenza-associated severe acute respiratory illness hospitalization in Rwanda, 2012-2014

José Nyamusore  1 , Joseph Rukelibuga  2 , Mwumvaneza Mutagoma  1 , Andrew Muhire  3 , Alice Kabanda  4 , Thelma Williams  5 , Angela Mutoni  1 , Julius Kamwesiga  1 , Thierry Nyatanyi  1 , Jared Omolo  2 , Adeline Kabeja  1 , Jean Baptiste Koama  2 , Agrippine Mukarurangwa  4 , Jeanne d'Arc Umuringa  4 , Carolina Granados  5 , Michel Gasana  6 , Ann Moen  5 , Stefano Tempia  5   7   8
Affiliations

The national burden of influenza-associated severe acute respiratory illness hospitalization in Rwanda, 2012-2014

José Nyamusore et al. Influenza Other Respir Viruses. 2018 Jan.

Abstract

Background: Estimates of influenza-associated hospitalization are severely limited in low- and middle-income countries, especially in Africa.

Objectives: To estimate the national number of influenza-associated severe acute respiratory illness (SARI) hospitalization in Rwanda.

Methods: We multiplied the influenza virus detection rate from influenza surveillance conducted at 6 sentinel hospitals by the national number of respiratory hospitalization obtained from passive surveillance after adjusting for underreporting and reclassification of any respiratory hospitalizations as SARI during 2012-2014. The population at risk was obtained from projections of the 2012 census. Bootstrapping was used for the calculation of confidence intervals (CI) to account for the uncertainty associated with all levels of adjustment. Rates were expressed per 100 000 population. A sensitivity analysis using a different estimation approach was also conducted.

Results: SARI cases accounted for 70.6% (9759/13 813) of respiratory admissions at selected hospitals: 77.2% (6783/8786) and 59.2% (2976/5028) among individuals aged <5 and ≥5 years, respectively. Overall, among SARI cases tested, the influenza virus detection rate was 6.3% (190/3022): 5.7% (127/2220) and 7.8% (63/802) among individuals aged <5 and ≥5 years, respectively. The estimated mean annual national number of influenza-associated SARI hospitalizations was 3663 (95% CI: 2930-4395-rate: 34.7; 95% CI: 25.4-47.7): 2637 (95% CI: 2110-3164-rate: 168.7; 95% CI: 135.0-202.4) among children aged <5 years and 1026 (95% CI: 821-1231-rate: 11.3; 95% CI: 9.0-13.6) among individuals aged ≥5 years. The estimates obtained from both approaches were not statistically different (overlapping CIs).

Conclusions: The burden of influenza-associated SARI hospitalizations was substantial and was highest among children aged <5 years.

Keywords: Rwanda; burden; hospitalization; influenza; severe acute respiratory illness.

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Figures

Figure 1
Figure 1
Monthly number of influenza‐positive cases among patients hospitalized with severe acute respiratory illness at 6 sentinel sites, Rwanda, 2012‐2014
Figure 2
Figure 2
Mean annual estimates of severe acute respiratory illness (SARI) and influenza‐associated severe acute respiratory illness hospitalization rates (per 100 000 population) by age group, Rwanda, 2012‐2014. (A) SARI hospitalization rates; (B) influenza‐associated SARI hospitalization rates
See this image and copyright information in PMC

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