Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis

Kathryn E Lafond, Rachael M Porter, Melissa J Whaley, Zhou Suizan, Zhang Ran, Mohammad Abdul Aleem, Binay Thapa, Borann Sar, Viviana Sotomayor Proschle, Zhibin Peng, Luzhao Feng, Daouda Coulibaly, Edith Nkwembe, Alfredo Olmedo, William Ampofo, Siddhartha Saha, Mandeep Chadha, Amalya Mangiri, Vivi Setiawaty, Sami Sheikh Ali, Sandra S Chaves, Dinagul Otorbaeva, Onechanh Keosavanh, Majd Saleh, Antonia Ho, Burmaa Alexander, Hicham Oumzil, Kedar Prasad Baral, Q Sue Huang, Adedeji A Adebayo, Idris Al-Abaidani, Marta von Horoch, Cheryl Cohen, Stefano Tempia, Vida Mmbaga, Malinee Chittaganpitch, Mariana Casal, Duc Anh Dang, Paula Couto, Harish Nair, Joseph S Bresee, Sonja J Olsen, Eduardo Azziz-Baumgartner, J Pekka Nuorti, Marc-Alain Widdowson and Global Respiratory Hospitalizations–Influenza Proportion Positive (GRIPP) Working Group

PLOS Medicine, 2021, vol. 18, issue 3, 1-17

Abstract: Background: Influenza illness burden is substantial, particularly among young children, older adults, and those with underlying conditions. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower-income settings. Methods and findings: We aggregated published data from a systematic review and unpublished data from surveillance platforms to generate global meta-analytic estimates for the proportion of acute respiratory hospitalizations associated with influenza viruses among adults. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996–31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle–Ottawa scale for observational data. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults ≥20 years and by age groups (20–64 years and ≥65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%–16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. The 63 data sources represent published observational studies (n = 28) and unpublished surveillance data (n = 35), from all World Health Organization regions (Africa, n = 8; Americas, n = 11; Eastern Mediterranean, n = 7; Europe, n = 8; Southeast Asia, n = 11; Western Pacific, n = 18). Data quality for published data sources was predominantly moderate or high (75%, n = 56/75). We estimate 32,126,000 (95% CI 20,484,000–46,129,000) influenza-associated LRI episodes and 5,678,000 (95% CI 3,205,000–9,432,000) LRI hospitalizations occur each year among adults. While adults

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1003550

DOI: 10.1371/journal.pmed.1003550

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