Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

Walaza, Sibongile; Cohen, Cheryl; Nanoo, Ananta; Cohen, Adam L.; McAnerney, Johanna M.; Mollendorf, Claire von; Moyes, Jocelyn; Tempia, Stefano

doi:10.1371/journal.pone.0129173

Cited by 47 publications

(45 citation statements)

References 29 publications

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“…In addition, HIV‐positive South Africans have been shown to be at greater risk for severe influenza illness 6. The high prevalence of underlying high‐risk medical conditions, including HIV and tuberculosis, likely contributes to higher influenza‐associated mortality in South Africa 7, 8…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Wong

Cohen

Norris

et al. 2016

Influenza Resp Viruses

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BackgroundUnderstanding knowledge and sentiment toward influenza and vaccination is important for effective health messages and prevention strategies. We aimed to characterize knowledge, attitudes, and practices surrounding influenza illness and vaccination in two South African communities and explore reasons for vaccine hesitancy.MethodsHousehold primary caregivers in Soweto and Klerksdorp townships were interviewed about knowledge of influenza and intention to receive an influenza vaccine using a structured questionnaire. Factors associated with unwillingness to receive vaccine were explored using multivariable regression.ResultsWe interviewed representatives of 973 households in Soweto and 1,442 in Klerksdorp. Most respondents in Soweto (692, 71%) and Klerksdorp (1247, 87%) thought weather or cold caused influenza. While most would get a free influenza vaccine, those unwilling to receive vaccine had concerns about efficacy (Soweto: 19%; Klerksdorp: 19%) and safety (Soweto: 17%; Klerksdorp: 10%). In Soweto, females (aRR 2·0, 95% CI 1·3–3·2) and those with higher household income (aRR 1·8, 95% CI 1·2–2·7) were less willing to receive vaccine. In Klerksdorp, more educated respondents (aRR 1·6, 95% CI 1·1–2·4) were less willing to receive vaccine; households reporting an HIV‐positive member were more willing to receive vaccine (aRR 0·3, 95% CI 0·1–0·8).ConclusionsAlthough findings suggest most community participants were amenable to influenza vaccination, knowledge gaps were present. Emphasizing the importance of influenza as a health problem and addressing vaccine safety and efficacy concerns may improve uptake. Populations less amenable to vaccination, including those with higher education and income, may benefit from targeted messaging efforts.

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Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Wong

Cohen

Norris

et al. 2016

Influenza Resp Viruses

Self Cite

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“…Another likely explanation for the trend toward higher female P&I mortality in the South involves the well‐known comorbidity of influenza and tuberculosis. Tuberculosis was highly prevalent in Newfoundland during this time period (House, ; Schmidt & Sattenspiel, ), and it has been repeatedly observed that infection with tuberculosis increases the risk of mortality from P&I (Mamelund, ; Noymer & Garenne, ; Oei & Nishiura, ; Walaza, Cohen, Nanoo, Cohen, McAnerney, von Mollendorf, Moyes, & Tempia, ). Preliminary observations of yearly vital records suggest that although tuberculosis had the highest mortality rates of any respiratory disease, year to year mortality rates did not vary significantly, and there was no clear significant excess during the 1918–1920 pandemic period.…”

Section: Discussionmentioning

confidence: 99%

Sex‐ and age‐based differences in mortality during the 1918 influenza pandemic on the island of Newfoundland

Paskoff

Sattenspiel

2018

American J Hum Biol

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Objectives Our aim was to understand sex‐ and age‐based differences in mortality during the 1918 influenza pandemic on the island of Newfoundland. The pandemic's impact on different age groups has been the focus of other research, but sex‐based differences in mortality are rarely considered. Aspects of social organization, labor patterns, and social behaviors that contribute to mortality between males and females at all ages are used to explain observed mortality patterns. Methods Recorded pneumonia and influenza deaths on the island (n = 1871) were used to calculate cause‐specific death rates and to evaluate differences in sex‐based mortality. Mortality levels in 17 districts and four regions (Avalon, North, South, and West) were compared using standardized mortality ratios (SMRs). A logistic regression model was fit to determine in which regions sex‐based mortality could be predicted using age and region as interactive predictors. Results Differences in sex‐based mortality varied across regions; they were not significant for the aggregate population. SMRs were also variable, with no significant sex‐based differences. Sex‐based differences were highly variable within regions. Results from a logistic regression analysis suggest that females in the South region may have experienced a higher probability of death than other island residents. Conclusions Mortality analysis for aggregate populations homogenizes important epidemiologic patterns. Men and women did not experience the 1918 influenza pandemic in the same way, and by analyzing data at the regional and district geographic levels, patterns emerge that can be explained by the economies and social organization of the people who lived there.

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“…A study of the influenza-associated mortality among individuals with PTB in South Africa from 1999-2009 observed an increased risk of influenza-associated mortality in persons with PTB compared to non-tuberculosis respiratory deaths [44]. In the same period of time (1999-2009), in South Africa, the mortality associated with seasonal and pandemic influenza among pregnant and non-pregnant women of childbearing age in a high HIV-prevalence setting was conducted.…”

Section: Mortalitymentioning

confidence: 99%

Influenza-Associated Morbidity and Mortality in Sub-Saharan Africa

Diop

Montomoli

Sanicas

et al. 2016

IJVV

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Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999–2009

Cited by 47 publications

References 29 publications

Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Sex‐ and age‐based differences in mortality during the 1918 influenza pandemic on the island of Newfoundland

Influenza-Associated Morbidity and Mortality in Sub-Saharan Africa

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