tetano
Editor, Senior Moderator
Clin Infect Dis. 2015 Jun 9. pii: civ448. [Epub ahead of print]
[h=1]Mortality Associated with Seasonal and Pandemic Influenza among Pregnant and Non-Pregnant Women of Childbearing Age in a High HIV Prevalence Setting - South Africa, 1999-2009.[/h] Tempia S[SUP]1[/SUP], Walaza S[SUP]2[/SUP], Cohen AL[SUP]3[/SUP], von Mollendorf C[SUP]2[/SUP], Moyes J[SUP]2[/SUP], McAnerney JM[SUP]4[/SUP], Cohen C[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Information on the mortality burden associated with seasonal and pandemic influenza virus infection among pregnant women is scarce in most settings, particularly in sub-Saharan Africa where pregnancy and maternal mortality rates as well as HIV prevalence are elevated.
[h=4]METHODS:[/h] We used an ecological study design to estimate the seasonal and A(H1N1)pdm09 influenza-associated mortality among pregnant and non-pregnant women of childbearing age (15-49 years) by HIV serostatus during 1999-2009 in South Africa. Mortality rates were expressed per 100,000 person-years.
[h=4]RESULTS:[/h] During 1999-2009 the estimated mean annual seasonal influenza-associated mortality rates were 12.6 (123 deaths) and 7.3 (914 deaths) among pregnant and non-pregnant women, respectively. Among pregnant women the estimated mean annual seasonal influenza-associated mortality rates were 74.9 (109 deaths) among HIV-infected and 1.5 (14 deaths) among HIV-uninfected individuals. Among non-pregnant women the estimated mean annual seasonal influenza-associated mortality rate was 41.2 (824 deaths) among HIV-infected and 0.9 (90 deaths) among HIV-uninfected individuals. Pregnant women experienced an increased risk of seasonal influenza-associated mortality compared to non-pregnant women (relative risk [RR]: 2.8; 95% confidence intervals [CI]: 2.1-3.7). In 2009 the estimated influenza A(H1N1)pdm09-associated mortality rates were 19.3 (181 deaths) and 9.4 (1189 deaths) among pregnant and non-pregnant women, respectively (RR: 3.2; 95% CI: 2.3-4.1).
[h=4]CONCLUSIONS:[/h] Among women of childbearing age, the majority of estimated seasonal influenza-associated deaths occurred in HIV-infected individuals. Pregnant women experienced an increased risk of death associated with seasonal and A(H1N1)pdm09 influenza infection compared to non-pregnant women.
? The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID: 26060287 [PubMed - as supplied by publisher]
[h=1]Mortality Associated with Seasonal and Pandemic Influenza among Pregnant and Non-Pregnant Women of Childbearing Age in a High HIV Prevalence Setting - South Africa, 1999-2009.[/h] Tempia S[SUP]1[/SUP], Walaza S[SUP]2[/SUP], Cohen AL[SUP]3[/SUP], von Mollendorf C[SUP]2[/SUP], Moyes J[SUP]2[/SUP], McAnerney JM[SUP]4[/SUP], Cohen C[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Information on the mortality burden associated with seasonal and pandemic influenza virus infection among pregnant women is scarce in most settings, particularly in sub-Saharan Africa where pregnancy and maternal mortality rates as well as HIV prevalence are elevated.
[h=4]METHODS:[/h] We used an ecological study design to estimate the seasonal and A(H1N1)pdm09 influenza-associated mortality among pregnant and non-pregnant women of childbearing age (15-49 years) by HIV serostatus during 1999-2009 in South Africa. Mortality rates were expressed per 100,000 person-years.
[h=4]RESULTS:[/h] During 1999-2009 the estimated mean annual seasonal influenza-associated mortality rates were 12.6 (123 deaths) and 7.3 (914 deaths) among pregnant and non-pregnant women, respectively. Among pregnant women the estimated mean annual seasonal influenza-associated mortality rates were 74.9 (109 deaths) among HIV-infected and 1.5 (14 deaths) among HIV-uninfected individuals. Among non-pregnant women the estimated mean annual seasonal influenza-associated mortality rate was 41.2 (824 deaths) among HIV-infected and 0.9 (90 deaths) among HIV-uninfected individuals. Pregnant women experienced an increased risk of seasonal influenza-associated mortality compared to non-pregnant women (relative risk [RR]: 2.8; 95% confidence intervals [CI]: 2.1-3.7). In 2009 the estimated influenza A(H1N1)pdm09-associated mortality rates were 19.3 (181 deaths) and 9.4 (1189 deaths) among pregnant and non-pregnant women, respectively (RR: 3.2; 95% CI: 2.3-4.1).
[h=4]CONCLUSIONS:[/h] Among women of childbearing age, the majority of estimated seasonal influenza-associated deaths occurred in HIV-infected individuals. Pregnant women experienced an increased risk of death associated with seasonal and A(H1N1)pdm09 influenza infection compared to non-pregnant women.
? The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID: 26060287 [PubMed - as supplied by publisher]