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Volume 21, Number 4—April 2015
CME ACTIVITY - Research

Deaths Associated with Respiratory Syncytial and Influenza Viruses among Persons ≥5 Years of Age in HIV-Prevalent Area, South Africa, 1998–20091

Cheryl CohenComments to Author , Sibongile Walaza, Cecile Viboud, Adam L. Cohen, Shabir A. Madhi, Marietjie Venter, Claire von Mollendorf, Jocelyn Moyes, Johanna M. McAnerney, and Stefano Tempia
Author affiliations: National Health Laboratory Service, Johannesburg, South Africa (S. Tempia, S. Walaza, S.A. Madhi, C. von Mollendorf, J. Moyes, J.M. McAnerney, C. Cohen); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Tempia, A.L. Cohen); Centers for Disease Control and Prevention, Pretoria, South Africa (S. Tempia, A.L. Cohen, M. Venter); National Institutes of Health, Bethesda, Maryland, USA (C. Viboud); University of the Witwatersrand, Johannesburg (S.A. Madhi, J. Moyes, C. Cohen)

Main Article

Table 2

Influenza A(H1N1)pdm09 excess deaths among persons ≥5 y of age, South Africa, July–September 2009*

Cause of death by age, y Influenza A(H1N1)pdm09 excess deaths in 2009 (95% CI)
Mortality rate ratio† (95% CI)
No. Rate† % Death over model baseline (95% CI)
All causes
5–19 682 (455–910) 4.4 (2.9–5.9) 12.7 (8.5–17.0) 5.4 (4.5–6.6)
20–44 1820 (1201–2403) 9.3 (6.2–12.4) 2.6 (1.7–3.5) 0.9 (0.6–1.2)
45–64 1301 (867–1735) 17.2 (11.5–23.0) 2.5 (1.7–3.4) 0.5 (0.3–0.7)
65–74 279 (186–373) 17.6 (11.8–23.5) 1.2 (0.8–1.6) 0.2 (0.1–0.3)
≥75 31 (20–42) 3.6 (2.4–4.8) 0.1 (0.06–1.3) 0.01 (0.006–0.013)
≥5
4113 (2729–5463)
9.2 (6.1–12.2)
2.6 (1.9–3.3)
0.4 (0.3–0.5)§
All respiratory
5–19 626 (417–835) 4.1 (2.7–5.4) 61.6 (41.1–82.2) 6.9 (5.5–8.6)
20–44 936 (624–1248) 4.8 (3.2–6.4) 6.0 (4.0–8.0) 1.2 (1.1–1.3)
45–64 729 (486–972) 9.6 (6.4–12.8) 6.3 (4.2–8.4) 0.6 (0.5–0.7)
65–74 159 (106–212) 10.1 (6.7–13.4) 3.3 (2.2–4.4) 0.2 (0.1–0.3)
≥75 16 (10–21) 1.8 (1.2–2.5) 0.2 (0.1–0.3) 0.01 (0.008–0.022)
≥5
2466 (1,643–3,288)
5.5 (3.6–7.3)
7.1 (5.5–8.7)
0.7 (0.6–0.8)§
All circulatory
5–19 7 (0–13) 0.05 (0.00–0.1) 1.7 (0.0–3.3) 0.2 (0.1–0.6)
20–44 252 (168–336) 1.3 (0.8–1.7) 4.1 (2.7–5.5) 1.0 (0.8–1.2)
45–64 404 (269–539) 5.3 (3.5–7.1) 3.0 (2.0–4.0) 0.4 (0.3–0.5)
65–74 75 (51–103) 4.7 (3.2–6.3) 0.8 (0.5–1.1) 0.1 (0.07–0.12)
≥75 13 (8–17) 1.5 (1.0–2.0) 0.09 (0.06–0.12) 0.01 (0.004–0.014)
≥5
751 (496–1008)
1.7 (1.1–2.2)
1.7 (1.3–2.0)
0.2 (0.1–0.3)§
Pneumonia and influenza
5–19 449 (297–586) 2.9 (1.9–3.9) 73.1 (48.7–97.4) 5.5 (4.3–6.9)
20–44 548 (365–731) 2.8 (1.8–3.7) 5.7 (3.8–7.6) 0.9 (0.7–1.1)
45–64 421 (281–562) 5.6 (3.7–7.4) 7.3 (4.8–9.7) 0.6 (0.5–0.7)
65–74 90 (54–126) 5.7 (2.8–5.9) 4.3 (2.9–5.8) 0.3 (0.2–0.4)
≥75 3 (0–12) 0.4 (0.0–1.9) 0.08 (0.0–0.2) 0.005 (0.001–0.009)
≥5 1511 (997–2017) 3.4 (2.2–4.5) 3.7 (2.9–4.5) 0.7 (0.6–0.8)§

*Estimated from model 1 (excess deaths irrespective of HIV status).

†Mortality rates per 100,000 person-years

‡Mortality rate ratio: 2009 influenza A(H1N1)pdm09 vs. 1998–2009 mean annual seasonal influenza.

§Age-adjusted rate ratio.

Main Article

1Data from this study were presented in part at the Options for the Control of Influenza Conference VIII; 2013 Sep 5–10; Cape Town, South Africa.

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Page updated: March 17, 2015
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