title: Influenza-associated mortality in 2009 in four sentinel sites in Bangladesh.
abstract: OBJECTIVE
  To estimate influenza-associated mortality in Bangladesh in 2009.
  
  
  METHODS
  In four hospitals in Bangladesh, respiratory samples were collected twice a month throughout 2009 from inpatients aged < 5 years with severe pneumonia and from older inpatients with severe acute respiratory infection. The samples were tested for influenza virus ribonucleic acid (RNA) using polymerase chain reaction. The deaths in 2009 in five randomly selected unions (the smallest administrative units in Bangladesh) in each hospital's catchment area were then investigated using formal records and informal group discussions. The deaths of those who had reportedly died within 14 days of suddenly developing fever with cough and/or a sore throat were assumed to be influenza-associated. The rate of such deaths in 2009 in each of the catchment areas was then estimated from the number of apparently influenza-associated deaths in the sampled unions, the proportion of the sampled inpatients in the local hospital who tested positive for influenza virus RNA, and the estimated number of residents of the sampled unions.
  
  
  RESULTS
  Of the 2500 people known to have died in 2009 in all 20 study unions, 346 (14%) reportedly had fever with cough and/or sore throat within 14 days of their deaths. The estimated mean annual influenza-associated mortality in these unions was 11 per 100,000 population: 1.5, 4.0 and 125 deaths per 100,000 among those aged < 5, 5-59 and > 59 years, respectively.
  
  
  CONCLUSIONS
  The highest burden of influenza-associated mortality in Bangladesh in 2009 was among the elderly.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Saheed Tajuddin Ahmed Sarani, Mohakhalai, Dhaka-1212, Bangladesh. nhomaira@icddrb.org
authors.forename: Nusrat
authors.initials: N
authors.lastname: Homaira
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.forename: A S M
authors.initials: AS
authors.lastname: Alamgir
authors.forename: Kariul
authors.initials: K
authors.lastname: Islam
authors.forename: Repon
authors.initials: R
authors.lastname: Paul
authors.forename: Jaynal
authors.initials: J
authors.lastname: Abedin
authors.forename: Mustafizur
authors.initials: M
authors.lastname: Rahman
authors.forename: Tasnim
authors.initials: T
authors.lastname: Azim
authors.forename: Goutam
authors.initials: G
authors.lastname: Podder
authors.forename: Badrul Munir
authors.initials: BM
authors.lastname: Sohel
authors.forename: Abdullah
authors.initials: A
authors.lastname: Brooks
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.forename: Joseph
authors.initials: J
authors.lastname: Bresee
authors.forename: Mahmudur
authors.initials: M
authors.lastname: Rahman
authors.forename: Eduardo
authors.initials: E
authors.lastname: Azziz-Baumgartner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001459:Bangladesh / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007251:Influenza, Human / Q000401:mortality* / Q000821:virology; D008875:Middle Aged; D009975:Orthomyxoviridae / Q000302:isolation & purification; D011014:Pneumonia / Q000401:mortality / Q000821:virology; D012140:Respiratory Tract Diseases / Q000401:mortality / Q000821:virology; D018571:Sentinel Surveillance; D055815:Young Adult