title: Hospitalizations associated with influenza and respiratory syncytial virus among patients attending a network of private hospitals in South Africa, 2007-2012.
abstract: BACKGROUND
  Influenza and respiratory syncytial virus (RSV) infection are common causes of lower respiratory tract illness. Data on their burden in low and middle-income settings and from Africa are scarce. We aimed to estimate age-specific rates of hospitalization attributable to influenza and RSV among patients attending private hospitals in South Africa during 2007-2012.
  
  
  METHODS
  We estimated annual age-specific rates of influenza- and RSV-associated hospitalization (that is respiratory hospitalizations likely due to influenza or RSV infection) by applying regression models to monthly administrative hospitalization data from a national private hospital group, using influenza and RSV surveillance data as covariates.
  
  
  RESULTS
  Estimated mean hospitalization rates associated with seasonal influenza were 75 (95% confidence interval (CI), 41-108) and 3 (95% CI, 2-5) per 100,000 person-years for all-respiratory and all-circulatory causes, respectively. Children <1 year and adults ≥75 years were the most affected, with influenza-associated all-respiratory hospitalization rates estimated at 255 (95% CI, 143-358) and 380 (95% CI, 227-506) per 100,000 person-years, respectively. Excess all-circulatory hospitalizations associated with seasonal influenza were only observed in adults ≥65 years. Annual hospitalization rates associated with RSV averaged an estimate of 223 (95% CI, 128-317) per 100,000 person-years for all-respiratory causes. Among children <1 year, RSV-associated all-respiratory hospitalization rate of 7,601 (95% CI, 4,312-10,817) per 100,000 person-years was estimated.
  
  
  CONCLUSIONS
  Influenza and RSV substantially contributed to hospitalizations over the study period.
authors.affiliation: Nuffield Department of Population Health, University of Oxford, Oxford, UK. rkyeyagalire@gmail.com.
authors.forename: Robert
authors.initials: R
authors.lastname: Kyeyagalire
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. stefanot@nicd.ac.za.|Influenza Division, Centers for Disease Control and Prevention, Pretoria, South Africa. stefanot@nicd.ac.za.|Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. stefanot@nicd.ac.za.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tempia
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. dvj1@cdc.gov.|Influenza Division, Centers for Disease Control and Prevention, Pretoria, South Africa. dvj1@cdc.gov.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
authors.affiliation: Nuffield Department of Population Health, University of Oxford, Oxford, UK. adrian.smith@dph.ox.ac.uk.
authors.forename: Adrian D
authors.initials: AD
authors.lastname: Smith
authors.affiliation: Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. jomca@nicd.ac.za.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: McAnerney
authors.affiliation: Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. veerlem@nicd.ac.za.
authors.forename: Veerle
authors.initials: V
authors.lastname: Dermaux-Msimang
authors.affiliation: Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. cherylc@nicd.ac.za.|School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa. cherylc@nicd.ac.za.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D016304:Hospitals, Private; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult