title: Estimating the burden of influenza-associated hospitalizations and deaths in Central America.
abstract: Our objective was to estimate the incidence of influenza-associated hospitalizations and in-hospital deaths in Central American Region.
  
  
  
  We used hospital discharge records, influenza surveillance virology data, and population projections collected from Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua to estimate influenza-associated hospitalizations and in-hospital deaths. We performed a meta-analysis of influenza-associated hospitalizations and in-hospital deaths.
  
  
  
  The highest annual incidence was observed among children aged <5 years (136 influenza-associated hospitalizations per 100 000 persons).
  
  
  
  Annually, 7 625-11 289 influenza-associated hospitalizations and 352-594 deaths occurred in the subregion.
  
  
  
  Our results suggest that a substantive number of persons are annually hospitalized because of influenza. Health officials should estimate how many illnesses could be averted through increased influenza vaccination.
authors.affiliation: Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Descalzo
authors.affiliation: U.S. CDC Regional Office for Central America Region (CDC-CAR), Guatemala Ciudad, Guatemala.
authors.forename: Wilfrido
authors.initials: W
authors.lastname: Clara
authors.affiliation: Caja Costarricense del Seguro Social (CCSS), San José, Costa Rica.
authors.forename: Guiselle
authors.initials: G
authors.lastname: Guzmán
authors.affiliation: Ministerio de Salud Pública y Asistencia Social de Guatemala (MSPAS), Guatemala Ciudad, Guatemala.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mena
authors.affiliation: Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador.
authors.forename: Julio
authors.initials: J
authors.lastname: Armero
authors.affiliation: Secretaría de Salud de Honduras, Tegucigalpa, Honduras.
authors.forename: Bredy
authors.initials: B
authors.lastname: Lara
authors.affiliation: Ministerio de Salud de Nicaragua (MINSA), Managua, Nicaragua.
authors.forename: Carlos
authors.initials: C
authors.lastname: Saenz
authors.affiliation: Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala.
authors.forename: Anabela
authors.initials: A
authors.lastname: Aragón
authors.affiliation: Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala.
authors.forename: Rafael
authors.initials: R
authors.lastname: Chacón
authors.affiliation: Pan American Health Organization, Washington, DC, USA.
authors.forename: Nathalie
authors.initials: N
authors.lastname: El-Omeiri
authors.affiliation: Pan American Health Organization, Washington, DC, USA.
authors.forename: Jairo
authors.initials: J
authors.lastname: Méndez-Rico
authors.affiliation: Pan American Health Organization, Washington, DC, USA.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Cerpa
authors.affiliation: Pan American Health Organization, Washington, DC, USA.|U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Rakhee
authors.initials: R
authors.lastname: Palekar
authors.affiliation: Universidad del Valle de Guatemala (UVG), Guatemala Ciudad, Guatemala.
authors.forename: Jorge
authors.initials: J
authors.lastname: Jara
authors.affiliation: U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Azziz-Baumgartner
mesh_terms: D000293:Adolescent; D000328:Adult; D002489:Central America / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000191:economics* / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: America; burden of disease; hospitalizations; influenza; meta-analysis; mortality; multiplier model