title: Incidence of medically attended influenza among residents of Shai-Osudoku and Ningo-Prampram Districts, Ghana, May 2013 - April 2015.
abstract: Influenza vaccination is recommended by the World Health Organization for high risk groups, yet few data exist on influenza disease burden in West Africa.
  
  
  
  We estimated medically attended influenza-associated illness rates among residents of Shai-Osudoku and Ningo Pram-Pram Districts (SONPD), Ghana. From May 2013 to April 2015, we conducted prospective surveillance for severe acute respiratory illness (SARI) and influenza-like illness (ILI) in 17 health facilities. In 2015, we conducted a retrospective assessment at an additional 18 health facilities to capture all SONPD SARI and ILI patients during the study period. We applied positivity rates to those not tested to estimate total influenza cases.
  
  
  
  Of 612 SARI patients tested, 58 (9%) were positive for influenza. The estimated incidence of influenza-associated SARI was 30 per 100,000 persons (95% CI: 13-84). Children aged 0 to 4 years had the highest influenza-associated SARI incidence (135 per 100,000 persons, 95% CI: 120-152) and adults aged 25 to 44 years had the lowest (3 per 100,000 persons, 95% CI: 1-7) (p < 0.01). Of 2,322 ILI patients tested, 407 (18%) were positive for influenza. The estimated incidence of influenza-associated ILI was 844 per 100,000 persons (95% CI: 501-1,099). The highest incidence of influenza-associated ILI was also among children aged 0 to 4 years (3,448 per 100,000 persons, 95% CI: 3,727 - 3,898). The predominant circulating subtype during May to December 2013 and January to April 2015 was influenza A(H3N2) virus, and during 2014 influenza B virus was the predominant circulating type.
  
  
  
  Influenza accounted for 9% and 18% of medically attended SARI and ILI, respectively. Rates were substantive among young children and suggest the potential value of exploring the benefits of influenza vaccination in Ghana, particularly in this age group.
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Michael Preko
authors.initials: MP
authors.lastname: Ntiri
authors.affiliation: Battelle Atlanta, Atlanta, Georgia, USA. JDuque@cdc.gov.|Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A32, Atlanta, GA, 30329, USA. JDuque@cdc.gov.
authors.forename: Jazmin
authors.initials: J
authors.lastname: Duque
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A32, Atlanta, GA, 30329, USA.|U.S. Public Health Service, Rockville, Maryland, USA.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: McMorrow
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Joseph Asamoah
authors.initials: JA
authors.lastname: Frimpong
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Prince
authors.initials: P
authors.lastname: Parbie
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Edem
authors.initials: E
authors.lastname: Badji
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A32, Atlanta, GA, 30329, USA.|CTS Global Inc, El Segundo, California, USA.
authors.forename: Ndahwouh Talla
authors.initials: NT
authors.lastname: Nzussouo
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Eve-Marie
authors.initials: EM
authors.lastname: Benson
authors.affiliation: Ghana Health Service, Accra, Ghana.
authors.forename: Michael
authors.initials: M
authors.lastname: Adjabeng
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A32, Atlanta, GA, 30329, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Dueger
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A32, Atlanta, GA, 30329, USA.
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS-A32, Atlanta, GA, 30329, USA.|U.S. Public Health Service, Rockville, Maryland, USA.
authors.forename: Fatimah S
authors.initials: FS
authors.lastname: Dawood
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Koram
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: William
authors.initials: W
authors.lastname: Ampofo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D007396:Internship and Residency; D008297:Male; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D014611:Vaccination / Q000639:trends; D014944:World Health Organization
chemical_list: D007252:Influenza Vaccines
keywords: Africa; Burden; Children; Ghana; Influenza; Rate; Respiratory; West Africa