Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017
Authors: Christopher E Troeger, Brigette F. Blacker, Ibrahim A. Khalil, Stephanie R M Zimsen, Samuel B. Albertson, Degu Abate, Jemal Abdela, Tara Ballav Adhikari, Sargis Aghasi Aghayan, Sutapa Agrawal, Alireza Ahmadi, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Kefyalew Addis Alene, Syed Mohamed Aljunid, Nelson Alvis-Guzman, Nahla Hamed Anber, Mina Anjomshoa, Carl Abelardo T. Antonio, Olatunde Aremu, Hagos Tasew Atalay, Suleman Atique, Engi F. Attia, Euripide F G A Avokpaho, Ashish Awasthi, Arefeh Babazadeh, Hamid Badali, Alaa Badawi, Joseph Adel Mattar Banoub, Aleksandra Barac, Quique Bassat, Neeraj Bedi, Abate Bekele Belachew, Derrick A. Bennett, Krittika Bhattacharyya, Zulfiqar A Bhutta, Ali Bijani, Félix Carvalho, Carlos A Castañeda-Orjuela, Devasahayam J Christopher, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Ahmad Daryani, Meaza Girma Degefa, Feleke Mekonnen Demeke, Meghnath Dhimal, Shirin Djalalinia, David Teye Doku, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Dumessa Edessa, Maysaa El Sayed Zaki, Hamed Fakhim, Eduarda Fernandes, Florian Fischer, Luisa Sorio Flor, Kyle J. Foreman, Teklu Gebrehiwo Gebremichael, Demeke Geremew, Keyghobad Ghadiri, Alessandra C Goulart, Jingwen Guo, Giang Hai Ha, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Samer Hamidi, Hamid Yimam Hassen, Chi Linh Hoang, Nobuyuki Horita, Mihaela Hostiuc, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Jost B. Jonas, Amaha Kahsay, André Karch, Amir Kasaeian, Tesfaye Dessale Kassa, Adane Teshome Kefale, Yousef Saleh Khader, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Young-Ho Khang, Abdullah T Khoja, Jagdish Khubchandani, Ruth W Kimokoti, Adnan Kisa, Luke D Knibbs, Sonali Kochhar, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Barthelemy Kuate Defo, G Anil Kumar, Dharmesh Kumar Lal, Prabhat Lamichhane, Cheru Tesema Leshargie, Miriam Levi, Shanshan Li, Erlyn Rachelle King Macarayan, Marek Majdan, Varshil Mehta, Addisu Melese, Ziad A Memish, Desalegn Tadese Mengistu, Tuomo J Meretoja, Tomislav Mestrovic, Bartosz Miazgowski, George J Milne, Branko Milosevic, Erkin M Mirrakhimov, Babak Moazen, Karzan Abdulmuhsin Mohammad, Shafiu Mohammed, Lorenzo Monasta, Lidia Morawska, Seyyed Meysam Mousavi, Oumer Sada S Muhammed, Srinivas Murthy, Ghulam Mustafa, Aliya Naheed, Huong Lan Thi Nguyen, Nam Ba Nguyen, Son Hoang Nguyen, Trang Huyen Nguyen, Muhammad Imran Nisar, Molly R Nixon, Felix Akpojene Ogbo, Andrew T Olagunju, Tinuke O Olagunju, Eyal Oren, Justin R Ortiz, Mahesh P A, Smita Pakhale, Shanti Patel, Deepak Paudel, David M Pigott, Maarten J Postma, Mostafa Qorbani, Anwar Rafay, Alireza Rafiei, Vafa Rahimi-Movaghar, Rajesh Kumar Rai, Mohammad Sadegh Rezai, Nicholas L S Roberts, Luca Ronfani, Salvatore Rubino, Saeed Safari, Saeid Safiri, Zikria Saleem, Evanson Zondani Sambala, Abdallah M. Samy, Milena M Santric Milicevic, Benn Sartorius, Shahabeddin Sarvi, Miloje Savic, Monika Sawhney, Sonia Saxena, Seyedmojtaba Seyedmousavi, Masood Ali Shaikh, Mehdi Sharif, Aziz Sheikh, Mika Shigematsu, David L Smith, Ranjani Somayaji, Joan B Soriano, Chandrashekhar T Sreeramareddy, Mu'awiyyah Babale Sufiyan, Mohamad-Hani Temsah, Belay Tessema, Mebrahtu Teweldemedhin, Miguel Tortajada-Girbés, Bach Xuan Tran, Khanh Bao Tran, Afewerki Gebremeskel Tsadik, Kingsley Nnanna Ukwaja, Irfan Ullah, Tommi Juhani Vasankari, Giang Thu Vu, Fiseha Wadilo Wada, Yasir Waheed, T. Eoin West, Charles Shey Wiysonge, Ebrahim M Yimer, Naohiro Yonemoto, Zoubida Zaidi, Theo Vos, Stephen S Lim, Christopher J L Murray, Ali H Mokdad, Simon I. Hay, Robert C Reiner
Journal: The Lancet Respiratory Medicine (2018)

BackgroundAlthough the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza.MethodsWe modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza.FindingsInfluenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000–200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16·4 deaths per 100 000 [95% UI 11·6–21·9]), and the highest rate among all ages was in eastern Europe (5·2 per 100 000 population [95% UI 3·5–7·2]). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000–22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000–259 851 000). We estimated that 11·5% (95% UI 10·0–12·9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000–73 864 000) episodes and 8 172 000 severe episodes (5 000 000–13 296 000).InterpretationThis comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed.FundingBill & Melinda Gates Foundation.