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Background Burden estimates of medically and nonmedically attended influenza-associated illness across syndromes and levels of severity are lacking. Methods We estimated the national burden of medically and nonmedically attended influenza-associated illness among individuals with different clinical presentations (all-respiratory, all-circulatory, and nonrespiratory/noncirculatory) and levels of severity (mild, fatal, and severe, nonfatal) using a combination of case-based (from laboratory-confirmed influenza surveillance) and ecological studies, as well as data from healthcare utilization surveys in South Africa during 2013–2015. In addition, we compared estimates of medically attended influenza-associated respiratory illness, obtained from case-based and ecological studies. Rates were reported per 100 000 individuals in the population. Results The estimated mean annual number of influenza-associated illness episodes was 10 737 847 (19.8% of 54 096 705 inhabitants). Of these episodes, 10 598 138 (98.7%) were mild, 128 173 (1.2%) were severe, nonfatal, and 11 536 (0.1%) were fatal. There were 2 718 140 (25.6%) mild, 56 226 (43.9%) severe, nonfatal, and 4945 (42.8%) medically attended should be after fatal episodes. Influenza-associated respiratory illness accounted for 99.2% (10 576 146) of any mild, 65.5% (83 941) of any severe, nonfatal, and 33.7% (3893) of any fatal illnesses. Ecological and case-based estimates of medically attended, influenza-associated, respiratory mild (rates: ecological, 1778.8, vs case-based, 1703.3; difference, 4.4%), severe, nonfatal (rates: ecological, 88.6, vs case-based, 75.3; difference, 15.0%), and fatal (rates: ecological, 3.8, vs case-based, 3.5; difference, 8.4%) illnesses were similar. Conclusions There was a substantial burden of influenza-associated symptomatic illness, including severe, nonfatal and fatal illnesses, and a large proportion was nonmedically attended. Estimates, including only influenza-associated respiratory illness, substantially underestimated influenza-associated, severe, nonfatal and fatal illnesses. Ecological and case-based estimates were found to be similar for the compared categories. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of the prevention of mother-to-child transmission (PMTCT) of the HIV programme at Levai Mbatha Community Health Centre (CHC), Evaton, South Africa. Methods: A retrospective analysis of HIV-infected mother--infant pairs was conducted between 1 August 2009 and 31 July 2010. The infants' HIV status was determined using HIV-specific qualitative DNA polymerase chain reaction (PCR). Demographic characteristics, mode of mother to child transmission (MTCT), choice of infant feeding, mode of delivery and CD4 count were included. Results: Of the 206 mothers, 10 infants had positive DNA PCR results at 6 weeks. The MTCT rate was 4.9%. The mean age of HIVinfected mothers was 28 years (SD 5.7, range 16-42 years). Overall, 74.2% (152) of HIV-positive mothers received dual therapy and 28.8% (53) were on HAART alone. Mothers with CD4 count < 200cells/µl (OR = 0.09 [CI, 0.01-0.75]; p = 0.026) and lack of prophylaxis during labour (OR = 9.50 [CI, 1.59-56.66]; p = 0.013) were identified as significant risk factors associated with MTCT. Conclusions: The PMTCT programme at Levai Mbatha CHC is effective in reducing the MTCT of HIV. Lack of ART prophylaxis and low CD4 count were the significant determinants of MTCT in the study. [ABSTRACT FROM AUTHOR]