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3. Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014

Author

François G. Schellevis, Raquel Guiomar, Zhibin Peng, Phuong Vu Mai Hoang, Brechla Moreno, Juan Yang, Cheryl Cohen, Lynnette Brammer, Jenny Lara, Hongjie Yu, Mai thi Quynh Le, Joshua A. Mott, Rodrigo Fasce, Gabriela Kusznierz, Simona Puzelli, Doménica de Mora, Leticia Castillo, Selim Badur, Akerke Ospanova, Vernon J. Lee, Liza Lopez, Richard Njouom, Douglas M. Fleming, Coulibaly Daouda, Nurhayati, Juan Manuel Rudi, Clotilde El-Guerche Séblain, Li Wei Ang, Joseph S. Bresee, Celina de Lozano, Sonam Gyeltshen, Maria Zambon, Maria Luisa Matute, Norosoa Harline Razanajatovo, Saverio Caini, Amal Barakat, Marie-Astrid Vernet, Alla Mironenko, Angel Balmaseda, Alexey Clara, Walquiria Aparecida Ferreira de Almeida, Richard Pebody, Herman Kosasih, Cláudio Maierovitch Pessanha Henriques, Marietjie Venter, Caterina Rizzo, Meral Akcay Ciblak, Olha Holubka, Gideon O. Emukule, Fatima el Falaki, Winston Andrade, Herve A. Kadjo, Alfredo Bruno, Kate Pennington, Lyazzat Kiyanbekova, Ana Paula Rodrigues, Rhonda Owen, John Paget, Peter Spreeuwenberg, Sue Q. Huang, Jean-Michel Heraud, Sonam Wangchuk, Luzhao Feng, Netherlands Institute for Health Services Research, Instituto Nacional de Enfermedades Respiratorias 'Dr. Emilio Coni', Department of Health and Ageing, Influenza Surveillance Section, Surveillance Branch, Office of Health Protection (DHAISS), Department of Health and Ageing, Influenza Surveillance Section, Surveillance Branch, Office of Health Protection, Woden, ACT, Australia, Office of Health Protection, Woden, ACT, Australia (DHAISS), Ministry of Health [Bhoutan], Ministry of Health [Brasília, Brazil], Centre Pasteur du Cameroun, Réseau International des Instituts Pasteur (RIIP), Instituto de Salud Pública de Chile (ISP), Chinese Centre for Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Ministry of Health [Costa Rica], Instituto Nacional de Investigación en Salud Pública [Guayaquil, Ecuador] (INSPI), Ministerio de Salud de El Salvador (MINSAL), Public Health England [London], Ministerio de Salud Publica y Asistencia Social [Guatemala] (MSPAS), US Centers for Disease Control, Ministry of Health [Honduras] (SESAL), US Naval Medical Research Unit n°2, Istituto Superiore di Sanita [Rome], Institut Pasteur de Côte d'Ivoire, Institut National d'Hygiène Publique [Côte d'Ivoire] (INHP), Astana Center of Sanitary Epidemiology Expertise, Centers for Disease Control and Prevention [Kenya], U.S. Public Health Service (USPHS), Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Ministry of Health [Morocco], Institute of Environmental Science and Research (ESR), Ministry of Health [Nicaragua] (MINSA), National Influenza Center, Instituto Nacional de Saùde Dr Ricardo Jorge [Portugal] (INSA), Ministry of Health [Singapore], Centers for Disease Control and Prevention, University of Pretoria [South Africa], University of the Witwatersrand [Johannesburg] (WITS), National Institute for Communicable Diseases [Johannesburg] (NICD), Istanbul University, National Academy of Medical Sciences of Ukraine, Centers for Disease Control and Prevention [Atlanta] (CDC), National Institute of Hygiene and Epidemiology [Hanoi, Vietnam] (NIHE), Chercheur indépendant, Sanofi Pasteur [Lyon, France], VU University Medical Center [Amsterdam], The Global Influenza B Study is funded by an unrestricted research grant from Sanofi Pasteur., The Global Influenza B Study group also includes the following members: Binay Thapa 4, Sangay Zangmo 4, Guy Vernet 6, Patricia Bustos 7, Patricio Loyola 7, Joanna Ellis 12, Antonino Bella 19, Maria Rita Castrucci 18, Gulzhan Muratbayeva 45, Julia Guillebaud 26, Laurence Randrianasolo 46, Ausenda Machado 47, Pedro Pechirra 32, Jeffery Cutter 34, Raymond Tzer Pin Lin 34. 45 Centers for Disease Control and Prevention, Central Asia Regional Office, Almaty, Kazakhstan 46 Epidemiology Unit, Institut Pasteur of Madagascar, Antananarivo, Madagascar 47 National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal, APH - Quality of Care, APH - Aging & Later Life, and General practice

Subjects
0301 basic medicine, Male, Databases, Factual, Distribution (economics), CHILDREN, Global Health, 0302 clinical medicine, Influenza A Virus, H1N1 Subtype, 1108 Medical Microbiology, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Influenza A Virus, H3N2 subtype, 030212 general & internal medicine, Young adult, Child, POPULATION, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Age Factors, Middle Aged, 3. Good health, Global Influenza B Study group, Infectious Diseases, INFECTIONS, Influenza A virus, Child, Preschool, H3N2 Subtype, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, BURDEN, Life Sciences & Biomedicine, Age distribution, 0605 Microbiology, Adult, medicine.medical_specialty, Surveillance data, Adolescent, Population, UNITED-STATES, Microbiology, Virus, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Young Adult, Age Distribution, Influenza, Human, medicine, Humans, H1N1 Subtype, COHORT, lcsh:RC109-216, education, Disease burden, METAANALYSIS, Aged, Science & Technology, business.industry, Public health, Influenza A Virus, H3N2 Subtype, Infant, Newborn, Infant, 1103 Clinical Sciences, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Estados de Saúde e de Doença, Influenza B Virus, Influenza, Influenza B virus, Meta-analysis, 030104 developmental biology, H1N1 subtype, Virus type, RISK-FACTORS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract

The database of the Global Influenza B Study was created by collecting surveillance datasets from each of the participating countries. These national datasets are owned by the participating countries, and thus cannot be shared publicly. Researchers interested in obtaining the country-specific datasets may contact the individuals listed below for further details regarding data access.Argentina (Santa Fe Province): Gabriela Kusznierz (labconi@yahoo.com.ar)Australia: Kate Pennington (kate.pennington@health.gov.au)Bhutan: Sonam Wangchuk (swangchuk@health.gov.bt)Brazil: Cláudio Maierovitch Pessanha Henriques (claudio.henriques@saude.gov.br)Cameroon: Guy Vernet (vernet@pasteur-yaounde.org)Chile: Rodrigo Fasce (rfasce@ispch.cl)China: Feng Luzhao (fenglz@chinacdc.cn)Costa Rica: Alexey W. Clara (wclara@cdc.gov)Ecuador: Alfredo Bruno (alfredobruno@yahoo.es)El Salvador: Alexey W. Clara (wclara@cdc.gov)England: Maria Zambon (maria.zambon@phe.gov.uk)Guatemala: Alexey W. Clara (wclara@cdc.gov)Honduras: Alexey W. Clara (wclara@cdc.gov)Indonesia: Herman Kosasih (hermaninarespond@gmail.com)Italy: Caterina Rizzo (caterina.rizzo@iss.it)Ivory Coast: Herve A. Kadjo (hervekadjo@pasteur.ci)Kazakhstan: Gulzhan Muratbayeva (hnv2@cdc.gov)Kenya: Joshua Mott (zud9@cdc.gov)Madagascar: Jean-Michel Heraud (jmheraud@pasteur.mg)Morocco: Amal Barakat (amal.barakat@yahoo.fr)New Zealand: Sue Huang (sue.huang@esr.cri.nz)Nicaragua: Alexey W. Clara (wclara@cdc.gov)Panama: Alexey W. Clara (wclara@cdc.gov)Portugal: Ana Paula Rodrigues (ana.rodrigues@insa.min-saude.pt)Singapore: Vernon Lee (vernonljm@hotmail.com)South Africa: Cheryl Cohen (cherylc@nicd.ac.za)Turkey: Meral Akcay Ciblak (ciblakm@yahoo.com)Ukraine: Alla Mironenko (miralla@ukr.net)Viet Nam: Le Thi Quinh Mai (lom9@hotmail.com); International audience; BACKGROUND:Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases).METHODS:For each virus, we calculated a Relative Illness Ratio (defined as the ratio of the percentage of cases in an age group to the percentage of the country population in the same age group) for young children (0-4 years), older children (5-17 years), young adults (18-39 years), older adults (40-64 years), and the elderly (65+ years). We used random-effects meta-analysis models to obtain summary relative illness ratios (sRIRs), and conducted meta-regression and sub-group analyses to explore causes of between-estimates heterogeneity.RESULTS:The influenza virus with highest sRIR was A(H1N1) for young children, B for older children, A(H1N1)pdm2009 for adults, and (A(H3N2) for the elderly. As expected, considering the diverse nature of the national surveillance datasets included in our analysis, between-estimates heterogeneity was high (I2>90%) for most sRIRs. The variations of countries' geographic, demographic and economic characteristics and the proportion of outpatients among reported influenza cases explained only part of the heterogeneity, suggesting that multiple factors were at play.CONCLUSIONS:These results highlight the importance of presenting burden of disease estimates by age group and virus (sub)type.

Published
2018

4. The epidemiological signature of influenza B virus and its B/Victoria and B/Yamagata lineages in the 21st century

Author

John Paget, Olga Bessonova, Joseph S. Bresee, Norosoa Harline Razanajatovo, Saverio Caini, Binay Thapa, Francisco José de Paula Júnior, Jenny Lara Araya, Florette K. Treurnicht, Walquiria Aparecida Ferreira de Almeida, Brechla Moreno Arévalo, Zhibin Peng, Raquel Guiomar, Gabriela Kusznierz, Q. Sue Huang, Herman Kosasih, Antonino Bella, Doménica de Mora, Rakhee Palekar, Olha Holubka, Maria R. Castrucci, Rudevelinda Rivera, Phuong Vu Mai Hoang, Gideon O. Emukule, Rodrigo Fasce, Rocio Higueros, Sandra S. Chaves, Fatima el Falaki, Mai T. Q. Le, Herve A. Kadjo, Patricia Bustos, Luzhao Feng, Ainash Makusheva, Vernon J. Lee, Richard Njouom, Ana Paula Rodrigues, Coulibaly Daouda, Gé Donker, Alfredo Bruno, Alla Mironenko, Cheryl Cohen, Jean-Michel Heraud, Li Wei Ang, Sonam Wangchuk, Mónica Jeannette Barahona de Gámez, Maria Zambon, Clotilde El Guerche-Séblain, Angel Balmaseda, Lynnette Brammer, Amal Barakat, Richard Pebody, Adam Meijer, Verònica Vera Garate, Tim Wood, Netherlands Institute for Health Services Research [Utrecht] (NIVEL), Instituto Nacional de Enfermedades Respiratorias Dr. Emilio Coni [Santa Fe, Argentina] (INER), Ministry of Health [Bhoutan], Ministry of Health [Brasília, Brazil], Centre Pasteur du Cameroun, Réseau International des Instituts Pasteur (RIIP), Instituto de Salud Pública de Chile (ISP), Chinese Center for Disease Control and Prevention, Ministry of Health [Costa Rica], Instituto Nacional de Investigación en Salud Pública [Guayaquil, Ecuador] (INSPI), Ministerio de Salud de El Salvador (MINSAL), Public Health England [London], Ministerio de Salud Publica y Asistencia Social [Guatemala] (MSPAS), Ministry of Health [Honduras] (SESAL), US Naval Medical Research Unit No.2 [Jakarta, Indonesia] (NAMRU-2), Naval Medical Research Center [Silver Spring, USA] (NMRC), Istituto Superiore di Sanita [Rome], Institut Pasteur de Côte d'Ivoire, Institut National de Santé Publique d'Abidjan-INSP, Ministry of Healthcare [Kazakhstan], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, Centers for Disease Control and Prevention [Kenya], Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Institut National d'Hygiène [Maroc], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Institute of Environmental Science and Research (ESR), Ministry of Health [Nicaragua] (MINSA), Pan American Health Organization [Washington] (PAHO), Instituto Conmemorativo Gorgas de Estudios de la Salud [Panamá], Instituto Nacional de Saùde Dr Ricardo Jorge [Portugal] (INSA), Ministry of Health [Singapore], National Institute for Communicable Diseases [Johannesburg] (NICD), University of the Witwatersrand [Johannesburg] (WITS), National Academy of Sciences of Ukraine (NASU), National Institute of Hygiene and Epidemiology [Hanoi, Vietnam] (NIHE), Sanofi Pasteur [Lyon, France], The study is supported by a research grant from Sanofi Pasteur: the ‘Global Epidemiology of Influenza B’ research project. The funder provided support in the form of salaries for two authors (CEGS and JP) but did not have any additional role in the data collection, analysis, decision to publish, or preparation of the manuscript., The 'Global Influenza B Study team' (group authorship) includes the following scientists: Juan Manuel Rudi (jmrudi@anlis.gov.ar), National Institute of Respiratory Diseases 'Emilio Coni', Santa Fe, Argentina, Dorji Wangchuk (dorjiwangchuk@health.gov.bt) and Sangay Zangmo (szangmo@health.gov.bt), Royal Centre for Disease Control, Department of Public Health, Ministry of Health, Thimphu, Bhutan, Daiana Araujo da Silva (daiana.silva@saude.gov.br), Ministry of Health, Department of Surveillance of Transmissible Diseases, Brasília/DF, Brazil, Winston Andrade (wandrade@ispch.cl), Sub-Department of Viral Diseases, Instituto de Salud Pública de Chile, Santiago, Chile, Jiandong Zheng (zhengjd@chinacdc.cn) and Ying Qin (qinying@chinacdc.cn), Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, P.R. China, Joanna Ellis (joanna.ellis@phe.gov.uk), Public Health England, London, United Kingdom, Simona Puzelli (simona.puzelli@iss.it), National Influenza Center, Department of Infectious Diseases, National Institute of Health, Rome, Italy, Caterina Rizzo (rizzocaterina@gmail.com), Bambino Gesù Children's Hospital, Rome, Italy, Linus Ndegwa (ikf7@cdc.gov), Influenza Program, Centers for Disease Control and Prevention, Nairobi, Kenya, Marit MA de Lange (marit.de.lange@rivm.nl) and Anne C. Teirlinck (anne.teirlinck@rivm.nl), National Institute for Public Health and the Environment, Centre for Infectious Diseases, Epidemiology and Surveillance, Bilthoven, The Netherlands, Jeffery Cutter (jeffery_cutter@moh.gov.sg) and Raymond Tzer Pin Lin (raymond_lin@moh.gov.sg), Public Health Group, Ministry of Health, Singapore, Singapore, Than T. Le (lmot82@yahoo.com), National Institute of Hygiene and Epidemiology, Hanoi, Vietnam, and Peter Kinuthia 42 (polorien@gmail.com), IHRC Inc., Atlanta, USA.

Subjects
RNA viruses, Male, Infecções Respiratórias, 0301 basic medicine, Viral Diseases, medicine.disease_cause, MESH: Influenza Vaccines, Seasonal influenza, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Epidemiology, Medicine and Health Sciences, Influenza A virus, 030212 general & internal medicine, MESH: Influenza B virus, Pathology and laboratory medicine, Northern Hemisphere, Vaccines, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Multidisciplinary, Geography, MESH: Influenza, Human, virus diseases, Medical microbiology, 3. Good health, Infectious Diseases, Influenza Vaccines, Population Surveillance, Viruses, Epidemiological Monitoring, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Medicine, Southern Hemisphere, Female, Age distribution, Seasons, Pathogens, MESH: History, 21st Century, Research Article, medicine.medical_specialty, Infectious Disease Control, Science, MESH: Influenza A virus, Biology, Microbiology, History, 21st Century, Virus, MESH: Population Surveillance, MESH: Influenza A Virus, H1N1 Subtype, 03 medical and health sciences, Age Distribution, Population Metrics, Influenza, Human, medicine, Influenza viruses, Humans, Epidemics, MESH: Epidemics, Disease burden, MESH: Humans, Biology and life sciences, Population Biology, Organisms, Viral pathogens, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Estados de Saúde e de Doença, Virology, Influenza, MESH: Male, Microbial pathogens, Earth sciences, Influenza B virus, Vaccine mismatch, 030104 developmental biology, Virus type, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Epidemiological Monitoring, Geographic areas, MESH: Seasons, MESH: Female, Orthomyxoviruses
Abstract

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31513690/ We describe the epidemiological characteristics, pattern of circulation, and geographical distribution of influenza B viruses and its lineages using data from the Global Influenza B Study. We included over 1.8 million influenza cases occurred in thirty-one countries during 2000-2018. We calculated the proportion of cases caused by influenza B and its lineages; determined the timing of influenza A and B epidemics; compared the age distribution of B/Victoria and B/Yamagata cases; and evaluated the frequency of lineage-level mismatch for the trivalent vaccine. The median proportion of influenza cases caused by influenza B virus was 23.4%, with a tendency (borderline statistical significance, p = 0.060) to be higher in tropical vs. temperate countries. Influenza B was the dominant virus type in about one every seven seasons. In temperate countries, influenza B epidemics occurred on average three weeks later than influenza A epidemics; no consistent pattern emerged in the tropics. The two B lineages caused a comparable proportion of influenza B cases globally, however the B/Yamagata was more frequent in temperate countries, and the B/Victoria in the tropics (p = 0.048). B/Yamagata patients were significantly older than B/Victoria patients in almost all countries. A lineage-level vaccine mismatch was observed in over 40% of seasons in temperate countries and in 30% of seasons in the tropics. The type B virus caused a substantial proportion of influenza infections globally in the 21st century, and its two virus lineages differed in terms of age and geographical distribution of patients. These findings will help inform health policy decisions aiming to reduce disease burden associated with seasonal influenza. info:eu-repo/semantics/publishedVersion

Published
2019

5. Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?

Author

Marietjie Venter, Juan Yang, Simona Puzelli, Antonino Bella, Joshua A. Mott, Rodrigo Fasce, Coulibaly Daouda, Jenny Lara, Hongjie Yu, Winston Andrade, Selim Badur, Cláudio Maierovitch Pessanha Henriques, François G. Schellevis, Jean-Michel Heraud, Akerke Ospanova, Sonam Wangchuk, Brechla Moreno, Herve A. Kadjo, Raymond T. P. Lin, Juan Manuel Rudi, Walquiria Aparecida Ferreira de Almeida, Gabriela Kusznierz, Joseph S. Bresee, Cheryl Cohen, Mai thi Quynh Le, Rhonda Owen, Maria Zambon, Maria Luisa Matute, Kunzang Dorji, Kate Pennington, Global Influenza B Study, Herman Kosasih, Nurhayati, Alla Mironenko, Ming Li, Angel Balmaseda, Alexey Clara, Alfredo Bruno, Richard Njouom, Phuong Vu Mai Hoang, Ana Paula Rodrigues, Celina de Lozano, Luzhao Feng, Olha Holubka, Amal Barakat, Lyazzat Kiyanbekova, Norosoa Harline Razanajatovo, Saverio Caini, Meral Akcay Ciblak, Raquel Guiomar, Richard Pebody, Leticia Castillo, Gideon O. Emukule, Liza Lopez, Doménica de Mora, Jeffery Cutter, Q. Sue Huang, Marie-Astrid Vernet, Abderrahman Bimohuen, John Paget, Lynnette Brammer, General practice, EMGO - Quality of care, Netherlands Institute for Health Services Research, Instituto de Salud Pública de Chile (ISP), Istanbul University, Ministry of Health [Nicaragua] (MINSA), Ministry of Health [Morocco], Istituto Superiore di Sanita [Rome], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, Instituto Nacional de Investigación en Salud Pública [Guayaquil, Ecuador] (INSPI), Ministerio de Salud Publica y Asistencia Social [Guatemala] (MSPAS), US Centers for Disease Control, University of the Witwatersrand [Johannesburg] (WITS), Ministry of Health, Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Ministerio de Salud de El Salvador (MINSAL), Ministry of Health [Bhoutan], US Centers for Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Instituto nacional de saude, Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), National Academy of Medical Sciences of Ukraine, Institute of Environmental Science and Research (ESR), Astana Center of Sanitary Epidemiology Expertise, US Naval Medical Research Unit n°2, Instituto Nacional de Enfermedades Respiratorias 'Dr. Emilio Coni', Ministry of Health [Costa Rica], National Institute of Hygiene and Epidemiology [Hanoi, Vietnam] (NIHE), Ministry of Health [Honduras] (SESAL), National Influenza Center, Centre Pasteur du Cameroun, Office of Health Protection, Woden, ACT, Australia (DHAISS), Public Health England [London], National Institute of Health, University of Pretoria [South Africa], The Global Influenza B Study is supported by an unrestricted research grant from Sanofi Pasteur. The study sponsor had no role in the design of the study, in the collection, analysis, and interpretation of data, in the writing of the report, and and in the decision to submit the paper for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The study sponsor had no access to the data in the study.

Subjects
Infecções Respiratórias, Influenza Viruses, Epidemiology, Gripe, Pathology and Laboratory Medicine, Geographical locations, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, DRIVERS, Estados de Saúde, Public and Occupational Health, SUB-SAHARAN AFRICA, lcsh:Science, MESH: Influenza B virus, Northern Hemisphere, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Geography, MESH: Influenza, Human, Vaccination, virus diseases, 3. Good health, Global Influenza B Study, MESH: Tropical Climate, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Science & Technology - Other Topics, Immunology, Disease Surveillance, SEASONAL INFLUENZA, Microbiology, Influenza Vaccin, 03 medical and health sciences, Influenza Vaccination, SURVEILLANCE, Humans, Microbial Pathogens, Retrospective Studies, MESH: Humans, Science & Technology, lcsh:R, Organisms, Correction, Influenza a, MESH: Retrospective Studies, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, Virology, Influenza, MADAGASCAR, lcsh:Q, Preventive Medicine, People and places, Demography, RNA viruses, Viral Diseases, lcsh:Medicine, medicine.disease_cause, Tropical climate, Medicine and Health Sciences, Influenza A virus, 030212 general & internal medicine, Multidisciplinary, Medical microbiology, Vaccination and Immunization, Multidisciplinary Sciences, Infectious Diseases, Viruses, Human mortality from H5N1, Southern Hemisphere, Seasons, Pathogens, Brazil, Research Article, Infectious Disease Control, General Science & Technology, 030231 tropical medicine, MESH: Influenza A virus, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], MD Multidisciplinary, Influenza, Human, Temperate climate, medicine, Tropical Climate, Biology and life sciences, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Viral pathogens, Tropics, MESH: Vaccination, South America, Seasonality, Earth sciences, Influenza B virus, Infectious Disease Surveillance, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Geographic areas, MESH: Seasons, Orthomyxoviruses
Abstract

Erratum in - Correction: Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination? PLoS One. 2016 May 2;11(5):e0155089. doi: 10.1371/journal.pone.0155089. Introduction: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes. Methods: This was a retrospective analysis of surveillance data between 2000 and 2014 from the Global Influenza B Study database. The seasonal peak of influenza was defined as the week with the most reported cases (overall, A, and B) in the season. The duration of seasonal activity was assessed using the maximum proportion of influenza cases during three consecutive months and the minimum number of months with 80% of cases in the season. We also assessed whether co-circulation of A and B virus types affected the duration of influenza epidemics. Results: 212 influenza seasons and 571,907 cases were included from 30 countries. In tropical countries, the seasonal influenza activity lasted longer and the peaks of influenza A and B coincided less frequently than in temperate countries. Temporal characteristics of influenza epidemics were heterogeneous in the tropics, with distinct seasonal epidemics observed only in some countries. Seasons with co-circulation of influenza A and B were longer than influenza A seasons, especially in the tropics. Discussion: Our findings show that influenza seasonality is less well defined in the tropics than in temperate regions. This has important implications for vaccination programmes in these countries. High-quality influenza surveillance systems are needed in the tropics to enable decisions about when to vaccinate. The Global Influenza B Study is supported by an unrestricted research grant from Sanofi Pasteur. info:eu-repo/semantics/publishedVersion

Published
2016

6. Inequality in the Incidence of Cervical Cancer: Costa Rica 1980-2010.

Author

Santamaría-Ulloa C and Valverde-Manzanares C

Abstract

Introduction: Cervical cancer is the third most incident and the fourth most lethal cancer among Costa Rican women. The purpose of this study was to quantify incidence inequality along three decades and to explore its determinants. Materials and Methods: This is a population-based study. Main data sources were the National Tumor Registry (1980-2010), CRELES (Costa Rican Longevity and Healthy Aging Study) longitudinal survey (2013), and published indices of economic condition (2007) and access to healthcare (2000). Cartography was made with QGIS software. Inequality was quantified using the Theil-T index. With the purpose of detecting differences by tumor's behavior, inequality was estimated for " in situ " and invasive incidence. In Situ /Invasive Ratios were estimated as an additional marker of inequality. Poisson and spatial regression analyses were conducted with Stata and ArcMap software, respectively, to assess the association between incidence and social determinants such as economic condition, access to healthcare and sub-utilization of Papanicolaou screening. Results: As measured by Theil-T index, incidence inequality has reached high (83 to 87%) levels during the last three decades. For invasive cervical cancer, inequality has been rising especially in women aged 50-59; increasing from 58% in the 1980's to 66% in 2000's. Poisson regression models showed that sub-utilization of Papanicolaou smear was associated with a significant decrease in the probability of early diagnosis. Costa Rican guidelines establish a Pap smear every 2 years; having a Pap smear every 3 years or longer was associated with a 36% decrease in the probability of early " in situ " diagnosis (IRR = 0.64, p = 0.003) in the last decade. Spatial regression models allowed for the detection of specific areas where incidence of invasive cervical cancer was higher than expected. Conclusion: Results from this study provide evidence of inequality in the incidence of cervical cancer, which has been high over three decades, and may be explained by sub-utilization of Papanicolaou smear screening in certain regions. The reasons why women do not adequately use screening must be addressed in future research. Interventions should be developed to stimulate the utilization of screening especially among women aged 50 to 59 where inequality has been rising.

Published
2019
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7. The Costa Rican experience: reduction of neural tube defects following food fortification programs.

Author

Chen LT and Rivera MA

Subjects
Costa Rica epidemiology, Humans, Prevalence, Folic Acid administration & dosage, Food, Fortified, Neural Tube Defects epidemiology, Neural Tube Defects prevention & control
Abstract

Fortification of wheat flour in 1997 and corn flour in 1999 with folic acid among other micronutrients was implemented in Costa Rica by means of two decrees, resulting in an effective public health impact. A prevalence of 25% of folic acid serum levels deficiency detected in fertile women in 1996 decreased 87% in urban areas two years later, whereas in rural areas diminished by 63%. In addition, a significant reduction of neural tube defects at the national level has been reported, dropping from a rate of 9.7 per 1000 lb during the period 1996-1998 to 6.3 per 1000 lb in the period 1999-2000. Finally, there has been a reported 74% reduction in the number of Neural Tube Defects at Birth (NTB) at the National Children's Hospital, resulting in 105 cases treated in 1995 to 26 cases in 2001.

Published
2004
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8. Post-disaster malaria in Costa Rica.

Author

Sáenz R, Bissell RA, and Paniagua F

Subjects
Costa Rica epidemiology, Female, Humans, Incidence, Male, Population Surveillance, Retrospective Studies, Risk Factors, Seasons, Disasters, Disease Outbreaks, Malaria epidemiology
Abstract

Introduction: In recent years, controversy has surrounded the issue of whether infectious disease should be considered a serious potential consequence of natural disasters. This article contributes to this debate with evidence of a significant outbreak of malaria in Costa Rica's Atlantic region after the 1991 earthquake and subsequent floods., Methods: This study is an epidemiologic investigation of the incidence of malaria for the periods of 22 months before the April 1991 Limón earthquake and for 13 months afterward. Data were obtained from the Costa Rican Ministry of Health's malaria control program., Results: Some of the cantons in the region experienced increases in the incidence of malaria as high as 1,600% and 4,700% above the average monthly rate for the preearthquake period (p < or = 0.01). Causal mechanisms are postulated as relating to changes in human behavior (increased exposure to mosquitoes while sleeping outside, and a temporary pause in malaria control activities), changes in the habitat that were beneficial to mosquito breeding (landslide deforestation, river damming, and rerouting), and the floods of August 1991., Conclusions: It is recommended that there be enhanced awareness of the potential consequences of disaster-wrought environmental changes. Date of Event: 22 April 1991; Type: Earthquake, 7.4 Richter scale;, Location: Costa Rica; Number of deaths and casualties: 54 deaths and 505 moderate to severe injuries.

Published
1995
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