Estimates of influenza-associated hospitalisations in tropical Singapore, 2010-2017: Higher burden estimated in more recent years

Abstract

Background: We previously estimated Singapore's influenza-associated hospitalisation rate for pneumonia and influenza (P&I) in 2010-2012 to be 29.6 per 100 000 person-years, which corresponds to 11.2% of all P&I hospitalisations. Objectives: This study aims to update Singapore's estimates of the influenza-associated pneumonia and influenza (P&I) hospitalisation burden using the latest data from 2010 to 2017. Methods: We estimated the number of P&I hospitalisations associated with influenza using generalised additive models. We specified the weekly number of admissions for P&I and the weekly influenza positivity in the models, along with potential confounders such as weekly respiratory syncytial virus (RSV) positivity and meteorological data. Results: In 2010-2017, 16.3% of all P&I hospitalisations in Singapore were estimated to be attributed to influenza, corresponding to an excess influenza-associated P&I hospitalisation rate of 50.1 per 100 000 person-years. Higher excess rates were estimated for children aged 0-4 years (186.8 per 100 000 person-years) and elderly aged ≥ 65 years (338.0 per 100 000 person-years). Higher influenza-associated hospitalisation rates were estimated for 2016 and 2017 (67.9 and 75.1 per 100 000 persons, respectively) years when the influenza A(H3N2) subtype was dominant. Conclusion: Influenza burden in Singapore has increased since 2010. Influenza vaccination programmes should continue to be prioritised for the young and the elderly.