Tempia, SMoyes, JCohen, A.LWalaza, SEdoka, IMcMorrow, M.LTreurnicht, F.KHellferscee, OWolter, Nvon Gottberg, ANguweneza, AMcAnerney, J.MDawood, HVariava, ECohen, E2024-06-292024-06-292019-09Tempia S, Moyes J, Cohen AL, Walaza S, Edoka I, McMorrow ML, Treurnicht FK, Hellferscee O, Wolter N, von Gottberg A, Nguweneza A, McAnerney JM, Dawood H, Variava E, Cohen C. Health and economic burden of influenza-associated illness in South Africa, 2013-2015. Influenza Other Respir Viruses. 2019 Sep;13(5):484-495. doi: 10.1111/irv.12650.https://doi.org/10.1111/irv.12650https://pubmed.ncbi.nlm.nih.gov/31187609/https://doi.org/10.1111/irv.12650https://hdl.handle.net/11288/596676Background: Economic burden estimates are essential to guide policy-making for influenza vaccination, especially in resource-limited settings. Methods: We estimated the cost, absenteeism, and years of life lost (YLL) of medically and non-medically attended influenza-associated mild and severe respiratory, circulatory and non-respiratory/non-circulatory illness in South Africa during 2013-2015 using a modified version of the World Health Organization (WHO) worksheet based tool for estimating the economic burden of seasonal influenza. Additionally, we restricted the analysis to influenza-associated severe acute respiratory illness (SARI) and influenza-like illness (ILI; subsets of all-respiratory illnesses) as suggested in the WHO manual. Results: The estimated mean annual cost of influenza-associated illness was $270.5 million, of which $111.3 million (41%) were government-incurred costs, 40.7 million (15%) were out-of-pocket expenses, and $118.4 million (44%) were indirect costs. The cost of influenza-associated medically attended mild illness ($107.9 million) was 2.3 times higher than that of severe illness ($47.1 million). Influenza-associated respiratory illness costs ($251.4 million) accounted for 93% of the total cost. Estimated absenteeism and YLL were 13.2 million days and 304 867 years, respectively. Among patients with influenza-associated WHO-defined ILI or SARI, the costs ($95.3 million), absenteeism (4.5 million days), and YLL (65 697) were 35%, 34%, and 21% of the total economic and health burden of influenza. Conclusion: The economic burden of influenza-associated illness was substantial from both a government and a societal perspective. Models that limit estimates to those obtained from patients with WHO-defined ILI or SARI substantially underestimated the total economic and health burden of influenza-associated illness.enSouth AfricaEconomic burdenInfluenzayears of life lostArticleInfluenza and Other Respiratory Viruses