Temporal Association in Hospitalizations for Tuberculosis, Invasive Pneumococcal Disease and Influenza Virus Illness in South African Children

The seasonal variability in hospitalization for tuberculosis may in part relate to super-imposed bacterial or predisposing respiratory viral infections. We aimed to study the temporal association between hospitalization for culture-confirmed pulmonary tuberculosis (PTB), invasive pneumococcal diseas...

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Bibliographic Details
Published in:PloS one Vol. 9; no. 3; p. e91464
Main Authors: Dangor, Ziyaad, Izu, Alane, Moore, David P., Nunes, Marta C., Solomon, Fatima, Beylis, Natalie, von Gottberg, Anne, McAnerney, Johanna M., Madhi, Shabir A.
Format: Journal Article
Language:English
Published: United States Public Library of Science 11.03.2014
Public Library of Science (PLoS)
Subjects:
Adolescent
Bacteria
Child
Child, Preschool
Children
Climate
Coinfection
Epidemics
Female
HIV Infections - epidemiology
Hospitalization
Humans
Infant
Influenza
Influenza viruses
Influenza, Human - epidemiology
Male
Medical research
Medicine
Mycobacterium tuberculosis
Pandemics
Pneumococcal Infections - epidemiology
Retrospective Studies
Risk Factors
Seasonal variability
Seasonal variations
Seasons
South Africa - epidemiology
Spatio-Temporal Analysis
Streptococcus pneumoniae
Temperate climates
Tuberculosis
Tuberculosis - epidemiology
Vaccines
Variability
Viruses
South Africa
ISSN:1932-6203, 1932-6203
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Summary:The seasonal variability in hospitalization for tuberculosis may in part relate to super-imposed bacterial or predisposing respiratory viral infections. We aimed to study the temporal association between hospitalization for culture-confirmed pulmonary tuberculosis (PTB), invasive pneumococcal disease (IPD) and influenza virus epidemics in South African children. We undertook a retrospective analysis which examined seasonal trends, from 2005 to 2008, for hospitalization for culture-confirmed PTB and IPD among children in relation to the influenza epidemics in Soweto, South Africa. Original time-series of the influenza virus epidemics and hospitalization rates for PTB and IPD were decomposed into three components: a trend cycle component, a seasonal component and an irregular component using the X-11 seasonal adjustment method. To compare the seasonality amongst the three series, the trend and irregular components were removed and only seasonal components examined. Across the study period, the influenza virus epidemics peaked during May to July (winter) months, which was closely followed by an increase in the incidence of hospitalization for IPD (August to October) and PTB (August to November). Within- and between-year temporal changes associated with childhood TB hospitalization may in part be driven by factors which influence temporal changes in pneumococcal disease, including potential variability in the severity of influenza virus epidemics in temperate climates. The dynamics of the interplay between the host and these infectious agents appears to be complex and multifactorial.
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Conceived and designed the experiments: ZD AI SAM. Performed the experiments: ZD AI SAM. Analyzed the data: ZD AI SAM. Contributed reagents/materials/analysis tools: DPM MCN FS NB AvG JMM. Wrote the paper: ZD AI SAM.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0091464