Influenza in the East African Region

Prior to 2006, little was known on influenza surveillance in the East African region. With the detection of avian influenza A (H5N1) in Africa, several countries in Africa started initiating influenza sentinel surveillance systems. We evaluated both published and unpublished literature to determine seasonal patterns and estimate burden of influenza in the East African region. Annually influenza has been observed to be associated with 9-25% of ILI outpatient visits and 5-10% of SARI hospitalizations in East Africa. Influenza circulates all year round peaking in the months of March to November. Most of the cases reported are children below five years of age. Despite the region having mostly a young population, and poor health seeking behavior, rates from this region are comparable to those seen in temperate countries. Seasonal vaccination using southern hemisphere vaccine in March may be more effective. Targeting selected populations of young children and pregnant women for influenza vaccination may be effective in controlling morbidity and mortality associated with influenza. Modification to the surveillance tools should be made to identify risk factors that may be present in the elderly population currently missed by the current surveillance system.