{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:47:04Z","timestamp":1772160424397,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Influenza burden (IB) estimates are crucial for monitoring disease trends, allocating limited resources, and promoting influenza vaccination. However, IB in Egypt is poorly understood. This study estimates the mean\u2010seasonal IB in Egypt, across levels of severity by age and regions using sentinel surveillance data between 2016 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Influenza surveillance was implemented among patients hospitalized with severe acute respiratory infection (SARI) at eight sentinel hospitals across Egypt. We estimated the influenza\u2010associated SARI hospitalization in two governorates and then extrapolated nationally using the World Health Organization (WHO)\u2013recommended methods. Thereafter, we estimated IB\u2010associated mild\/moderate illness and deaths using IB pyramid tool developed by WHO and the John Hopkins Center for Health Security. Rates were reported per 100,000 population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The estimated mean seasonal number of influenza\u2010associated mild\/moderate illness, hospitalized noncritically and critically ill patients, and deaths was 16,425,938 (95% CI: 1,150,888\u201340,409,614), 30,335 (95% CI: 9971\u2013670,288), 9110 (95% CI: 580\u201316,321), and 2660 (95% CI: 154\u20139908), respectively. The highest rate of influenza\u2010associated mild\/moderate illness was among aged 5\u201314\u2009year (22,932; 95% CI: 825\u201325,546.3), whereas the highest rates of severe influenza were among aged &gt;\u200965\u2009years (hospitalizations: 159.4, 95% CI: 121.7\u2013205.0; deaths: 56.0, 95% CI: 0.6\u2013111.0). Children aged &lt;\u20095\u2009years also experience high rates of influenza\u2010associated hospitalization (52.0, 95% CI: 43.0\u201362.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The WHO method estimated a high burden of severe influenza among aged \u2265\u200965 and aged &lt;\u20095\u2009years in Egypt. To reduce severe IB, increased influenza vaccine uptake together with enhanced immunization strategies implementations among the elderly and children are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70061","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:40:41Z","timestamp":1735173641000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The National Burden of Influenza\u2010Associated Respiratory Illness Across Levels of Severity in Egypt, 2016\u20132019"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-4818","authenticated-orcid":false,"given":"Manal","family":"Fahim","sequence":"first","affiliation":[{"name":"Preventive Sector Ministry of Health and Population  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5022-5484","authenticated-orcid":false,"given":"Ola","family":"Deghedy","sequence":"additional","affiliation":[{"name":"Preventive Sector Ministry of Health and Population  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5059-1473","authenticated-orcid":false,"given":"Walaa","family":"Alim","sequence":"additional","affiliation":[{"name":"Preventive Sector Ministry of Health and Population  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6973-2662","authenticated-orcid":false,"given":"Reham","family":"Kamel","sequence":"additional","affiliation":[{"name":"Preventive Sector Ministry of Health and Population  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossam","family":"Hassan","sequence":"additional","affiliation":[{"name":"Egypt Country Office World Health Organization  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amira","family":"Mohsen","sequence":"additional","affiliation":[{"name":"Egypt Country Office World Health Organization  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-6181","authenticated-orcid":false,"given":"Rania","family":"Attia","sequence":"additional","affiliation":[{"name":"Eastern Mediterranean Regional Office World Health Organization  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hala","family":"Abou\u00a0El\u00a0Naja","sequence":"additional","affiliation":[{"name":"Eastern Mediterranean Regional Office World Health Organization  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salma","family":"Afifi","sequence":"additional","affiliation":[{"name":"Ministry of Health and Population  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4395-347X","authenticated-orcid":false,"given":"Stefano","family":"Tempia","sequence":"additional","affiliation":[{"name":"Global Influenza Program World Health Organization  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr","family":"Kandeel","sequence":"additional","affiliation":[{"name":"Ministry of Health and Population  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2407.171270"},{"key":"e_1_2_13_3_1","unstructured":"World Health Organization \u201cInfluenza (Seasonal) Fact Sheet \u201d (2023) https:\/\/www.who.int\/en\/news\u2010room\/fact\u2010sheets\/detail\/influenza\u2010(seasonal)."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001977"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.26719\/2016.22.7.428"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-018-0136-1"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12867"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.26719\/2016.22.7.499"},{"key":"e_1_2_13_9_1","volume-title":"Egypt Demographic and Health Survey 2014","author":"Ministry of Health and Population (Egypt), El\u2010Zanaty and Associates (Egypt), and ICF International","year":"2015"},{"key":"e_1_2_13_10_1","unstructured":"World Health Organization \u201cA Manual for Estimating Disease Burden Associated With Seasonal Influenza \u201d (2015) http:\/\/apps.who.int\/iris\/bitstream\/10665\/178801\/1\/9789241549301_eng.pdf?ua=1&ua=1."},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056882"},{"key":"e_1_2_13_12_1","unstructured":"\u201cSeasonal Influenza Disease Burden Estimator \u201dhttps:\/\/www.flutool.org."},{"key":"e_1_2_13_13_1","unstructured":"World Health Organization \u201cGlobal Influenza Program. 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