{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T06:40:15Z","timestamp":1758868815595,"version":"3.44.0"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Influenza contributes substantially to severe acute respiratory infection (SARI) morbidity and mortality worldwide. However, few countries have estimated influenza disease burden, especially middle and low\u2010income countries. Burden data are important to understand the impacts of illness on the population and to inform interventions. Currently, Niger has no recommendations for seasonal influenza vaccination or antiviral use. We estimated the national number and rates of SARI and influenza\u2010associated SARI hospitalizations, mild\/moderate illness, and death among children aged &lt; 5\u2009years in Niger.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We utilized influenza surveillance data among children aged &lt; 5\u2009years hospitalized with SARI at three sentinel hospitals located in Niamey during 2015\u20132018 along with estimated catchment area population data to calculate the influenza\u2010associated SARI hospitalization rates per 100,000 population. Rates were calculated for age groups &lt; 1, 1\u20134, and &lt; 5\u2009years using the World Health Organization (WHO) methods and a hospital admission survey; then, we extrapolated the estimates nationally. We also used the influenza burden pyramid tool developed by WHO and the John Hopkins Center for Health Security to estimate influenza\u2010associated mild\/moderate illnesses and influenza\u2010associated deaths for Niger.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Influenza viruses were detected in 175\/1796 (9.7%) specimens collected and tested during the study period from children aged &lt; 5\u2009years at the three SARI sentinel surveillance sites. The influenza percentage positive was 7.7% (58\/754) among infants aged &lt; 1\u2009year and 11.3% (117\/1038) among children aged 1\u20134\u2009years. The estimated mean annual national number of SARI hospitalizations among children aged &lt; 5\u2009years was 16,406 (95% CI: 15,117\u201317,779) and the estimated SARI hospitalization rate per 100,000 population was 405.3 (95% CI: 373.5\u2013439.2). The estimated mean annual national number of influenza\u2010associated SARI hospitalizations among children aged &lt; 5\u2009years was 1484 (95% CI: 1162\u20131813; rate: 36.7; 95% CI: 28.7\u201344.8). The estimated mean annual national number of influenza\u2010associated mild illnesses, hospitalized patients, and deaths among children aged &lt; 5\u2009years in Niger was 218,030 (95% CI: 43,303\u2013527,236), 1261 (95% CI: 38\u20133271), 223 (95% CI: 22\u2013614), and 15 (95% CI: 6\u2013373) respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>\u2019This study estimated a substantial influenza disease burden among children aged &lt; 5\u2009years in Niger, highlighting, for decision makers, the importance of resource allocation and public health interventions like vaccination. Future efforts should consider estimating the potential cost\u2013benefit of implementing prevention and control measures (e.g., influenza vaccine or antivirals) among children aged 6\u201359\u2009months in Niger.<\/jats:p><\/jats:sec>","DOI":"10.1111\/irv.70160","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T14:20:46Z","timestamp":1758205246000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The National Burden of Influenza\u2010Associated Respiratory Illness Among Children Aged &lt;5\u2009Years in Niger, 2015\u20132018"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0101-9048","authenticated-orcid":false,"given":"Adamou","family":"Lagare","sequence":"first","affiliation":[{"name":"Centre de Recherche M\u00e9dicale et Sanitaire (CERMES)  Niamey Niger"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7062-9531","authenticated-orcid":false,"given":"William\u00a0W.","family":"Davis","sequence":"additional","affiliation":[{"name":"Influenza Division, Centre for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha\u00a0N.","family":"Patel","sequence":"additional","affiliation":[{"name":"Influenza Division, Centre for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goumbi","family":"Kadade","sequence":"additional","affiliation":[{"name":"Ministry of Public Health  Niamey Niger"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Testa","sequence":"additional","affiliation":[{"name":"Ministry of Public Health  Niamey Niger"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saidou","family":"Mamadou","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Abdou Moumouni  Niamey Niger"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Fitzner","sequence":"additional","affiliation":[{"name":"Global Influenza Programme, World Health Organization  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Tempia","sequence":"additional","affiliation":[{"name":"Influenza Division, Centre for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Global Influenza Programme, World Health Organization  Geneva Switzerland"},{"name":"The Partnership for International Vaccine Initiative, the Taskforce for Global Health  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8742-3687","authenticated-orcid":false,"given":"A.\u00a0Danielle","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Influenza Division, Centre for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_11_2_1","DOI":"10.1016\/S2214-109X(19)30545-5"},{"doi-asserted-by":"publisher","key":"e_1_2_11_3_1","DOI":"10.1016\/S0140-6736(12)61901-1"},{"doi-asserted-by":"publisher","key":"e_1_2_11_4_1","DOI":"10.1371\/journal.pone.0265933"},{"doi-asserted-by":"publisher","key":"e_1_2_11_5_1","DOI":"10.3201\/eid2307.161959"},{"doi-asserted-by":"publisher","key":"e_1_2_11_6_1","DOI":"10.1016\/S0140-6736(17)30129-0"},{"doi-asserted-by":"publisher","key":"e_1_2_11_7_1","DOI":"10.1016\/j.vaccine.2020.09.048"},{"doi-asserted-by":"publisher","key":"e_1_2_11_8_1","DOI":"10.1093\/ofid\/ofw262"},{"doi-asserted-by":"publisher","key":"e_1_2_11_9_1","DOI":"10.1016\/S0140-6736(17)33293-2"},{"doi-asserted-by":"publisher","key":"e_1_2_11_10_1","DOI":"10.7189\/jogh.09.020421"},{"doi-asserted-by":"publisher","key":"e_1_2_11_11_1","DOI":"10.1111\/irv.12529"},{"doi-asserted-by":"publisher","key":"e_1_2_11_12_1","DOI":"10.1136\/bmjopen-2018-022949"},{"doi-asserted-by":"publisher","key":"e_1_2_11_13_1","DOI":"10.1002\/hsr2.137"},{"unstructured":"WHO.A 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