Impact of H1N1 on socially disadvantaged populations: summary of a systematic review

Abstract

BackgroundPrevious reviews found that the H1N1 pandemic was associated with a large proportion of hospitalizations, severe illness, workplace absenteeism, and high costs. However, the burden among socially disadvantaged groups of the population is unclear. This is a summary of a previously published systematic review commissioned by the World Health Organization on the burden of H1N1 pandemic (influenza A/Mexico/2009 (H1N1)) among socially disadvantaged populations.Methods MEDLINE and EMBASE were searched to identify studies reporting hospitalization, severe illness, and mortality attributable to the 2009 H1N1 pandemic among socially disadvantaged populations, including ethnic minorities and low‐income or lower‐middle‐income economy countries (LIC/LMIC). SAS and Review Manager were used to conduct random effects meta‐analysis.ResultsForty‐eight cohort studies and 14 companion reports including 44 777 patients were included after screening 787 citations and 164 full‐text articles. Twelve of the included studies provided data on LIC/LMIC, including one study from Guatemala, two from Morocco, one from Pakistan, and eight from India, plus four companion reports. The rest provided data on ethnic minorities living in high‐income economy countries (HIC). Significantly more hospitalizations were observed among ethnic minorities versus nonethnic minorities in two North American studies [1313 patients, odds ratio (OR) 2·26 (95% confidence interval: 1·53–3·32)]. Among hospitalized patients in HIC, statistically significant differences in intensive care unit admissions (n = 8 studies, 15 352 patients, OR 0·84 [0·69–1·02]) and deaths (n = 6 studies, 14 757 patients, OR 0·85 [95% CI: 0·73–1·01]) were not observed.ConclusionWe found significantly more hospitalizations among ethnic minorities versus nonethnic minorities in North America, yet no differences in intensive care unit admissions or deaths among H1N1‐infected hospitalized patients were observed in North America and Australia. Our results suggest a similar burden of H1N1 between ethnic minorities and nonethnic minorities living in HIC.

Community awareness, use and preference for pandemic influenza vaccines in Pune, India

“…A large burden of 2009 H1N1 influenza was borne by lowincome countries. 14,15 India reported 39,977 cases and 2,113 deaths from H1N1 influenza between May 2009 and August 2010. 16 These numbers, which refer to laboratory-confirmed cases, are likely underestimated.…”

Pandemics, past and present: The role of biological anthropology in interdisciplinary pandemic studies

“…Pandemic H1N1‐related hospitalization was significantly higher among American Indians, Blacks and Hispanics than among non‐Hispanic Whites in New Mexico, US, and was higher among persons of younger age and lower household income (Thompson et al, 2011 ). Similarly, Tricco, Lillie, Soobiah, Perrier, & Straus ( 2013 ) found significantly more hospitalizations among ethnic minorities versus nonethnic minorities in North America, yet no differences in ICU admissions or deaths among hospitalized patients in North America and Australia. They argued that their results suggest a similar burden of H1N1 between ethnic minorities and nonethnic minorities living in high‐income countries (Tricco et al, 2013 ).…”

Black and Minority Ethnic (BAME) Alliance Against COVID-19: One Step Forward

“…Zhoe et al (2015) recommended the importance of quick screening for high-risk individuals for severe influenza, as they mentioned that highest risk group for mortality during the 2009/2010 influenza pandemic were those of Pakistani ethnicity followed by non-White ethnicity in comparison with White populations [11]. In addition, systematic review by Tricco et al showed that hospitalizations were significantly higher among ethnic minorities in comparison with nonethnic minorities during the influenza pandemic [12]. Therefore, it is plausible to suggest that if actions were taken at the time of influenza pandemic in 2009/2010, these actions in part may have decreased the highest mortality and mortality in BAME population during the COVID-19 pandemic in 2020.…”