Objectives: Our objective was to estimate the incidence of influenza-associated hospitalizations and in-hospital deaths in Central American Region.

Design and setting: We used hospital discharge records, influenza surveillance virology data, and population projections collected from Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua to estimate influenza-associated hospitalizations and in-hospital deaths. We performed a meta-analysis of influenza-associated hospitalizations and in-hospital deaths.

Main outcome measures: The highest annual incidence was observed among children aged <5 years (136 influenza-associated hospitalizations per 100 000 persons).

Results: Annually, 7 625-11 289 influenza-associated hospitalizations and 352-594 deaths occurred in the subregion.

Conclusions: Our results suggest that a substantive number of persons are annually hospitalized because of influenza. Health officials should estimate how many illnesses could be averted through increased influenza vaccination.