Influenza-Associated Morbidity and Mortality in Sub-Saharan Africa

Diop, Doudou; Montomoli, Emanuele; Sanicas, Melvin; Diongue, Mayassine

doi:10.15406/ijvv.2016.02.00041

Cited by 6 publications

(7 citation statements)

References 45 publications

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“…In countries with high HIV prevalence in Africa, persons living with HIV 24 and those with chronic lung conditions such as tuberculosis are at risk of influenza-associated severe disease. 25,26 The highest influenza percentage positivity in our surveillance data was reported in school aged children 5-17 years, who are known to shed influenza virus for longer periods and to increase community transmission. 27 School-based influenza vaccination programs recommended in the United States and United Kingdom have significant benefits because this reduces transmission to vulnerable older age groups not easy to reach as part of the healthcare system.…”

Section: Discussionmentioning

confidence: 81%

“…In countries with high HIV prevalence in Africa, persons living with HIV 24 and those with chronic lung conditions such as tuberculosis are at risk of influenza‐associated severe disease. 25 , 26 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, children with reported underlying illness, especially those living with HIV, had greater odds of in‐hospital death compared with HIV negative children. In countries with high HIV prevalence in Africa, persons living with HIV 24 and those with chronic lung conditions such as tuberculosis are at risk of influenza‐associated severe disease 25,26 …”

Section: Discussionmentioning

confidence: 99%

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Severe acute respiratory illness surveillance for influenza in Kenya: Patient characteristics and lessons learnt

Gachari

Ndegwa

Emukule

et al. 2022

Influenza Resp Viruses

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Background We describe the epidemiology and clinical features of Kenyan patients hospitalized with laboratory‐confirmed influenza compared with those testing negative and discuss the potential contribution of severe acute respiratory illness (SARI) surveillance in monitoring a broader range of respiratory pathogens. Methods We described demographic and clinical characteristics of SARI cases among children (<18 years) and adults, separately. We compared disease severity (clinical features and treatment) of hospitalized influenza positive versus negative cases and explored independent predictors of death among SARI cases using a multivariable logistic regression model. Results From January 2014 to December 2018, 11,166 persons were hospitalized with SARI and overall positivity for influenza was ~10%. There were 10,742 (96%) children (<18 years)—median age of 1 year, interquartile range (IQR = 6 months, 2 years). Only 424 (4%) of the SARI cases were adults (≥18 years), with median age of 38 years (IQR 28 years, 52 years). There was no difference in disease severity comparing influenza positive and negative cases among children. Children hospitalized with SARI who had an underlying illness had greater odds of in‐hospital death compared with those without (adjusted odds ratio 2.11 95% CI 1.09–4.07). No further analysis was done among adults due to the small sample size. Conclusion Kenya's sentinel surveillance for SARI mainly captures data on younger children. Hospital‐based platforms designed to monitor influenza viruses and associated disease burden may be adapted and expanded to other respiratory viruses to inform public health interventions. Efforts should be made to capture adults as part of routine respiratory surveillance.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Severe acute respiratory illness surveillance for influenza in Kenya: Patient characteristics and lessons learnt

Gachari

Ndegwa

Emukule

et al. 2022

Influenza Resp Viruses

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“…A systematic review (1980 to 2009) on assessing influenza disease burden, influenza epidemiology and issues related to public health policy in sub-Saharan Africa, found that about 16% of children had ARI and was attributable to influenza [8]. Also, populations in sub-Saharan Africa are more vulnerable to influenza related complications because of the high prevalence of underlying health problems and limited access to healthcare [9].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Influenza Disease in Shai-Osudoku and Ningo-Prampram Districts in the Greater Accra Region of Ghana

Adjabeng

Frimpong

Couston-Appiah

et al. 2023

IJTDH

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Aims: This study sought to determine the risk factors of Influenza by investigating the characteristics of patients with Acute Respiratory Infections (ARIs). Study Design: An unmatched case-control study. Place and Duration of Study: This was conducted among residents of Shai-Osudoku (SO) and Ningo-Prampram (NP) Districts from April to November 2016. Methods: Prospective cases of ARIs from a facility-based sentinel surveillance on respiratory illnesses were screened for Influenza-Like-Illnesses (ILIs). Respiratory samples were obtained from those meeting the case definition for ILI and investigated. A total of 147 samples were influenza virus-positive and selected as case-patients. Another 294 patients were selected as control-patients from the pool of influenza negative tests. These two groups were used to assess the risk factors of influenza. Crude and adjusted odds ratios were calculated. A purposive selection logistic regression was used for the adjusted modelling. Results: The study identified Influenza A(H3N2) and Influenza B as the predominant circulating influenza viruses. Study participants had poor knowledge on the causes and prevention of acute respiratory illness. After the multivariate analysis, ILI patients presenting with Chills had 4 times odds (aOR:4.57; 95%CI: 1.51 – 13.76) of having influenza as compared with the controls. In addition, ILI patients with recent travel history in past 2 weeks had 3 times odds (aOR:3.05; 95%CI: 1.07 – 8.73) of being infected with the influenza virus compared with controls with no history of travel. Conclusion: The study provided clues for increasing the index of suspicion of clinicians in identifying patients with respiratory signs who could be at risk of influenza infection. Communication of the significant risk factors identified in the study to all health workers should be prioritized as an action. This important knowledge about factors associated with influenza among ILIs will inform early detection and appropriate health interventions to reduce the burden influenza disease.

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“…Before the onset of the COVID-19 pandemic, influenza was the most common cause of severe life threatening and vaccine preventable viral lower respiratory disease among adults worldwide [9][10][11][12]. In addition, numerous other viral pathogens are recognized as important causes of lower respiratory tract infections (LRTI).…”

Section: Introductionmentioning

confidence: 99%

A prospective observational study of community acquired pneumonia in Kenya: the role of viral pathogens

et al. 2021

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Background Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infected patients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence. Methods We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. The patients were followed for etiology and clinical outcomes. Viral PCR testing was performed using the FTD respiratory pathogen-21 multiplex kit on nasopharyngeal or lower respiratory samples. Additional microbiologic workup was performed as determined by the treating physicians. Results A potential etiologic agent(s) was identified in 57% including 43% viral, 5% combined viral and bacterial, 5% bacterial and 4% Pneumocystis. The most common etiologic agent was Influenza A which was associated with severe clinical disease. The most common underlying conditions were cardiovascular disease, diabetes and lung disease, while HIV infection was identified in only 13% of patients. Critical care admission was required for 24, and 31% had acute kidney injury, sometimes in combination with acute respiratory distress or sepsis. Conclusion Viruses, especially influenza, were commonly found in patients with CAP. In contrast to other studies from sub-Saharan Africa, the underlying conditions were similar to those reported in high resource areas and point to the growing concern of the double burden of infectious and noncommunicable diseases.

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Influenza-Associated Morbidity and Mortality in Sub-Saharan Africa

Cited by 6 publications

References 45 publications

Severe acute respiratory illness surveillance for influenza in Kenya: Patient characteristics and lessons learnt

Severe acute respiratory illness surveillance for influenza in Kenya: Patient characteristics and lessons learnt

Risk Factors for Influenza Disease in Shai-Osudoku and Ningo-Prampram Districts in the Greater Accra Region of Ghana

A prospective observational study of community acquired pneumonia in Kenya: the role of viral pathogens

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