Influenza‐associated severe acute respiratory infections in 2 sentinel sites in Lebanon—September 2015 to August 2016

Abstract

BackgroundGiven the sparse information on the burden of influenza in Lebanon, the Ministry of Public Health established a sentinel surveillance for severe acute respiratory infections (SARI) to identify the attribution of influenza to reported cases. We aim to highlight the proportion of influenza‐associated SARI from September 1st, 2015 to August 31st, 2016 in 2 Lebanese hospitals.MethodsThe study was conducted in 2 sentinel sites located in Beirut suburbs and southern province of Lebanon. WHO's 2011 standardized SARI case definition was used. Data from September 1, 2015 to August 31, 2016 were reviewed, and all‐cause hospital admission numbers were obtained. Nasopharyngeal swabs were collected and tested by RT‐PCR. Descriptive and bivariate analyses were conducted using STATA 13.ResultsThe 2 sentinel sites reported 746 SARI cases during the studied time frame: 467 from the southern province site and 279 from the Beirut suburbs site. SARI reports peaked between January and March 2016. All, except 4, cases were sampled, and a co‐dominance of influenza B (43%) and influenza A (H1N1) (41%) was evident. A high proportion of cases was reported in children <2 years 274 (37%). The proportional contribution of influenza‐associated SARI to all‐cause hospital admissions was high in children <2 years in the south (4.5% [95% CI: 3.1‐6.5]) and in children <5 years in Beirut (0.7% [95% CI: 0.6‐0.8]).ConclusionThis is the first study to highlight the proportion of influenza‐associated SARI in 2 hospitals in Lebanon. The findings will be beneficial for supporting respiratory prevention and immunization program policies.

The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

“…Therefore, a population based prospective surveillance study is needed to better estimate the burden of Influenza-related hospitalizations. The average annual positivity rate (the number of positive tests divided by the total number of requested tests) for tested patients was 14% and this is similar to the positivity rate (13.4%) reported by the Lebanese SARI Sentinel Surveillance conducted by the Ministry of Public Health for the 2015/2016 season [37]. Moghoofei et al estimated an influenza infection prevalence of 10% in the Middle East that approaches our positivity rate in Lebanon [38].…”

Improved capacity for influenza surveillance in the WHO Eastern Mediterranean Region: Progress in a challenging setting

“…A total of 4172 seasonal influenza virus specimens were sent to the WHO Collaborating Centres by 15 NICs and influenza laboratories of the Region during the period from 2011 to 2018. The number of seasonal influenza virus samples sent to WHO CCs for vaccine strain selection increased from 142 specimens in 2011 (median 11, IQR [4][5][6][7][8][9][10][11][12][13][14][15][16] to 1473 specimens at the end of 2018 (median 89, IQR 82-174). During the same period, the number of shipments also increased from 11 shipments per year from 8 national influenza centers during 2011 to 33 shipments per year from 15 national influenza centers and influenza laboratories at the end of 2018.…”

“…In 2011, when the second phase of the enhanced influenza surveillance programme began, no country in the Region had published any information on influenza disease burden. However, by 2018 at least eight countries in the Region had published data on the influenza disease burden and seasonality in peer-reviewed medical journals [3][4][5][6][7][8][9][10][11] leading to improved knowledge of the epidemiology of seasonal influenza in the Region (Table 4). Although, data on influenza disease burden across countries are not consistent and comparable owing to different study methods and designs used by the countries-from descriptive studies to modelling.…”

Pandemic influenza preparedness (PIP) framework: Progress challenges in improving influenza preparedness response capacities in the Eastern Mediterranean Region, 2014–2017

“…By the end of 2017, nearly one-third of countries (seven out of 22) in the Region had estimated their disease burden including three L&S PIP priority countries. Five countries have already published their findings (Egypt, Iran (Islamic Republic of), Lebanon, Oman and Tunis) [16][17][18][19][20], while the manuscripts from Jordan and Morocco are under peer-review. National disease burden estimates can now be used by countries to inform pandemic influenza policy such as for risk-group identification and response measures required.…”