Influenza in Latin America: A report from the Global Influenza Initiative (GII)

Gentile, Ángela; Paget, John; Bellei, Nancy; Torres, Juan Pablo; Vázquez, Cynthia; Laguna-Torres, V. Alberto; Plotkin, Stanley А.

doi:10.1016/j.vaccine.2019.03.081

Cited by 21 publications

(22 citation statements)

References 36 publications

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“…Most Latin American countries have a seasonal influenza vaccination policy in place and the vaccine is recommended and publicly financed for children aged under 6 years, people with chronic comorbidity, adults aged over 60 years, pregnant women within 20 weeks of gestation, or women in the postpartum period [6]. WHO recommends the attainment of 90% coverage for all universal vaccinations for 2020 [7].…”

Section: Introductionmentioning

confidence: 99%

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates

González-Block

Calderón

Pelcastre‐Villafuerte

et al. 2020

PLoS ONE

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Introduction Influenza morbidity and mortality are significant in the countries of South America, yet influenza vaccination is as low as 56.7% among pregnant women, reaching 76.7% of adults with chronic diseases. This article measures the relative values for the vaccination hesitancy indicators of confidence, complacency and convenience by risk-groups in urban areas of five countries of South America with contrasting vaccination rates, analyzing their association with sociodemographic variables and self-reported immunization status. Methods An exit survey was applied to 640 individuals per country in Brazil, Chile, Paraguay, Peru and Uruguay, distributed equally across risk groups of older adults, adults with risk factors, children ≤6 and pregnant women. Indicators were constructed for vaccine confidence, complacency and convenience. Analysis of variance and multiple logistic analysis was undertaken. Results Adults with risk factors are somewhat more confident of the influenza vaccine yet also more complacent. Convenience is higher for mothers of minors. Children and older adults report higher levels of vaccination. The 3Cs are more different across countries than across risk groups, with values for Chile higher for confidence and those for Uruguay the lowest. Complacency is lower in Brazil and higher in Uruguay. Results suggest that confidence and complacency affect vaccination rates across risk groups and countries. Conclusions Influenza vaccine confidence, complacency and convenience have to be bolstered to improve effective coverage across all risk groups in the urban areas of the countries studied. The role played by country contextual and national vaccination programs has to be further researched in relation to effective coverage of influenza vaccine.

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Section: Introductionmentioning

confidence: 99%

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates

González-Block

Calderón

Pelcastre‐Villafuerte

et al. 2020

PLoS ONE

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“…Each year, 10-20% of the global population experiences symptomatic influenza, including 3-5 million cases of severe illness and 290-650 thousand deaths [6]. For these reasons, influenza is regarded as the greatest threat to global health in the twenty-first century [7].…”

Section: Introductionmentioning

confidence: 99%

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

Liang

Han

et al. 2020

Respir Res

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Background: The pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) score have been shown to predict mortality in community-acquired pneumonia. Their ability to predict influenza-related pneumonia, however, is less well-established. Methods: A total of 693 laboratory-confirmed FluA-p patients diagnosed between Jan 2013 and Dec 2018 and recruited from five teaching hospitals in China were included in the study. The sample included 494 patients in the derivation cohort and 199 patients in the validation cohort. The prediction rule was established based on independent risk factors for 30-day mortality in FluA-p patients from the derivation cohort. Results: The 30-day mortality of FluA-p patients was 19.6% (136/693). The FluA-p score was based on a multivariate logistic regression model designed to predict mortality. Results indicated the following significant predictors (regression statistics and point contributions toward total score in parentheses): blood urea nitrogen > 7 mmol/L (OR 1.604, 95% CI 1.150-4.492, p = 0.040; 1 points), pO 2 /F i O 2 ≤ 250 mmHg (OR 2.649, 95% CI 1.103-5.142, p = 0.022; 2 points), cardiovascular disease (OR 3.967, 95% CI 1.269-7.322, p < 0.001; 3 points), arterial PH < 7.35 (OR 3.959, 95% CI 1.393-7.332, p < 0.001; 3 points), smoking history (OR 5.176, 95% CI 2.604-11.838, p = 0.001; 4 points), lymphocytes < 0.8 × 10 9 /L (OR 8.391, 95% CI 3.271-16.212, p < 0.001; 5 points), and early neurominidase inhibitor therapy (OR 0.567, 95% CI 0.202-0.833, p = 0.005; − 2 points). Seven points was used as the cut-off value for mortality risk stratification. The model showed a sensitivity of 0.941, a specificity of 0.762, and overall better predictive performance than the PSI risk class (AUROC = 0.908 vs 0.560, p < 0.001) and the CURB-65 score (AUROC = 0.908 vs 0.777, p < 0.001). Conclusions: Our results showed that a FluA-p score was easy to derive and that it served as a reliable prediction rule for 30-day mortality in FluA-p patients. The score could also effectively stratify FluA-p patients into relevant risk categories and thereby help treatment providers to make more rational clinical decisions.

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“…For these reasons, influenza is regarded by some experts as the greatest threat to global health in the 21st century [7].…”

Section: Introductionmentioning

confidence: 99%

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

Chen

Han

et al. 2020

Preprint

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Background The pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) score have been shown to predict mortality in community-acquired pneumonia. Their ability to predict influenza-related pneumonia, however, is less well-established. Methods A total of 693 laboratory-confirmed FluA-p patients diagnosed between Jan 2013 and Dec 2018 and recruited from five teaching hospitals in China were included in the study. The sample included 494 patients in the derivation cohort and 199 patients in the validation cohort. The prediction rule was established based on independent risk factors for 30-day mortality in FluA-p patients from the derivation cohort. Results The 30-day mortality of FluA-p patients was 19.6% (136/693). The FluA-p score was based on a multivariate logistic regression model designed to predict mortality. Results indicated the following significant predictors (regression statistics and point contributions toward total score in parentheses): blood urea nitrogen > 7 mmol/L ( OR 1.604, 95% CI 1.150-4.492, p = 0.040; 1 points), pO 2 /F i O 2 ≤ 250 mmHg ( OR 2.649, 95% CI 1.103-5.142, p = 0.022; 2 points), cardiovascular disease ( OR 3.967, 95% CI 1.269-7.322, p <0.001; 3 points), arterial PH < 7.35 ( OR 3.959, 95% CI 1.393-7.332, p < 0.001; 3 points), smoking history ( OR 5.176, 95% CI 2.604-11.838, p = 0.001; 4 points), lymphocytes < 0.8×10 9 /L ( OR 8.391, 95% CI 3.271-16.212, p <0.001; 5 points), and early neurominidase inhibitor therapy ( OR 0.567, 95% CI 0.202-0.833, p = 0.005; -2 points). Seven points was used as the cut-off value for mortality risk stratification. The model showed a sensitivity of 0.941, a specificity of 0.762, and overall better predictive performance than the PSI risk class (AUROC = 0.908 vs 0.560, p < 0.001) and the CURB-65 score (AUROC = 0.908 vs 0.777, p < 0.001). Conclusions Our results showed that a FluA-p score was easy to derive and that it served as a reliable prediction rule for 30-day mortality in FluA-p patients. The score could also effectively stratify FluA-p patients into relevant risk categories and thereby help treatment providers to make more rational clinical decisions.

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Influenza in Latin America: A report from the Global Influenza Initiative (GII)

Cited by 21 publications

References 36 publications

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates

Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

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