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

Abstract

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.

Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia

“…The proportion of influenza A and B was higher than previous reports in Ethiopia 3% [40], and Egypt, but lower than previous reports in Egypt, Ethiopia, and Pakistan [42,43,47,48]. However, our current study result (13%) is similar to reports from Beijing(China), Indonesia, Malawi, Kenya, Central China, and Zambia 16.6%, 12.1%, 14.5%, 10%, 13%, and 16.3% [7,33,34,36,41,45] respectively. Influenza A (H3N2) was attributed to 25 (89.3%) cases, while A (H1N1) pdm2009 was lower than previous reports.…”

Characterization of influenza infection in a high-income urban setting in Nairobi, Kenya

“…In this study, 16.8% of the participants presenting with ILI were infected with the influenza virus. Observed prevalence was within the national estimate, that has been shown to range from 12% to 19% [9,12,20,30] and up to 27% among medically attended patients [10]. Influenza A/pandemic H1N1 was the most prevalent subtype during the study duration, with minimal detection of H3N2 during the entire period.…”

Estimation of seasonal influenza disease burden using sentinel site data in Pakistan 2017–2019: A cross‐sectional study

“…Severe acute respiratory infections (SARIs), including influenza, constitute a major cause of morbidity and mortality globally. 5 Influenza A(H1N1)pdm09 pandemic emphasized reliable influenza disease burden estimates from LMICs like Pakistan to better recognize the impact of this vaccine preventable disease. Although global data on SARI is present, reliable information on disease burden estimates due to Influenza are still not available for Pakistan.…”