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Infez Med
. 2020 Sep 1;28(3):407-415.
Seroepidemiology of seasonal influenza virus among unvaccinated pregnant women in Lagos, Nigeria
Abdul Azeez Adeyemi Anjorin 1 , Juliet Ebere Nwammadu 1
Affiliations
- PMID: 32920577
Abstract
Nigeria is the most populous African nation in the world having a population of over 200 million with little or no data on maternal influenza and its co-morbidities. In most developing countries, there is paucity of data for prioritization of strategies for the prevention and control of influenza with possible co-morbidities common in pregnancy. We therefore investigated recent infection of seasonal influenza virus with co-infection of malaria parasitaemia and typhoid fever in pregnant women in Lagos State, Nigeria. A descriptive hospital-based cross-sectional study was designed according to the Consortium for the Standardization of Influenza Seroepidemiology (CONSISE) guideline in 6 public health institutions between July 2016 and October 2018. Enzyme Immunoassay (Demeditec, Germany) was used to detect IgM specific antibodies to influenza A (H1N1) and (H3N2). P-values were determined with Chi-square using GraphPad Prism, USA. Demographic characteristics of the patients showed median age of 29 (mean 29.3; mode, 28; and range, 18-45) years. Out of 182 pregnant women screened, 103 (56.6%) were IgM seropositive for influenza A. Patients with underlying diseases accounted for 72%, approximately three-times higher compared to 28% without underlying disease. Co-infection was detected with malaria parasitaemia (54%), typhoid fever (50.5%), and malaria and typhoid fever (33%). The most commonly reported symptoms were fever, cold, dizziness, swollen legs, and cough. Age group 21-30 years was the most affected while patients from densely populated area had the highest seroprevalence. This study revealed that seasonal influenza circulates with co-morbidities in pregnant women in Lagos. This may exacerbate their immunosuppressed state and lead to complication in pregnancy. Apt treatment of influenza-like illness should be considered in such women. Furthermore, there is need for enhanced surveillance including monitoring of the potential transmissibility of influenza to the foetus and newborns. We therefore recommend sturdy advocacy on preventing exposure to influenza virus, its optimal early diagnosis, vaccination and disease management in pregnancy.