tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Sep 21;21(1):986.
doi: 10.1186/s12879-021-06677-5.
Facility-based surveillance for influenza and respiratory syncytial virus in rural Zambia
Gideon Loevinsohn[SUP] 1 2 [/SUP], Mutinta Hamahuwa[SUP] 3 [/SUP], Pamela Sinywimaanzi[SUP] 3 [/SUP], Katherine Z J Fenstermacher[SUP] 4 [/SUP], Kathryn Shaw-Saliba[SUP] 4 [/SUP], Andrew Pekosz[SUP] 4 5 [/SUP], Mwaka Monze[SUP] 6 [/SUP], Richard E Rothman[SUP] 4 [/SUP], Edgar Simulundu[SUP] 3 [/SUP], Philip E Thuma[SUP] 3 5 [/SUP], Catherine G Sutcliffe[SUP] 7 [/SUP]
Affiliations
Abstract
Background: While southern Africa experiences among the highest mortality rates from respiratory infections, the burden of influenza and respiratory syncytial virus (RSV) in rural areas is poorly understood.
Methods: We implemented facility-based surveillance in Macha, Zambia. Outpatients and inpatients presenting with influenza-like illness (ILI) underwent testing for influenza A, influenza B, and RSV and were prospectively followed for 3 to 5 weeks to assess clinical course. Log-binomial models assessed correlates of infection and clinical severity.
Results: Between December 2018 and December 2019, 17% of all outpatients presented with ILI and 16% of inpatients were admitted with an acute respiratory complaint. Influenza viruses and RSV were detected in 17% and 11% of outpatient participants with ILI, and 23% and 16% of inpatient participants with ILI, respectively. Influenza (July-September) and RSV (January-April) prevalence peaks were temporally distinct. RSV (relative risk [RR]: 1.78; 95% confidence interval [CI] 1.51-2.11), but not influenza, infection was associated with severe disease among patients with ILI. Underweight patients with ILI were more likely to be infected with influenza A (prevalence ratio [PR]: 1.72; 95% CI 1.04-2.87) and to have severe influenza A infections (RR: 2.49; 95% CI 1.57-3.93).
Conclusions: Populations in rural Zambia bear a sizeable burden of viral respiratory infections and severe disease. The epidemiology of infections in this rural area differs from that reported from urban areas in Zambia.
Keywords: Influenza; RSV; Risk factors; Rural; Severity; Southern Africa.
. 2021 Sep 21;21(1):986.
doi: 10.1186/s12879-021-06677-5.
Facility-based surveillance for influenza and respiratory syncytial virus in rural Zambia
Gideon Loevinsohn[SUP] 1 2 [/SUP], Mutinta Hamahuwa[SUP] 3 [/SUP], Pamela Sinywimaanzi[SUP] 3 [/SUP], Katherine Z J Fenstermacher[SUP] 4 [/SUP], Kathryn Shaw-Saliba[SUP] 4 [/SUP], Andrew Pekosz[SUP] 4 5 [/SUP], Mwaka Monze[SUP] 6 [/SUP], Richard E Rothman[SUP] 4 [/SUP], Edgar Simulundu[SUP] 3 [/SUP], Philip E Thuma[SUP] 3 5 [/SUP], Catherine G Sutcliffe[SUP] 7 [/SUP]
Affiliations
- PMID: 34548020
- PMCID: PMC8453466
- DOI: 10.1186/s12879-021-06677-5
Abstract
Background: While southern Africa experiences among the highest mortality rates from respiratory infections, the burden of influenza and respiratory syncytial virus (RSV) in rural areas is poorly understood.
Methods: We implemented facility-based surveillance in Macha, Zambia. Outpatients and inpatients presenting with influenza-like illness (ILI) underwent testing for influenza A, influenza B, and RSV and were prospectively followed for 3 to 5 weeks to assess clinical course. Log-binomial models assessed correlates of infection and clinical severity.
Results: Between December 2018 and December 2019, 17% of all outpatients presented with ILI and 16% of inpatients were admitted with an acute respiratory complaint. Influenza viruses and RSV were detected in 17% and 11% of outpatient participants with ILI, and 23% and 16% of inpatient participants with ILI, respectively. Influenza (July-September) and RSV (January-April) prevalence peaks were temporally distinct. RSV (relative risk [RR]: 1.78; 95% confidence interval [CI] 1.51-2.11), but not influenza, infection was associated with severe disease among patients with ILI. Underweight patients with ILI were more likely to be infected with influenza A (prevalence ratio [PR]: 1.72; 95% CI 1.04-2.87) and to have severe influenza A infections (RR: 2.49; 95% CI 1.57-3.93).
Conclusions: Populations in rural Zambia bear a sizeable burden of viral respiratory infections and severe disease. The epidemiology of infections in this rural area differs from that reported from urban areas in Zambia.
Keywords: Influenza; RSV; Risk factors; Rural; Severity; Southern Africa.