tetano
Editor, Senior Moderator
BMC Infect Dis
. 2024 Nov 5;24(1):1246.
doi: 10.1186/s12879-024-10140-6. Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic
Ruth Khadembu Lucinde[SUP] 1 [/SUP], Henry Gathuri[SUP] 2 [/SUP], Lynda Isaaka[SUP] 2 [/SUP], Morris Ogero[SUP] 2 [/SUP], Livingstone Mumelo[SUP] 2 [/SUP], Dennis Kimego[SUP] 2 [/SUP], George Mbevi[SUP] 2 [/SUP], Conrad Wanyama[SUP] 2 [/SUP], Edwin Onyango Otieno[SUP] 2 [/SUP], Stella Mwakio[SUP] 2 [/SUP], Metrine Saisi[SUP] 2 [/SUP], Elizabeth Isinde[SUP] 2 [/SUP], Irene Njeri Oginga[SUP] 3 [/SUP], Alvin Wachira[SUP] 4 [/SUP], Evans Manuthu[SUP] 5 [/SUP], Hazel Kariuki[SUP] 6 [/SUP], Jared Nyikuli[SUP] 7 [/SUP], Cyprian Wekesa[SUP] 7 [/SUP], Amos Otedo[SUP] 8 [/SUP], Hannah Bosire[SUP] 8 [/SUP], Steve Biko Okoth[SUP] 9 [/SUP], Winston Ongalo[SUP] 9 [/SUP], David Mukabi[SUP] 10 [/SUP], Wilber Lusamba[SUP] 10 [/SUP], Beatrice Muthui[SUP] 11 [/SUP], Isaac Adembesa[SUP] 12 [/SUP], Caroline Mithi[SUP] 12 [/SUP], Mohammed Sood[SUP] 13 [/SUP], Nadia Ahmed[SUP] 14 [/SUP], Bernard Gituma[SUP] 15 [/SUP], Matiko Giabe[SUP] 16 [/SUP], Charles Omondi[SUP] 17 [/SUP], Rashid Aman[SUP] 18 [/SUP], Patrick Amoth[SUP] 18 [/SUP], Kadondi Kasera[SUP] 18 [/SUP], Fred Were[SUP] 19 [/SUP], Wangari Nganga[SUP] 20 [/SUP], James A Berkley[SUP] 2 21 [/SUP], Benjamin Tsofa[SUP] 2 [/SUP], Jospeh Mwangangi[SUP] 2 [/SUP], Philip Bejon[SUP] 2 [/SUP], Edwine Barasa[SUP] 2 [/SUP], Mike English[SUP] 2 21 [/SUP], John Athony Gerard Scott[SUP] 2 22 [/SUP], Samuel Akech[SUP] 2 [/SUP], Eunice Wangeci Kagucia[SUP] 2 [/SUP], Ambrose Agweyu[SUP] 2 21 [/SUP], Anthony Oliwa Etyang[SUP] 2 [/SUP]
Affiliations
Background: There are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic.
Methods: We conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) and progression to inpatient mortality among patients admitted with SARI, using a test-negative case control design.
Results: Of the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10-1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24-1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27-0.77).
Conclusion: We have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.
Keywords: COVID-19; Hospital surveillance; Severe acute respiratory illness; Vaccine effectiveness.
. 2024 Nov 5;24(1):1246.
doi: 10.1186/s12879-024-10140-6. Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic
Ruth Khadembu Lucinde[SUP] 1 [/SUP], Henry Gathuri[SUP] 2 [/SUP], Lynda Isaaka[SUP] 2 [/SUP], Morris Ogero[SUP] 2 [/SUP], Livingstone Mumelo[SUP] 2 [/SUP], Dennis Kimego[SUP] 2 [/SUP], George Mbevi[SUP] 2 [/SUP], Conrad Wanyama[SUP] 2 [/SUP], Edwin Onyango Otieno[SUP] 2 [/SUP], Stella Mwakio[SUP] 2 [/SUP], Metrine Saisi[SUP] 2 [/SUP], Elizabeth Isinde[SUP] 2 [/SUP], Irene Njeri Oginga[SUP] 3 [/SUP], Alvin Wachira[SUP] 4 [/SUP], Evans Manuthu[SUP] 5 [/SUP], Hazel Kariuki[SUP] 6 [/SUP], Jared Nyikuli[SUP] 7 [/SUP], Cyprian Wekesa[SUP] 7 [/SUP], Amos Otedo[SUP] 8 [/SUP], Hannah Bosire[SUP] 8 [/SUP], Steve Biko Okoth[SUP] 9 [/SUP], Winston Ongalo[SUP] 9 [/SUP], David Mukabi[SUP] 10 [/SUP], Wilber Lusamba[SUP] 10 [/SUP], Beatrice Muthui[SUP] 11 [/SUP], Isaac Adembesa[SUP] 12 [/SUP], Caroline Mithi[SUP] 12 [/SUP], Mohammed Sood[SUP] 13 [/SUP], Nadia Ahmed[SUP] 14 [/SUP], Bernard Gituma[SUP] 15 [/SUP], Matiko Giabe[SUP] 16 [/SUP], Charles Omondi[SUP] 17 [/SUP], Rashid Aman[SUP] 18 [/SUP], Patrick Amoth[SUP] 18 [/SUP], Kadondi Kasera[SUP] 18 [/SUP], Fred Were[SUP] 19 [/SUP], Wangari Nganga[SUP] 20 [/SUP], James A Berkley[SUP] 2 21 [/SUP], Benjamin Tsofa[SUP] 2 [/SUP], Jospeh Mwangangi[SUP] 2 [/SUP], Philip Bejon[SUP] 2 [/SUP], Edwine Barasa[SUP] 2 [/SUP], Mike English[SUP] 2 21 [/SUP], John Athony Gerard Scott[SUP] 2 22 [/SUP], Samuel Akech[SUP] 2 [/SUP], Eunice Wangeci Kagucia[SUP] 2 [/SUP], Ambrose Agweyu[SUP] 2 21 [/SUP], Anthony Oliwa Etyang[SUP] 2 [/SUP]
Affiliations
- PMID: 39501217
- DOI: 10.1186/s12879-024-10140-6
Background: There are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic.
Methods: We conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) and progression to inpatient mortality among patients admitted with SARI, using a test-negative case control design.
Results: Of the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10-1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24-1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27-0.77).
Conclusion: We have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.
Keywords: COVID-19; Hospital surveillance; Severe acute respiratory illness; Vaccine effectiveness.