tetano
Editor, Senior Moderator
PLoS One. 2018 Apr 26;13(4):e0196495. doi: 10.1371/journal.pone.0196495. eCollection 2018.
[h=1]Estimation of community-level influenza-associated illness in a low resource rural setting in India.[/h] Saha S[SUP]1[/SUP], Gupta V[SUP]2[/SUP], Dawood FS[SUP]3[/SUP], Broor S[SUP]4[/SUP], Lafond KE[SUP]3[/SUP], Chadha MS[SUP]5[/SUP], Rai SK[SUP]2[/SUP], Krishnan A[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To estimate rates of community-level influenza-like-illness (ILI) and influenza-associated ILI in rural north India.
[h=4]METHODS:[/h] During 2011, we conducted household-based healthcare utilization surveys (HUS) for any acute medical illness (AMI) in preceding 14days among residents of 28villages of Ballabgarh, in north India. Concurrently, we conducted clinic-based surveillance (CBS) in the area for AMI episodes with illness onset ≤3days and collected nasal and throat swabs for influenza virus testing using real-time polymerase chain reaction. Retrospectively, we applied ILI case definition (measured/reported fever and cough) to HUS and CBS data. We attributed 14days of risk-time per person surveyed in HUS and estimated community ILI rate by dividing the number of ILI cases in HUS by total risk-time. We used CBS data on influenza positivity and applied it to HUS-based community ILI rates by age, month, and clinic type, to estimate the community influenza-associated ILI rates.
[h=4]FINDINGS:[/h] The HUS of 69,369 residents during the year generated risk-time of 3945 person-years (p-y) and identified 150 (5%, 95%CI: 4-6) ILI episodes (38 ILI episodes/1,000 p-y; 95% CI 32-44). Among 1,372 ILI cases enrolled from clinics, 126 (9%; 95% CI 8-11) had laboratory-confirmed influenza (A (H3N2) = 72; B = 54). After adjusting for age, month, and clinic type, overall influenza-associated ILI rate was 4.8/1,000 p-y; rates were highest among children <5 years (13; 95% CI: 4-29) and persons≥60 years (11; 95%CI: 2-30).
[h=4]CONCLUSION:[/h] We present a novel way to use HUS and CBS data to generate estimates of community burden of influenza. Although the confidence intervals overlapped considerably, higher point estimates for burden among young children and older adults shows the utility for exploring the value of influenza vaccination among target groups.
PMID: 29698505 DOI: 10.1371/journal.pone.0196495
[h=1]Estimation of community-level influenza-associated illness in a low resource rural setting in India.[/h] Saha S[SUP]1[/SUP], Gupta V[SUP]2[/SUP], Dawood FS[SUP]3[/SUP], Broor S[SUP]4[/SUP], Lafond KE[SUP]3[/SUP], Chadha MS[SUP]5[/SUP], Rai SK[SUP]2[/SUP], Krishnan A[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To estimate rates of community-level influenza-like-illness (ILI) and influenza-associated ILI in rural north India.
[h=4]METHODS:[/h] During 2011, we conducted household-based healthcare utilization surveys (HUS) for any acute medical illness (AMI) in preceding 14days among residents of 28villages of Ballabgarh, in north India. Concurrently, we conducted clinic-based surveillance (CBS) in the area for AMI episodes with illness onset ≤3days and collected nasal and throat swabs for influenza virus testing using real-time polymerase chain reaction. Retrospectively, we applied ILI case definition (measured/reported fever and cough) to HUS and CBS data. We attributed 14days of risk-time per person surveyed in HUS and estimated community ILI rate by dividing the number of ILI cases in HUS by total risk-time. We used CBS data on influenza positivity and applied it to HUS-based community ILI rates by age, month, and clinic type, to estimate the community influenza-associated ILI rates.
[h=4]FINDINGS:[/h] The HUS of 69,369 residents during the year generated risk-time of 3945 person-years (p-y) and identified 150 (5%, 95%CI: 4-6) ILI episodes (38 ILI episodes/1,000 p-y; 95% CI 32-44). Among 1,372 ILI cases enrolled from clinics, 126 (9%; 95% CI 8-11) had laboratory-confirmed influenza (A (H3N2) = 72; B = 54). After adjusting for age, month, and clinic type, overall influenza-associated ILI rate was 4.8/1,000 p-y; rates were highest among children <5 years (13; 95% CI: 4-29) and persons≥60 years (11; 95%CI: 2-30).
[h=4]CONCLUSION:[/h] We present a novel way to use HUS and CBS data to generate estimates of community burden of influenza. Although the confidence intervals overlapped considerably, higher point estimates for burden among young children and older adults shows the utility for exploring the value of influenza vaccination among target groups.
PMID: 29698505 DOI: 10.1371/journal.pone.0196495